Chatelaine

Why Some Women Respond to Treatment, but Others Don’t

Heart disease is different for everybody. The Peter Munk Cardiac Centre is using artificial intelligen­ce to figure out why.

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Imagine this scenario.

Two women, both 45-yearsold and leading a similar lifestyle, arrive at the hospital severely fatigued and exhibiting shortness of breath. They are both found to have heart failure; a condition where your heart is not effectivel­y pumping blood throughout your body.

A diagnosis of heart failure is severe for anyone, but treatment is designed to manage the symptoms. In this case, one woman responds well to the treatment and is able to be discharged from the hospital the next day, while the other woman continues to experience shortness of breath and has to be transferre­d to the intensive care unit. Despite a heightened level of care, the woman’s kidneys begin to fail. Soon, other organs follow suit. She dies within a matter of days.

Why did the women respond so differentl­y to treatment?

Today’s medical landscape The current standard in medicine is a “one treatment fits all” approach.“Right now, treatment plans include guidelines on how to manage the average patient. The plans are infrequent­ly stratified into groups, let alone tailored to individual­s,” explains Dr. Heather Ross, Division Head of Cardiology at the Peter Munk Cardiac Centre, Director of the Ted Rogers Centre for Heart Research, and Loretta A. Rogers Chair in Heart Function. “This can be problemati­c for heart disease patients, particular­ly women,” Dr. Ross continues, “since the guidelines are based on clinical trials where women are underrepre­sented.”

When prescribin­g a treatment plan for heart disease, there is a wealth of data, imaging, laboratory testing, and medical history that should be taken into account to have a better chance of success. The problem is the sheer volume of data and time-sensitive nature of treatment which make it impossible to interpret the data in a meaningful way. Without assistance, the amount of data available now exceeds the capacity of the human mind. That’s where artificial intelligen­ce comes in.

Tomorrow’s medical future

The team at the Peter Munk Cardiac Centre is learning more about the intersecti­on of artificial intelligen­ce and cardiac care. Artificial intelligen­ce takes a tremendous amount of patient data and uncovers patterns the human brain cannot see.

“We currently ignore some data because it’s so complex,” notes Dr. Cedric Manlhiot, Director of the Cardiovasc­ular Data Management Centre at the Ted Rogers Centre for Heart Research. “For example, right now, after an exercise test, clinicians focus on a handful of data points out of the thousands that are generated by the test. We have created an artificial intelligen­ce algorithm that interprets the data that has traditiona­lly been left out. For the first time, clinicians are now provided with unique insights allowing them to select the most appropriat­e therapy for each individual patient,” he explains.

The future of artificial intelligen­ce does not stop at developing a more responsive treatment plan, however. “By making sense of the personaliz­ed data that is available, we will be able to offer patients the right treatment at the right time, before heart disease occurs,” says Dr. Carolina Alba, a Cardiologi­st and Scientist at the Peter Munk Cardiac Centre. By developing specialize­d algorithms, cardiologi­sts can move towards preventati­ve monitoring as opposed to reactive treatment.

Thanks to advancemen­ts in artificial intelligen­ce, a new scenario is possible. In it, two women visit their doctor’s office for a routine check-up and their physicians calmly explain that based on their age, sex, ethnic background, genetic compositio­n, tests, and medical history, they are both at risk of heart disease. Undeterred, the physician proceeds to develop a personaliz­ed treatment plan for each woman that successful­ly prevents the disease from developing in their lifetime.

 ?? Photo: Tim Fraser ?? Dr. Heather Ross at the Peter Munk Cardiac Centre, where they are at the forefront of integratin­g artificial intelligen­ce in medicine.
Photo: Tim Fraser Dr. Heather Ross at the Peter Munk Cardiac Centre, where they are at the forefront of integratin­g artificial intelligen­ce in medicine.

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