Why Every Cardiac Patient Needs a Virtual Heart 62
the_newsbeagle writes: In the latest high-tech approach to personalized medicine, cardiologists can now create a computer model of an individual patient's heart and use that simulation to make a treatment plan. In this new field of computational medicine, doctors use a patient's MRI scans to make a model showing that patient's unique anatomy and pattern of heart disease. They can then experiment on that virtual organ in ways they simply can't with a flesh-and-blood heart. Proponents say this tech can "improve therapies, minimize the invasiveness of diagnostic procedures, and reduce health-care costs" in cardiology.
Every patient? (Score:1)
Or just those who can afford to pay for this?
Oh, that's right, in America, the poor are expected to just hurry up and die instead of getting good treatment.
And you clowns think this is the natural order of things.
Assholes. It's your rich libertarians who need to be allowed to die.
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The other thing I noticed was I RTFA.
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He's right, and it's called Medicaid, though you have to be extremely poor to get on it, many working poor are 'too wealthy' to be eligible.
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Doctor wasn't told that he might have been exposed to Ebola.
The nurse was told when she gathered the patient history.
Are you saying that process incompetence is fine, so long as it's bad for the patient, but medical malpractice is not ok, even when they get the same result?
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Nope. I'm saying one mistake is not representative of healthcare in the US.
I'm saying that mistakes are representative of healthcare in the US, and that's just one of many examples.
And if I went to a hospital feeling sick a few days after being with someone who had Ebola I'd sure as heck make sure the doctor I talked to knew it.
He did. Would you repeat your medical history to everyone that you see? Or would you tell it once to the person that asks, and assume that everyone who sees you saw your chart? If you repeated your medical history to everyone in the hospital, they'd put you in the psych ward, rather than the Ebola ward.
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By and large, better treatment options cost less, not more, than the status quo.
Every once in a while, changes are things like "get an MRI scan as part of your lab work", which adds more than it takes(but saves lives). But things like this that prevent readmission is as good for the patient financially as it is medically.
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By and large, better treatment options cost less, not more, than the status quo.
It is not clear that this treatment option is "better". So far there is no evidence that 3D heart models result in better health outcomes. Even if they do, it is not clear that this is the best way to spend healthcare dollars. Doctors love shiny new technology, patients like to feel they are getting the "best" care, and neither has much incentive to care about the cost.
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OK - I'll bite. Dollars seem to be pretty negligible here. Equipment to capture the images? Already there. Hardware to generate the model? Sunk cost - re-up every 3 years to keep it fresh. Software development? More or less done, not that it is a prohibitive cost in the first place. Administration of the hardware? They still pay sysadmins somewhere? Training on how to use it? Surely not much more than the cost of a hospital aspirin per trainee.
What's the huge financial burden here?
Re:Every patient? (Score:4, Informative)
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Um. Ask me anything?
1. How much does the system cost for one installation?
2. What is the incremental cost of using it for one additional patient?
3. How much training is required to use the system, and to interpret the results?
Re:Every patient? (Score:4, Informative)
2. It depends on what you factor in. There are a lot of costs to cover engineering and so on. The patient needs an MRI if they weren't already going to have one. That's the biggest cost depending on the hosptial (~US$2k). It's not currently being sold and pricing will have to be determined.
3. We operate the backend, all the doctors have to do is upload the MRI. Minimal training is required to interpret the results. We're working on presenting the data to EPs in forms they are already familiar with.
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Off topic question, "what is the hardware configuration that's being used for the testing and imaging?" That would be cool to know.
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I got my Ph.D. in this industry as well(patient-specific cardiovascular modeling). I'm posting AC, but I'm not HawkeyeMI. There is definitely some work in this field that is probably not going to improve outcomes. Maybe the uncertainties of CT/MRI images produce simulated "outcomes" that don't match reality. Or maybe you get a good image, and do a simulation for a patient that needs a bypass graft. You find that the 'best' angle for the bypass graft in patient A is to be stitched on at 17 degrees from
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Take a breath, have your coffee, and post trying posting again in a way people might actually engage you in actual conversation. While I may get where you're trying to go with your points, your delivery is severely lacking.
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Seems much more likely that you are an American who found a canadian site (probably off a conservative blog rant) and are lying to make it seem like the care in the US is anything but poor. I've been to doctors on 5 continents. The US medical system is the wor
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Great. I haven't seen them, and they are not recommended by the article you posted that referenced them, and in fact what you posted indicated the times were wrong and misleading.
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http://en.wikipedia.org/wiki/Lutheran_Health_Network
http://www.lutheranhealth.net/... [lutheranhealth.net]
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Cost less? Doubtful. (Score:3)
The cost of alternative treatments is set based on the cost of the original treatment. Just because it is cheaper to produce doesn't mean that the cost to the end recipient is going to reflect that. If there is a $200,000 surgery to correct your defect, and for $180,000 we can cure you without surgery, that $18,000 sounds like a bargain. There is no effective competition, so whether that cure costs $100 or $10,000, the $180k price will stick. Of course, if surgery isn't necessary, we could do the procedure to more borderline cases - ones that might never need surgery. If we catch just 15% extra people that would have opted out of surgery, we have spent more money.
