Muteb Alshammari, BS, MS, PhD
Department of Health Informatics, School of Public Health and Health Informatics

The beginning of this decennia has been branded in mankind’s memory as one of the worst sanitary crises (2019-nCoV) that has so far claimed hundreds of thousands of lives worldwide. This time, however, matters have been managed rather differently as technological advances allowed countries to closely follow the spread and act upon it to curb further damage. Indeed, fighting such a serious disease requires fast large-scale measures as well as instruments that would enable faster diagnoses and treatment delivery, as well as prevention tools, which is easier said than done when dealing with billions of people underrating the situation.  

Tech Innovation in Times of Pandemic

Some countries displayed better skills than others at the head of the train Asian countries, as they have displayed an arsenal of technologies. Some might think they had more time to learn and adapt. Yet, the truth is they faced it first and have been leading the fight against the COVID-19 with advanced technological instruments that have been widely deemed subversive and violating human rights. Yet, those same tools are seemingly effective and helped Asian countries get the upper hand on the virus. 

Tracking, Informing and Preventing More Spread

Governments have used CCTVs and GPS data provided by phones to track people’s whereabouts. This enables us to pinpoint infected patients’ whereabouts prior to quarantine, to find out where they went, what they did, and who they met. Thus, setting perimeter of risk areas and identifying people that might have been exposed. The countries that have extensively used such technics to restrain a wider spread were South Korea, Singapore, China, and Taiwan. 

A total of fifteen countries so far have successfully developed tracking apps, such as Singapore, China, Isreal, Ghana, Australia, Saudi Arabia, Colombia, etc., just to name a few. Singapore was one of the first countries to launch an app using a digital contact tracking protocol as a response to the COVID-19 in mid-March. The Singaporean government has developed an app called TraceTogether that uses the BlueTrace protocol. 

Likewise, mobile apps have also been used to inform and help people navigate this crisis. Major Chinese tech behemoths – Tencent and Alibaba – have developed the Health Code (???) app that attributes people colored QR codes. The app compiles all the information on health status and travel history collected by the Chinese government. The service is accessible through WeChat and Alipay and attributes both locals and foreigners a color (green, yellow, or red) based on their health condition and risk level. The QR code is then scanned by local authorities to prevent high-risk individuals from traveling and entering public areas where they could infect more people. There have been slight update bugs that would show the wrong color for a small number of users, but deleting and reinstalling fixes the issue. This app has permitted China to restore a normal routine without suffering a dreaded second wave so far. 

Surviving the Crisis and Discovering New Lifestyles

Massive lockdowns and broad strict distancing policies have left people stuck home in a floating state, deprived of all the means to complete their daily routines. This pandemic pushed us to adapt to a new model of work from home based on social platforms and apps that enable us to organize online meetings, classes, interviews, medical consultations, etc. Companies, schools, and universities have all been functioning via using apps such as Zoom, Skype, Google Hangouts, Tencent Meeting, Alibaba Cloud Conference, etc. The word went virtual and has acquired some habits that experts say could stay with us. 

Informational mobile apps have also been very commonly used for prevention purposes. For instance, the South Korean Corona 100m or CoronaMap that use GPS to track locations and supervise citizens’ quarantine locations. If an individual using this mobile app comes within 100 meters radius of an infected person, they automatically receive a push notification warning them of the situation. Likewise, they track locations where infected individuals have been and the facilities they have used. The main purpose of this functionality is to encourage users to avoid such risky areas.

A plethora of mobile apps has been designed specially to help people and governments safely navigate this pandemic. The last couple of weeks have enabled us to notice how mobile apps have been a critical weapon in this fight. Indeed, tracking apps have helped save countless lives by significantly reducing infection rates and quickly identifying potentially infected people. Therefore, these mobile apps have all been proven effective to a certain extent. Yet, despite its highly controversial features, China’s color-coding apps (Health Code) seem to stand out from the lot.

