RECENT ADVANCES IN PERSONALIZED MEDICINE AND DIAGNOSTICS 2021

Due to the research efforts of the last century, the face of medicine is currently undergoing a huge transition. An explosion of data coupled with advances in machine learning has propelled medicine into an age of extreme precision and personalization. The old paradigm in which one series of treatments is the golden standard for a specific diagnosis is about to fall away, being replaced with a new paradigm which focuses entirely on the biology of the individual.

The following article discusses some of the latest medical advances in 2021, all of which are in alignment with personalized medicine - the medicine of the future, now. Digital healthcare wearables, nanoscopic diagnostic tools, and medical vocal analysis tools are some of the newest inventions featured down below.

What is Personalized Medicine?

Personalized medicine refers to medicine that is specifically tailored to every individual^{[1] [2]}. Through the course of time and understanding, it has become exceedingly obvious that each person consists of a very unique biologic makeup. The genes one is born with and the way in which they are configured throughout the course of life builds a unique signature of health. Multiple factors alter our genetic configuration^[3], the main ones of which include the environment, our lifestyle choices and the food we eat.

Given this fact, the future of medicine is moving into an era of personalization. The current paradigm in which there is one type of treatment for a diagnosis is swiftly falling away. With the inclusion of artificial intelligence and the massive surge of data that has been generated over the last several decades, diagnostics and treatment options are improving at a rapid pace. Better detection at the genetic and cellular levels allows for extremely precise treatment options. Another name for personalized medicine is precision medicine^[4].

Top 12 Precision Medical Innovations of 2021

The following 12 innovations briefly describe what’s new to the healthcare scene of 2021.

• Digital Healthcare Wearables

Digital healthcare wearables are electronic devices that are able to track one’s vital signs, such as heart rate. Their demand has been increasing throughout the last couple of years, as they provide an exceedingly convenient way to track one’s health for users, physicians and healthcare insurance brokers.

The following 5 healthcare wearables^[5] are some of the top personalized medical devices available as of 2021:

1. Fitness Trackers

There are a range of wrist wearables that are able to track one’s fitness levels, in terms of several vital signs and daily physical activity. Generally, they can measure one’s heart rate as one exercises, which gives a good indication of one’s level of fitness.

The heart rate of athletes, for instance, tends to be slower during both rest and exercise than members of the general population. This naturally indicates a high level of fitness. When the heart rate gets too high, it is a sign that one has exerted oneself too much for one’s fitness levels. These devices can help to temper physical activity in a way that helps gently increase one’s physical fitness without becoming extremely exhausted. In this way, moderate exercise at regulated intervals can be achieved with relative ease.

The information generated by fitness monitors is often able to be transmitted to various apps able to sync with the device to monitor one’s progress. Users agree that making use of fitness monitors helps them to engage with exercise more than without. Some of these devices are designed specifically for monitoring the steps one takes, for walking or jogging to keep fit. These can help to keep one’s motivation up and ensure that a sufficient amount of physical activity is achieved for optimal fitness.

2. Biometric Smartwatches

The latest smartwatches double up as both biometric sensing devices and mobile phones. The best technology currently available is able to detect blood oxygen levels, blood pressure, sleep quality and heart rhythm. Unlike heart rate, heart rhythm is far more accurate and can detect whether a person is experiencing heart arrhythmia or not, as well as predict the risk of having a heart attack.

These devices are complete game changers, especially for those with heart conditions, diabetes, hypertension, leukemia, chronic infectious illnesses and other diseases in which sleep and blood parameters are affected. These watches are able to send messages to caretakers and healthcare providers the moment an abnormality is detected, being of major benefit to those vulnerable to suffering sudden heart attacks, strokes or other abnormalities.

Furthermore, smartwatches are able to integrate the same functionality as fitness trackers, with added features. These include taking readings of one’s elevation, location, distance traveled and the amount of calories the user has burned.

3. Epileptic Detectors

Still amongst some of the most popular devices available, these wrist wearables were some of the first healthcare devices of their kind to hit the market. Taking measurements of heart rate and skin conductance variability, these devices are able to predict with a high degree of accuracy when someone is about to suffer an epileptic seizure. Often the skin on the one side of the body experiences a contradictory result to the other, forewarning of an electrical event in the nervous system. Many people have been rushed off to hospital and stabilized just in the nick of time thanks to these devices.

