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虚拟医院和人工智能:创新型医疗系统在罕见脑血管病护理中的初步应用

Virtual hospital and artificial intelligence: a first step towards the application of an innovative health system for the care of rare cerebrovascular diseases.

机构信息

Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.

Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy.

出版信息

Neurol Sci. 2024 May;45(5):2087-2095. doi: 10.1007/s10072-023-07206-9. Epub 2023 Nov 29.

Abstract

The development of virtual care options, including virtual hospital platforms, is rapidly changing the healthcare, mostly in the pandemic period, due to difficulties in in-person consultations. For this purpose, in 2020, a neurological Virtual Hospital (NOVHO) pilot study has been implemented, in order to experiment a multidisciplinary second opinion evaluation system for neurological diseases. Cerebrovascular diseases represent a preponderant part of neurological disorders. However, more than 30% of strokes remain of undetermined source, and rare CVD (rCVD) are often misdiagnosed. The lack of data on phenotype and clinical course of rCVD patients makes the diagnosis and the development of therapies challenging. Since the diagnosis and care of rCVDs require adequate expertise and instrumental tools, their management is mostly allocated to a few experienced hospitals, making difficult equity in access to care. Therefore, strategies for virtual consultations are increasingly applied with some advantage for patient management also in peripheral areas. Moreover, health data are becoming increasingly complex and require new technologies to be managed. The use of Artificial Intelligence is beginning to be applied to the healthcare system and together with the Internet of Things will enable the creation of virtual models with predictive abilities, bringing healthcare one step closer to personalized medicine. Herein, we will report on the preliminary results of the NOVHO project and present the methodology of a new project aimed at developing an innovative multidisciplinary and multicentre virtual care model, specific for rCVD (NOVHO-rCVD), which combines the virtual hospital approach and the deep-learning machine system.

摘要

虚拟医疗选项的发展,包括虚拟医院平台,由于面对面咨询的困难,正在迅速改变医疗保健行业,尤其是在大流行期间。出于这个目的,2020 年,实施了一项神经科虚拟医院(NOVHO)试点研究,以便对神经疾病的多学科二次意见评估系统进行试验。脑血管疾病是神经系统疾病的主要组成部分。然而,超过 30%的中风仍然来源不明,罕见的 CVD(rCVD)经常被误诊。rCVD 患者表型和临床过程的数据缺乏,使得诊断和治疗具有挑战性。由于 rCVD 的诊断和护理需要足够的专业知识和仪器工具,它们的管理大多分配给少数经验丰富的医院,使得获得护理的公平性变得困难。因此,虚拟咨询策略越来越多地应用于患者管理,即使在偏远地区也有一些优势。此外,健康数据变得越来越复杂,需要新技术来管理。人工智能的使用开始应用于医疗保健系统,与物联网相结合将能够创建具有预测能力的虚拟模型,使医疗保健更接近个性化医疗。在此,我们将报告 NOVHO 项目的初步结果,并介绍一个旨在开发一种创新的多学科和多中心虚拟护理模型的新项目的方法,该模型针对 rCVD(NOVHO-rCVD),结合了虚拟医院方法和深度学习机器系统。

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