References:

1. Brohi, Sarfraz&Brohi, Nida&Brohi, M Nawaz. (2020). Key Applications of State-of-the-Art Technologies to Mitigate and Eliminate COVID-19. 10.36227/techrxiv.12115596.
2. Ten technologies to fight coronavirus, EPRS | European Parliamentary Research Service Author: MihalisKritikos Scientific Foresight Unit (STOA) PE 641.543 – April 2020
3. Ting, D.S.W., Carin, L., Dzau, V. et al. Digital technology and COVID-19. Nat Med 26, 459–461 (2020). https://doi.org/10.1038/s41591-020-0824-5
4. How countries are using technology to fight coronavirus, G SEETHARAMANET Bureau | Updated: Mar 29, 2020, 09.59 AM IST

5. https://economictimes.indiatimes.com/tech/software/how-countries-are-using-technology-to-fight-coronavirus/articleshow/74867177.cms
6. https://www.mobihealthnews.com/news/roundup-techs-role-tracking-testing-treating-covid-19
7. https://thejournalofmhealth.com/how-technology-is-helping-healthcare-practitioners-combat-the-covid-19-pandemic/
8. https://www.techuk.org/insights/opinions/item/17236-how-tech-is-helping-the-nhs-fight-covid-19
9. https://www.who.int/news-room/detail/27-04-2020-who-timeline—covid-19
10. https://en.as.com/en/2020/04/18/other_sports/1587167182_422066.html
11. https://edition.cnn.com/2020/03/12/asia/coronavirus-south-korea-testing-intl-hnk/index.html
12. https://en.wikipedia.org/wiki/COVID-19_apps

Personalized Dental Medicine

Personalized medicine is receiving an increasing global attention and interest from scientific communities. It relies on understanding genomic structure of individuals which allows for establishing proper treatment planning. Personalized dental medicine is a hot topic that recently attracted researchers, policy makers and dental educators. Traditional dentists and dental educators may think personalized dental medicine focuses on oncology therapy. Yet, personalized dental medicine might be related to everyday practice more one could expect.

Personalized dental medicine allows periodontists, general dentists, preventive dentistry professionals, and prenatal dental counselors to deliver tailored treatments, instructions and risk assessments to patients in need. Dentistry is the healthcare discipline that has a well-documented long history in implementing preventive measures at community and personal levels. Personalized dental medicine helps periodontists to identify patients at higher risk to develop periodontal diseases and establish proper preventive scheme. There is a well-established bidirectional interaction between oral health status and medical diseases. Scientific literature showed that oral care may reduce the risk of complications and improve the status of number of systemic conditions. Personalized dental medicine should allow identifying proper scheme that help mitigate the risk for progression of chronic conditions.

One major challenge that faces the concept of personalized dental medicine is that dental students receive little, if any, genetic education. Education is all about the future of the practice and we are entering the era that genetic and genome play a major role. Revision of dental school’s curriculum becomes a necessity to meet recent revolution in biomedical science. Traditional dental education that defines dentistry as drill and fill will soon become obsolete and will be replaced by recent revolution in the field of biomedical science that integrate preventive medicine into dentistry. Genetic and genome education at dental schools should not be limited to limited to theoretical introduction to definitions and basic concepts. Instead, it should cover practical application in early detection of genetic disorders, sequencing technology, the role of genetic in development of various diseases, and infection between genes and environmental factors and individual attitudes and characteristics.play a major role. Revision of dental school’s curriculum becomes a necessity to meet recent revolution in biomedical science. Traditional dental education that defines dentistry as drill and fill will soon become obsolete and will be replaced by recent revolution in the field of biomedical science that integrate preventive medicine into dentistry. Genetic and genome education at dental schools should not be limited to limited to theoretical introduction to definitions and basic concepts. Instead, it should cover practical application in early detection of genetic disorders, sequencing technology, the role of genetic in development of various diseases, and infection between genes and environmental factors and individual attitudes and characteristics.