4. Portable ECG Monitors

Perhaps one of the most impressive devices that have recently been released includes the portable electrocardiogram monitor. An electrocardiogram or ECG is a device that reads the electrical impulses of the heart, able to detect arrhythmias, arterial fibrillation, cardiac blood supply blockages, and heart enlargement^[6]. Patients that will receive the most benefit include those with coronary heart disease, cardiomyopathy, those who suffer from cardiorespiratory disorders and those at a high risk for heart attacks.

The level of accuracy of these devices now matches cutting edge diagnostic technology that was previously reserved for top medical establishments. The quality of the readings from these devices is good enough to be used by doctors as a diagnostic tool.

5. Biosensors

Biosensors are the next in-line innovations after smartwatches, taking on the form of self-adhesive patches. A step up from wrist-wearables, these patches perform many of the same functions, with the added feature of measuring one’s respiratory rate, temperature, and movement.

Their use is intended for patients that require monitoring. While out on the go, biosensors can alert healthcare providers not only of the user’s vitals, but also keep track of activities and locations that may either positively or negatively have an impact on their health. For example, if a patient experiences worse symptoms on a hot day, inside a busy mall or consuming certain food, the biosensor would be able to keep track. In some instances, these devices are able to predict and potentially protect against both cardiac and respiratory arrest.

• Medical Apps of the Future

Many medical apps exist that allow users to record various aspects of their health, documenting their biorhythms through time. This gives insight into the lifestyle factors that affect well-being, offering a useful perspective that is precisely tailored to the individual. Often these apps also provide healthcare service feedback and helpful suggestions for managing immediate symptoms.

6. Wearable Device App Integration

The majority of wearables are accompanied by an app that tracks all recorded results, storing them for multiple purposes. Depending on the type of device one is using, the information may simply compare previous readings so that the user can track their fitness progress or health status. Other apps are connected directly to a healthcare provider, offering real-time feedback to a physician in the event of a life-threatening situation.

These apps, in conjunction with their wearable devices, are estimated to prevent a large proportion (just under 90%!) of heart attacks by monitoring heart arrhythmias, blood pressure and other relevant vitals.

7. Vocal Analysis

As unlikely as it sounds, vocal analysis is very likely to become the future of diagnostics in medicine. Right now, the technology already exists where a sample of a person’s voice can be analyzed and accurately used to assess the state of their health. This relatively new field of medicine is referred to as bio-acoustics, revealing the power of the spoken word for deciphering one’s biology.

A few decades of researching the voice revealed that the frequencies in the voice can serve as highly accurate biomarkers for disease and that those with the same illness typically carry the same frequencies in their voices.^[7] After taking a 30 second voice recording, the frequencies of the person’s voice are matched to that of a database. The results offer an extremely accurate set of readings at the cellular level, providing personalized health information as to the underlying mechanisms of a person’s set of symptoms. In the hands of a practiced health professional, this information can be used to precisely guide an appropriate treatment plan, tailored to the individual.

Vocal analysis apps are about to be released onto the market, which allow for this potent technology to be used by anyone with a smartphone that possesses a good enough microphone. They are already being used with great success in clinical trials, particularly for diagnosing and treating heart conditions^[8].

8. Facial Imaging and Symptom Detection

Some apps exist out there that are able to scan your facial expression, using facial imaging technology in order to assess one’s mental health. While this technology is still in its infancy, micro expressions on the face can give additional information on how one is feeling.

Alongside facial recognition, the user can typically select from a list of symptoms they are experiencing that day. After the data has been consolidated, the app offers a list of useful suggestions for attempting to improve mood and lessen symptom severity. One’s daily symptoms pertaining to mental health are tracked through time, offering a useful tool for assessing what suggestions helped the most and what behaviors resulted in worse outcomes.

• Latest Diagnostic Tools

It is becoming increasingly clearer that symptoms displayed on the surface can have multiple underlying causes unique to the individual. Diagnostic tools are becoming far more far more precise, tailored towards cellular biomarkers and genetics.

9. Nanoparticles

Nanoparticles have been showing promise as both transport systems for treatment and for enhancing diagnostic tools. This is especially true for rapid antigen testing and enhancing imaging technologies, such as MRI. Currently a number of nanoparticles are under investigation for quickly diagnosing a selection of biomarkers. Gold nanoparticles and diamond nanoparticles appear to be some of the best, with the most sensitivity^[9]. These particles are easily taken up by cells and can penetrate many nanoscopic structures in a cell, including DNA and RNA^[10].