I'm not convinced that a cardiac surgeon is going to cost less if he spends 8 hours experimenting on a heart and 4 hours in surgery vs 2 hours reviewing current imaging data and 6 hours in surgery.
As someone who works with computational models, knowing the exact answer is not always going to lead to a more effective or useful result in the field. Knowing you need a 1.77245 mm incision has little value over knowing that a 1.8mm incision will work with a scalpel operator which is only accurate to 0.2mm. There will always be shoulder cases where it may make a difference, but are you willing to pay 3X the cost for every procedure to cover the 10% in which it might make a difference? (That's a trick question, by the way, because you aren't paying, your insurance company is - and I can almost guarantee what their answer will be)
Re:Cost less? Doubtful. (Score:4, Informative)
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As someone who works with computational models, knowing the exact answer is not always going to lead to a more effective or useful result in the field. Knowing you need a 1.77245 mm incision has little value over knowing that a 1.8mm incision will work with a scalpel operator which is only accurate to 0.2mm.
You are presuming the only use is surgical accuracy. You are wrong. It could be choosing between an shunt and a stent. Or determining if a leak or defect is bad enough that it requires surgery, or if alternative treatments would be effective, forgoing surgery completely.
It's not about optimizing the surgery, but determining whether it's even needed, or what to do if it's done.
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> I'm not convinced that a cardiac surgeon is going to cost less if he spends 8 hours experimenting on a heart and 4 hours in surgery vs 2 hours reviewing current imaging data and 6 hours in surgery.
As someone who has had 3 open heart surgeries from age 2 to 40 with some less severe procedures along the way. My first memory is being wheeled into an operating room and my last surgery was a few years ago. This is obviously not for everyone (as the article suggests), but it's important for many people as he
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Everyday you exercise beats the alternative. After reading the article, my first question was, "Is there an App for that?" It can't come fast enough.
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Thanks. Is the code available somewhere so others can play with it?
It looks like this was the software used, which appears impressive:
http://research.cardiosolv.com/services/
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if this had been posted on October 31st... (Score:2)
the headline would have been, "Researchers improve their simulations significantly when perfecting their vision on random patients' live, beating hearts."
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OK, here goes (Score:2)
<3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3 <3
(virtual hearts for cardiac patients)
Misses point: most heart disease nutritional (Score:3)
https://www.drfuhrman.com/libr... [drfuhrman.com]
"Interventional cardiology and cardiovascular surgery is basically a scam based on a misunderstanding of the nature of heart disease. Searching for and treating obstructive plaque does not address the areas of the coronary vascular tree most likely to rupture and cause heart attacks. If there was never another CABG or angioplasty performed or stent placed, patients with heart disease would be better off. Doctors would be forced to educate our citizens that their heart disease risk is determined by what they place on their forks. Millions of lives would be dramatically extended. To abandon the theory of stretching and cutting out areas with plaque would shut down interventional cardiology, nearly all cardiovascular surgery, and many suppliers of the biotechnology. In many cases, interventional cardiology is the major income generator to hospitals. The ending of this ill-conceived, out-dated and ineffective technology would dramatically downsize hospitals in the United States and free up over $100 billion annually in medical care costs. Besides being ineffective, interventional cardiology places the responsibility in the hands of the doctor and not the patients. When patients finally realize they must take control of their heart problems with aggressive dietary modifications (and when needed medications for temporary periods) we will essentially solve the health crisis in America.
The sad thing is surgical interventions and medications are the foundation of modern cardiology and both are relatively ineffective compared to nutritional excellence. My patients routinely reverse their heart disease, and no longer have vulnerable plaque or high blood pressure, so they do not need medical care, hospitals or cardiologists anymore. The problem is that in the real world cardiac patients are not even informed that heart disease is predictably reversed with nutritional excellence. They are not given the opportunity to choose and just corralled into these surgical interventions.
Trying to figure out how to pay for ineffective and expensive medicine by politicians will never be a real solution. People need to know they do not have to have heart disease to begin with, and if they get it, aggressive nutrition is the most life-saving intervention. And it is free."
Models of the Heart (Score:2)
I used to work in the "new" field of computational medicine about 15 years. (Is 15 years new? I don't think so - and some of those heart models well before my time.) The Cardiac Mechanics Computational Group at UCSD, if anyone cares.
Personalized medicine was a very big driver for the models we were working on. You could introduce ischemias or other defects into the modeled heart tissue and observe how it changed the propagation of potentials across the tissue surfaces.
I personally worked on smaller models o