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Using Avatars to Understand Adverse Drug Reactions

Do you know how your body may react to a drug?

3 min read
Using Avatars to Understand Adverse Drug Reactions

A few years ago, I wrote about some pioneering work done on creating a “Google Earth for the Body” by Andre Elisseeff and a research team at IBM’s Zurich Research Lab.  The idea was to create a means of visualizing a person’s electronic health record (EHR) using a three-dimensional image of the human-body.  Over the past few years, the approach has been used successfully at Thy-Mors Hospital in northern Denmark, and is slowly rolling out to other hospitals in Denmark as well as in Switzerland.

Elisseeff and some of his co-workers spun off a company called Nhumi (“new-me”) Technologies in 2009 to explore additional ways of using 3-dimensional views of the human-body, aka 3D avatars, to easily manage and visualize clinical data. A short while ago Elisseeff contacted me about their most recent work involving drug safety events. Nhumi modified their previously developed avatar modeling technology so that hundreds or thousands of medical histories–in this case, all the events reported to the U.S. Food and Drug Administration 's (FDA) Adverse Event Reporting System (AERS) since 2004–could be visualized directly on the human body, allowing a person to see a “heat map” of the body parts that are most adversely affected by a particular drug.
You can go to Nhumi drug safety web site (beta) and type in a drug or an ingredient and see which parts of the body have been reportedly affected by it, along with supporting information.  For instance, there are different medical-condition filters you can apply to as well as a "workbench" to explore drug safety data.  There is also prescription information from the FDA so that visitors can check the efficacy or the reason a drug is prescribed. You can watch a short video on how the site works here.The approach may look like “too much” information, but Elisseeff and his team wanted to make sure visitors have access to all available data about a particular drug. Says Elisseeff:

 "One can easily be fooled by drug safety data and it is important to be specific about who reported what and when. A drug given to an older population can appear less safe than another drug simply because elderly are more subject to adverse reactions than younger people, not because it is inherently more risky. Cause-effect relationships are complex to detect and can only be analyzed with tools that let the visitors compare and explore the influence of different factors."

Currently, the site is meant more for medical and pharmacological experts or very informed patient who can properly interpret the results (and the risks depicted)  than for the general populace. After typing in a few common ingredients or drugs (e.g., acetaminophen, ibuprofen, amoxicillin or vioxx) and seeing what they possibly can do to your body, you might be tempted to swear off all drugs forever. One has to remember that the data depicted are adverse effects, and are not balanced out against a drug’s positive effects (which would be nice to see as well).
For now, the information depicted is an aggregate, but in the future a user may be able to call up individual FDA reports of adverse reactions to look at them in detail, Elisseeff told me. Nhumi is also contemplating the depiction of the negative effects of drug interactions as an additional feature.
There are two other companies that have also recently set up web systems to report FDA AERS data, Adverse Events and Clarimed (the latter is much broader and reports on adverse medical device information, hospital ratings, etc.), but neither use avatars.  You can read more about them in this Wall Street Journalstory.
Nhumi’s use of 3D avatars is one of the several ways visualization is being used in the medical field. For example, Rensselaer Polytechnic Institute is using what it calls “virtual patients” to study  how radiation interacts with the human body, while the FDA’s Center for Devices and Radiological Health “has created a ‘virtual family’ of adults and children in order to study how best to implant medical devices in children, such as heart defibrillators,” this other WSJ article reports.

Nhumi is working on several different efforts to help access and depict medical data in addition to the adverse drug work, such as a quick way for clinicians and radiologists to access patient images and scans and then directly show them over a virtual model of the human anatomy.  Elisseeff also recently told me that he received a short demo of IBM’s Watson and his team is now thinking about how Watson and the company’s 3D avatars could be linked up in the medical arena.

Probably the biggest problem for Nhumi is maintaining its focus:  there are so many opportunities for using avatars in the medical and pharmaceutical fields that it is easy to start pursuing the proverbial white rabbit. However, I think it is only a matter of time before everyone has their own medical 3D avatar, and I would be surprised if Nhumi (along with IBM) is not one of the leaders in the area.

Photo: Courtesy of Nhumi Technologies

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Restoring Hearing With Beams of Light

Gene therapy and optoelectronics could radically upgrade hearing for millions of people

13 min read
A computer graphic shows a gray structure that’s curled like a snail’s shell. A big purple line runs through it. Many clusters of smaller red lines are scattered throughout the curled structure.

Human hearing depends on the cochlea, a snail-shaped structure in the inner ear. A new kind of cochlear implant for people with disabling hearing loss would use beams of light to stimulate the cochlear nerve.

Lakshay Khurana and Daniel Keppeler

There’s a popular misconception that cochlear implants restore natural hearing. In fact, these marvels of engineering give people a new kind of “electric hearing” that they must learn how to use.

Natural hearing results from vibrations hitting tiny structures called hair cells within the cochlea in the inner ear. A cochlear implant bypasses the damaged or dysfunctional parts of the ear and uses electrodes to directly stimulate the cochlear nerve, which sends signals to the brain. When my hearing-impaired patients have their cochlear implants turned on for the first time, they often report that voices sound flat and robotic and that background noises blur together and drown out voices. Although users can have many sessions with technicians to “tune” and adjust their implants’ settings to make sounds more pleasant and helpful, there’s a limit to what can be achieved with today’s technology.

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