In principle, each particle gives off a unique spin; the properties of which can be measured and catalogued in accordance with different biologic media that house the inserted nanoparticles. In this way, unique readings can be collected and used to accurately assess biomarkers specific to various diseases.

There is room for applying nanoparticles in MRI scans, as they can access much deeper crevices of the tissues being scanned, producing a much more accurate picture ^[11]. In this instance, the device emits a form of electromagnetic radiation that causes the particles to spin in a specific way and the device is able to read the “echo” of the emission.

10. Improved Gene Sequencing

Gene sequencing technology is not new to the medical diagnostics arena, with user-friendly services being available for several years already. What makes gene sequencing diagnostic tools stand out in 2021 would be their increasing sophistication at picking up genetic biomarkers, improving their accuracy as diagnostic tools.^[12]

This is particularly important for diseases with an epigenetic component, where the genes pertaining to one type of illness may express a large degree of variability amongst individuals^[13]. Examples of such conditions include autism, cancer^[14], and complex autoimmune diseases such as multiple sclerosis. In these conditions, hundreds to thousands of different genetic configurations may pertain to the same diagnosis, in which precision medicine is an absolute requirement for treatment.

Identifying which genes may be the same and which may be unique to individuals within a spectrum of one disease has begun to vastly improve treatment options. Better combinations of compounds are now being used effectively to target diseases at the genetic level, with variation for emergent genetic profiles amongst patients. Genetic sequencing has made the most progress in terms of oncology, with a whole host of selective treatment options for cancer now available for precise genetic markers.

• Enhanced Precision Medical Treatments

With the explosion of research that has occurred in the last decade or so, scientists have begun to get a better grasp of the underlying mechanisms for disease. However, treatment options have still some time to catch up with the expansion of biomarkers and testing now available for diagnostics.

Older therapies are being retracted as they are now being found out to affect multiple areas of the body in unanticipated ways; while newer ones are being explored in this context for improved treatment outcomes.

11. AI Health Data Integration

Given all the rapid enhancements in diagnostics and treatment options, it is obvious that the burden on healthcare physicians has become increased due to information overload. When offered a print out of thousands of biomarkers, it’s not always an easy task to make sense of all the information and then to fish out the best treatment option.

This is where seamless integration of artificial intelligence has begun to play a major role in determining the best course of action with the available data^[15]; including real-time feedback from the patient, biomarker results and the latest research. In combination with the practical experience of the physician, patients will be able to receive the best possible treatment plans possible, tailored entirely to their unique biological requirements.

12. Improved Drug Delivery

The last few years have seen major improvements in drug delivery methods. While scientists have found a myriad of compounds able to treat multiple components of chronic illness, translating these compounds into a workable cure is not quite as simple as taking a tablet or two. Treating problems that are beyond the microscopic level, at various stations inside specific cells, takes a considerable amount of biological ingenuity.

Scientists have been working on creating improved delivery systems to overcome this problem. Liposomal delivery was the latest invention of a few years ago, however this still is not entirely selective enough to treat areas of the body on the periphery, being most effective for reaching the liver. Once there, metabolites are potentially able to make it elsewhere, yet the effectiveness of the treatment is still reduced.

Nanoparticles are showing a lot more promise at delivering drugs past this check point, as these particles are small enough to be absorbed by just about any cell type. There are many ways in which nanoparticles can be manipulated as well once inside the body in order to reach tissues traditionally tricky to enter, such as the brain. Gold nanoparticles are one promising option as they can be easily attached to many chemical components and are easily absorbed by many types of cell, bypassing the gut and liver when designed properly.

Another promising option in the pipeline would be making use of extracellular vesicles. These are already being used by our cells all the time in order to chemically transport substances, such as hormones and neurotransmitters. When applied to drug delivery in animals, they appear to be highly effective for lowering inflammation associated with a whole host of diseases.^[16]

Conclusion

Healthcare is about to receive a long-awaited facelift that emphasizes the individual over a single standard of treatment. Already in 2021, people no longer need to be kept in the dark about the state of their health, having access to information about their vital signs at all times thanks to smart bio-sensing wearables. Seamless integration with healthcare providers and artificial intelligence is taking diagnostics and treatment to the next level. Numerous treatments are underway to modify treatment options in a way that target precise biomarkers, unique to the patient in question.

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