by Martin Rakusa
Lectures in the third plenary symposium covered state of the art topics from artificial intelligence to new biomarkers and the most expensive drugs in the world. However, with fast progress comes also a great responsibility and new ethical dilemmas.
In the first lecture, ‘Epidemiology meets deep learning and artificial intelligence’, professor Marcel Salathé presented a concept of digital epidemiology. The definition of digital epidemiology is developing with time. First, the term determined epidemiology with digital data. Today, it means epidemiology with a digital data stream that was not created for epidemiology. In the near future, it will mean epidemiology that is enabled by the tools and data of digitisation. He presented three examples of how data may be used. One was using mobile phones to track disease outbreak. The second was analysing search terms during an influenza outbreak. The last was analysing Twitter for vaccine sentiment and uptake. In comparison to classical epidemiology, digital epidemiology has three key advantages. It is affordable, fast, and it can produce new data streams. In the previously described processes, artificial intelligence (AI) plays a crucial role. Interestingly, after less than four years of development, AI can do certain image analysis far better than humans. In the future, we will use more artificial intelligence to analyse epidemiological data, language processing, and decision-making.
Professor Henrik Zetterberg gave the second lecture, ‘Current and future use of precise fluid biomarker tools for personalised diagnosis and prognosis’. He started his talk with the hallmark biomarker for the Alzheimer’s disease – amyloid-beta 42 (AB). AB42 levels are typically low in patients with Alzheimer’s disease. However, levels may also be low in neuroinflammatory diseases such as multiple sclerosis or normal pressure hydrocephalus. On the other hand, the ratio of AB42/AB40 or AB42/AB38 may better predict patients with Alzheimer’s disease. The next biomarker was tau, which is increased in the cerebrospinal fluid in patients with Alzheimer’s disease but not in most other neurodegenerative diseases. Other biomarkers are the neurofilaments light chain, which are elevated in the case of neurodegeneration. Some studies suggest that they may be used as a predictor of the progression of mild cognitive impairment. In the end, he presented promising results for the serum test of AB, p-tau and neurofilament light chain.
The next lecture was ‘Individual treatment decisions based on precision neurology’. Professor Francesco Muntoni first presented different types of spinal muscular atrophy. Then he explained possible treatments. At the moment, there are three different drugs. The question remains if one drug is superior to the other. Although we may find differences in the beginning, we still do not have enough long term data. For successful treatment, the age and stage of the patient may also be more important than the drug itself. We also do not know all the side effects. Nonetheless, we live in an exciting time, where we can finally treat patients with muscle disorders, he concluded.
The final lecture, ‘Precision Medicine without limits? Ethical and economic challenges’, was given by professor Christiane Druml. She briefly presented the history of medicine, the terminology and the goals of precision medicine. Next, she reminded us of the ethical aspects of medicine. In the end, she pointed to justice in medicine and unequal access to healthcare in a single country and worldwide.