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[电子健康与“医院围墙外的癌症”,大数据与人工智能]

[E-health and "Cancer outside the hospital walls", Big Data and artificial intelligence].

作者信息

Bertucci François, Le Corroller-Soriano Anne-Gaëlle, Monneur Audrey, Fluzin Sylvain, Viens Patrice, Maraninchi Dominique, Goncalves Anthony

机构信息

Institut Paoli-Calmettes, département d'oncologie médicale, 13009 Marseille, France; Aix-Marseille université, Centre de recherche en cancérologie de Marseille, Inserm U1068-CNRS U7258, 13009 Marseille, France.

Aix-Marseille université, SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, Inserm UMR912, 13009 Marseille, France.

出版信息

Bull Cancer. 2020 Jan;107(1):102-112. doi: 10.1016/j.bulcan.2019.07.006. Epub 2019 Sep 19.

Abstract

To heal otherwise in oncology has become an imperative of Public Health and an economic imperative in France. Patients can therefore receive live most of their care outside of hospital with more ambulatory care. This ambulatory shift will benefit from the digital revolution and the development of digital health or e-health. Cancer research will also benefit with Big Data and artificial intelligence, which gather and analyze a huge amount of data. In this synthesis, we describe the different e-health tools and their potential impacts in oncology, at the levels of education and information of patients and caregivers, prevention, screening and diagnosis, treatment, follow-up, and research. A few randomized studies have already demonstrated clinical benefits. Large Big Data projects such as ConSoRe and Health Data Hub have been launched in France. We also discuss the issues and limitations of "cancer outside the hospital walls and e-health" from the point of view of patients, health care professionals, health facilities and government. This new organization will have to provide remote support "outside the walls" with care and follow-up of quality, continuous and prolonged in total safety and equity. Ongoing and future randomized clinical trials will need to definitively demonstrate areas of interest, advantages and drawbacks not only for patients, but also for caregivers, health facilities and governments.

摘要

在肿瘤学领域实现其他方式的治愈,已成为法国公共卫生的当务之急和经济上的必然要求。因此,患者可以在医院外接受更多门诊护理,从而获得大部分治疗。这种门诊化转变将受益于数字革命以及数字健康或电子健康的发展。癌症研究也将受益于大数据和人工智能,它们可以收集和分析大量数据。在本综述中,我们描述了不同的电子健康工具及其在肿瘤学中的潜在影响,涉及患者和护理人员的教育与信息、预防、筛查与诊断、治疗、随访以及研究等层面。一些随机研究已经证明了临床益处。法国已经启动了诸如ConSoRe和健康数据中心等大型大数据项目。我们还从患者、医疗保健专业人员、医疗机构和政府的角度讨论了“院外癌症与电子健康”的问题和局限性。这种新的组织形式必须在完全安全和平等的前提下,提供高质量、持续且长期的远程“院外”支持与随访。正在进行和未来的随机临床试验将需要明确证明其不仅对患者,而且对护理人员、医疗机构和政府的感兴趣领域、优势和劣势。

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