PubMed · 11435061
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M Piccart, L Cataliotti, M Buchanan, G Freilich, J Jassem. 2001. Brussels Statement document.. https://doi.org/10.1016/s0959-8049(01)00134-4
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PURPOSE: Precision medicine, also known as personalized medicine, enables the provision of tailored health services to patients. In the prevention, early detection, and treatment of cancers, precision medicine is highly promising, given the increasing use of genomic profiling for diagnosis and adapting therapies in several tumor types. Artificial Intelligence (AI) can support this process by analyzing vast amounts of relevant data. However, high-quality data and financial investments in the health system are essential for the implementation of precision medicine and AI solutions in routine cancer care. DESIGN/METHODOLOGY/APPROACH: Building on the quantitative outcomes of a foresight exercise published in another study, this article collects qualitative data to gain more detailed insights into the future of precision oncology in Belgium and discusses the role of AI in this field. It reports the results of a series of expert workshops, focusing on four hypothetical future scenarios that are centered around technological and economic issues that must be overcome for the widespread use of precision oncology in Belgium. FINDINGS: The study concludes that all four scenarios discussed in the workshops would require supportive policy measures in Belgium, which should go beyond mere technological and economic considerations, such as involving patient associations and the public in policy design or creating multi-disciplinary expert groups for precision medicine. ORIGINALITY/VALUE: To the best of our knowledge, this is the first study to employ foresight methodology to illustrate possible future scenarios, scrutinize feasible approaches for implementing precision oncology in Belgium, and discuss the use of AI in this context.
For large-scale accidents, and for specific categories of wounds there is, in addition to the extramural assistance provided by helicopter teams and mobile medical teams, a need for secondary triage so that patients can be transferred as quickly as possible and the use of limited treatment capacity for specific injuries (such as serious burns) is optimised. After the cafe fire in Volendam, 203 patients were admitted to 27 hospitals. In almost all of these cases it concerned burns, often complicated by inhalation injury. Burns triage teams selected in the second instance patients with 30-80% surface burns who required artificial respiration, for admission to one of the burn centres in the Netherlands, Belgium or Aachen (Germany). The mortality under 75 patients with burns and an inhalation trauma who underwent a planned curative treatment was just 5.3%. Trauma triage teams should be officially recognised within the chain of the project 'Medical assistance in accidents and disasters' (Dutch acronym: GHOR) so that together with the uniform guidelines for the treatment of specific injuries that are present in casualty departments (for example the 'emergency management of severe burns (ESMB) protocol', a protocol for the care of patients with serious burns) the quality of care can be improved.
BACKGROUND: The impact of treating emotional distress on prognosis in coronary heart disease (CHD) has not been documented convincingly. We tested the hypothesis that treatment-related changes in emotional distress may explain the beneficial effect of rehabilitation on prognosis. METHODS AND RESULTS: In this nonrandomized clinical trial, 150 men with CHD participated in rehabilitation (n=78) or received standard medical care (n=72). There were no differences between rehabilitation and control patients with regard to left ventricular ejection fraction (LVEF) or standard care. End points were reduction in distress after 3 months and mortality after 9 years. At the end of the 3-month trial, 64 patients (43%) reported improvement and 22 (15%) reported deterioration in negative affect. Rehabilitation patients improved more (P=0.004) and deteriorated less (P=0.001) than control patients; rehabilitation was effective in reducing distress. After 9 years of follow-up, 15 patients had died (13 cardiac and 2 cancer deaths). Mortality was associated with LVEF </=50% (P=0.038) and deterioration in negative affect (P=0.007). Rate of death was 17% (12/72) for control patients versus 4% (3/78) for rehabilitation patients (P=0.009); rehabilitation was effective in reducing mortality. LVEF </=50% (OR 3.2; 95% CI 1.1 to 9.8; P=0.041) and rehabilitation (OR 0.2; 95% CI 0.1 to 0.7; P=0.016) were independent predictors of mortality. Rehabilitation warded off the deleterious effect of deterioration in negative affect on prognosis. CONCLUSIONS: Deterioration in negative affect is associated with a high long-term mortality risk. Warding off deterioration in negative affect is a mechanism that may explain the beneficial effect of comprehensive rehabilitation on prognosis in patients with CHD.