Advancing Rheumatology Care Through Machine Learning.

Publication date: Feb 29, 2024

Rheumatologic diseases are marked by their complexity, involving immune-, metabolic- and mechanically mediated processes which can affect different organ systems. Despite a growing arsenal of targeted medications, many rheumatology patients fail to achieve full remission. Assessing disease activity remains challenging, as patients prioritize different symptoms and disease phenotypes vary. This is also reflected in clinical trials where the efficacy of drugs is not necessarily measured in an optimal way with the traditional outcome assessment. The recent COVID-19 pandemic has catalyzed a digital transformation in healthcare, embracing telemonitoring and patient-reported data via apps and wearables. As a further driver of digital medicine, electronic medical record (EMR) providers are actively engaged in developing algorithms for clinical decision support, heralding a shift towards patient-centered, decentralized care. Machine learning algorithms have emerged as valuable tools for handling the increasing volume of patient data, promising to enhance treatment quality and patient well-being. Convolutional neural networks (CNN) are particularly promising for radiological image analysis, aiding in the detection of specific lesions such as erosions, sacroiliitis, or osteoarthritis, with several FDA-approved applications. Clinical predictions, including numerical disease activity forecasts and medication choices, offer the potential to optimize treatment strategies. Numeric predictions can be integrated into clinical workflows, allowing for shared decision making with patients. Clustering patients based on disease characteristics provides a personalized care approach. Digital biomarkers, such as patient-reported outcomes and wearables data, offer insights into disease progression and therapy response more flexibly and outside patient consultations. In association with patient-reported outcomes, disease-specific digital biomarkers via image recognition or single-camera motion capture enables more efficient remote patient monitoring. Digital biomarkers may also play a major role in clinical trials in the future as continuous, disease-specific outcome measurement facilitating decentralized studies. Prediction models can help with patient selection in clinical trials, such as by predicting high disease activity. Efforts are underway to integrate these advancements into clinical workflows using digital pathways and remote patient monitoring platforms. In summary, machine learning, digital biomarkers, and advanced imaging technologies hold immense promise for enhancing clinical decision support and clinical trials in rheumatology. Effective integration will require a multidisciplinary approach and continued validation through prospective studies.

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Concepts Keywords
Apps Activity
Cnn Algorithms
Increasing Biomarkers
Medicine Care
Pandemic Clinical
Decentralized
Digital
Learning
Outcome
Patient
Reported
Rheumatology
Specific
Trials
Wearables

Semantics

Type Source Name
disease VO organ
disease MESH COVID-19 pandemic
disease VO volume
disease IDO quality
disease MESH sacroiliitis
disease MESH osteoarthritis
disease MESH disease progression
disease VO efficient
disease VO effective
disease MESH rheumatoid arthritis
pathway KEGG Rheumatoid arthritis
disease MESH systemic lupus erythematosus
pathway KEGG Systemic lupus erythematosus
disease MESH vascular diseases
disease MESH fibromyalgia
disease MESH inflammation
disease IDO cell
disease MESH fibrosis
drug DRUGBANK Esomeprazole
disease MESH rheumatic diseases
disease VO time
disease MESH psoriatic arthritis
disease MESH arthritis
disease MESH inflammatory bowel disease
pathway KEGG Inflammatory bowel disease
drug DRUGBANK Trestolone
disease MESH osteophytes
disease IDO algorithm
disease VO population
disease MESH diabetes mellitus
disease IDO blood
drug DRUGBANK Dextrose unspecified form
disease IDO intervention
disease VO injection
drug DRUGBANK Cortisone
disease VO dose
disease VO frequency
drug DRUGBANK Tropicamide
disease MESH spondylarthritis
disease MESH edema
disease IDO process
disease MESH knee osteoarthritis

Original Article

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