III Digital

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Digital revolution and e-vascular health

Introduction
François Becker (France)

New information technologies and nanotechnologies are expected to change the medical world deeply. Soon, telemedicine will be organized for vascular physicians, and image transfer will become common. These changes will affect the consultation regimens (acrosyndromes, ulcers, trophic disorders, limb edema, superficial venous thrombosis, etc), the management of vascular risk factors, the prevention of primary and secondary disease, the follow-up of chronic diseases, and the monitoring of patient compliance. The diagnosis and management of claudicant patients will evolve with sports applications, which will become peripheral arterial disease applications. Not only will blood pressure measurements become (already are) automated, but the screening and follow-up tests for asymptomatic patients will also become automated. Delays regarding the clinical visits and the overall costs will diminish. The author concluded by stating that whether we agree or not, a revolution is happening. Thus, the question is not if vascular physicians approve it or not, but whether they will become involved in the digital revolution.

Connected objects and e-health: what are we talking about?
Antoine Poignant (France)

Currently, 15 billion devices are connected worldwide, but it is estimated that this number will reach 80 to 100 billion by 2018. In France, three million patients were already using ambulatory monitoring devices in 2013, and it is estimated that this number will reach 19 million in 2018. Thus, connected health is becoming the new paradigm in medicine. Today, there are portable EKGs or automated retinopathy diagnostic devices that can detect and send relevant information to physicians. A very promising innovative device for vascular physicians is the InstentR. By providing instantaneous and noninvasive identification of the composition of tissues in contact with the stent (either myoepithelial cells from hyperplasia and restenosis or thrombus), InstentR sensor technology can overcome the limitations of vascular imaging techniques that are used in both interventions and patient follow-up, and it can alert the physician if any critical problem occurs. The combination between the life sciences and technology is now considered the third coevolution, making the victory of the transhumanism inevitable.

Place of the physician in this time of big data
Mehdi Benchoufi (France)

Big data in health care refers to the digital collection of health data that is so large or complex that conventional database management tools are insufficient to deal with the data. Three basic paradigms have been associated with the internet: connectivity, collectivity, and calculability. The possibility of putting together all existing data regarding a particular disease or a patient (medical notes, imaging, laboratory testing, sensor data, or even social applications (eg, Twitter, Tinder, blogs) will probably help save lives and money. In fact, finding associations or recognizing patterns and trends within the available data can be effective for these purposes. For instance, Spotify can track the first symptoms of depression, and Twitter has been used to keep up with HIV infections. The current issue concerning big data in medicine is to clearly understand how to predict, how to conceive, and how to know.