Home gene sequencing is available over-the-counter. Many are able to sequence their genes and identify their risk at home, which will result soon in a considerable cohort of the population aware of their risk to develop certain diseases and conditions including dental ones. Increasing public awareness demand dental students equipped with proper knowledge. Nevertheless, the growing “One Health” concept that addresses global health issues in multi- and inter-disciplinary approach requires traditionalists to collaborate with visionary futurists for the overall benefit of the profession.

Written by:

Restorative/ prosthetic treatment planning is a complex task, where several biological, physical, chemical, and financial factors interact. Dentists understand that despite the restoration quality, they have to face the challenge of restoration failure, post-operative sensitivity, and possible lack of patients’ compliance. In addition to the material physical and chemical characteristics, the dynamic nature of the oral cavity presents another challenge.

Where replacement of lost tooth structure or missing tooth is challenging, failed restoration is more challenging. The risk to remove extra-tooth structure and pulp exposure is one factor to consider. Other factors include the amount of remaining tooth structure, biological width, need for surgical tissue preparation, status of oral hygiene, occlusion, and patient’s financial status. Fixing failed restoration may cause more damage to the oral tissue and to the tooth itself. Sometimes, extraction is the only choice left, replacement with fixed or removable prosthesis or even implant is another dilemma. Even prosthesis and implants may fail. Complex cases treatment planning is often more challenging.

4-D printing may change the practice of restorative dentistry. The concept of 4-D printing relies on the ability of printed material to adjust itself under any circumstances without human control. It may sound off-track. Yet, Skylar Tibbits has already developed the model and predicted that 4-D printing is going soon to replace 3-D printing. If so, restorative dentistry is awaiting a revolution in techniques and materials. 4-D printed dental materials should be able to adjust itself, fix failed parts, and compensate lost tooth structure. However, 4-D printed dental materials may not totally eliminate the need for human control. The oral environment is dynamic yet the 4-D printed materials are but with limited capacity.

The emerging 4-D printing techniques awakens concerns that were once associated with 3-D digital impression CAD/CAM technique. Shipping and handling, cost, and technique sensitivity are three main factors that limited the wide use of CAD/CAM technology. Yet, 4-D printing may differ from CAD/CAM that dentist has a full control over the material during the initial phase of restoration. However, the long-term performance of the 4-D printed materials is yet unclear. A collaborative activity between material scientists and dentists is essential to ensure maximum efficacy.

Written by:
Weam Banjar; BDS., MSc. Clinical Research

Incidence and prevalence measure the extent of a disease in a population. Both terms are often used interchangeably. However, they are not similar . Incidence provides information about change in status from non-diseased to diseased and limited to new cases that are still surviving over a specified period of time. However, prevalence provides information on the overall disease occurrence.

Our mindmap will help you to differentiate between Incidence and Prevalence, Enjoy it

To view the mindmap, Click HERE

Mindmap was created by:

Muteb H Alshammari, BS., MS., PhD student in Biomedical Informatics

Translational research refers to translate scientific findings into practical setting. It is classified into T1 and T2 researches. T1 research refers to apply findings from laboratory into clinical studies that involve human subjects and often defined as “bench-to-bedside”. T2 research refers to utilizing findings of clinical studies to alter health practices in the community in an attempt to modify the standard of care or promote preventive practice on bases of findings of clinical trials. Translational research requires collaboration between laboratory and population-based investigators.

Reference:

Health Information Exchange Model and Standards

Interoperability refers to the ability of two or more systems to share information and use shared information _[1]. Health service authorities realized that health information has to be interoperable and easy to be accessed and shared electronically. Proper use of health information exchange (HIE) facilitates better communication and allows for more coordinated services across health facilities. Effective communication is essential to improve the quality of care and lower the total cost. There are various conceptual models of HIEs; each has its interoperability, sustainability and maintenance, and privacy and security issues _[2].

            There are three health data exchange models: centralized, federated and hybrid. Health record banking model is another business model aids in health information exchange.  _[2,3]. In centralized model; health data are collected from local source and stored in a central repository. Requested data is retrieved from the central repository _[2,4]. This model is quicker in responding to users’ quires, and time saver. It allows for better communication and data sharing. Data are available for scientific and logistic use. Problems that are related to this model can be solved internally _[2]. However, this model requires strong data coordination for proper data management, data exchange occurs through large central database, huge effort to maintain and update the data. Updating centralized models are difficult and has to be done at one setting rather than incremental updating _[2]. Data matching is the major challenge of this model. Accurate matching process between data available at local systems to the central repository should be exercised. Privacy issue is another major concern because as a result of difficult data matching, error in transferring data from local sources to the central repository may result in serious privacy breach.  Decentralized or federated model provides organizational control over health data they owned and provides framework for data-sharing and exchange. Organization serves as a data-owner. This model allows for easier data update. Limited access can be given to unauthorized personnel under special circumstances. It gives the ownership of the data to who initiated it. Federated model is controlled by an internal network _[2]. The hybrid model is an interaction between centralized and federated scheme. It provides interface engine for which organizations communicate. This model stores key identifiers and requests for the information that is distributed across the network. Identifier is used to gather, store, and transfer health data to the requesting eligible individual/ institution. In this model, partial replication to the central data repository took place. Most of the data are owned by the organization following the federated model scheme _[2]. Health record banking model provides the ownership to the consumers who can access their records stored in central data repository. Many believe that consumers’ control over their data resolves privacy issues and reserve HIPPA policies for confidentiality. Supporters suggest that data can be shared with eligible personnel approved by consumers _[2].

            The balance between organizational and customer needs and demands and the OSHA and HIPPA regulations is the primary challenge that faces implementation of HIE models. However, collaborative activities between policy makers, health care providers, and consumer is essential to ensure the effectiveness and satisfaction.

References:

1. IEEE Standard Computer Dictionary: A compolation of IEEE standard computer glossaries (New York: 1990)
2. Topic series: HIE technical models. From the HIMSS guide to participating HIE. HIMSS HIE Guide Work Group. Health Information and Management Systems Society (HIMSS); 2009
3. Just BH, Durkin S, Clinical data exchange models: matching HIE goals with IT foundation. JAHIMA 2008;79:2
4. Allison MA Matull M. A review of current & emerging HIE architecture models. CalRhio Summer Summit 2007.

Health Information Exchange Model and Standards

By: Muteb H Alshammari; BS., MS., PhD student in Biomedical Informatics 

Personalized Medicine

The ultimate goal of personalized medicine is to maximize the therapeutic benefits and minimize risks of adverse events. Studies suggested that genetic variability at the individuals’ level may influence the course of a disease and individual’s response to prescribed medications. As a result, the concept of pharmacogenetics emerged.

The term pharmacogenetics refers to studying the pharmacological effect of different medication on bases of genetic structure of individuals. It aims to design an individual-based therapeutic scheme that selection of medication and treatment regime relies on matching with genetic sequence that best fits the proposed regime. However, genetic profile alone might only be beneficial in rare occasions to determine definite treatment. Challenges that face the pharmacogenetics advocates are related to the multifactorial nature of disease pathogenesis, coexistence of other diseases and conditions, and factors that may affect the genetic expression in various diseases. Determining the genetic profile of individuals is expensive. Nevertheless, understanding the interaction between genetic and environmental risk factors and determine their role on immune response is essential, as well as factors related to patient him/er– self; age, gender, race, etc. Personalized medicine might be beneficial where targeted treatment strategy is necessary to avoid unnecessary damage resulted from exposure to treatment.

Written for SaudiDent.com by:

Muteb H Alshammari, BS., MS., PhD student in Biomedical Informatics

References:

Xie H, Frueh FW. Pharmacogenomics steps toward personalized medicine. Personalized medicine 2005; 2(4): 325-37