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Cleveland Clinic

INNOVATION

Top 10 Medical Innovations of 2017

As we have done before, we are proud to feature the medical advances deemed by the Cleveland Clinic to be the most important upcoming ones in 2017. In a field as broad, diverse, active and complex as healthcare, these are just a handful among many great and promising achievements for us to look forward to. And you may know of others you think equally important. When there is great concern about what the future holds for our industry, it’s nice to take a glance at the good news, and see how much we’re delivering on the promise to provide better patient care. Your end-of-year gift from Cleveland:

1 The Microbiome to Prevent, Diagnose & Treat Disease

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Strange as it seems, the gut is a gold mine. Trillions of bacteria making up communities in our body—the microbiome—are unlocking mysteries at a rapid pace. The crux of the discovery is that our microbes have a mind of their own. The chemicals they emit interfere with the way food is digested, medicine is deployed, and even how a disease progresses. Biotech companies once focused on the genomic market are pivoting to the potential of the microbiome to develop new diagnostics, new therapies, and “probiotic” products to prevent dangerous microbe imbalances. With the National Microbiome Initiative accelerating research and development, experts believe 2017 is the year the microbiome cements itself as the healthcare industry’s most promising and lucrative frontier.

2 Diabetes Drugs that Reduce Cardiovascular Disease & Death
Nearly a decade ago, a wave of new diabetes drugs hit the market with promises of lowering blood sugar. They fell far short of blunting the scariest statistics for type 2 diabetes patients: half will die from complications from cardiovascular disease. In 2016, new medications began dropping the mortality rates considerably. Empaglifozin proved to modify the progression of heart disease by working with the kidney while liraglutide has a comprehensive effect on many organs. Experts predict 2017 will mark a complete shift in the lineup of medicines prescribed for diabetes patients, as well as a new wave of research into new avenues to target type 2 diabetes and its co-morbidities.

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3 Cellular Immunotherapy to Treat Leukemia & Lymphomas
In 2016, nearly 16,000 children and adolescents will be diagnosed with cancer, more than a quarter of them with leukemia. Yet there is good news coming in the battle against leukemia as well as against Non-Hodgkin lymphomas. One of the first cellular immunotherapies is about to hit the market, and early results suggest these diseases, even in advanced stages, may be curable. Chimeric antigen receptor (CAR) T-cell therapies represent a type of immunotherapy where a patient’s immune system T-cells are removed and genetically reprogrammed to seek and destroy tumor cells. They seek out antigens, multiply, and attack and kill the foreign cancer cells, then often stick around to minimize chances of relapse. Results of these cellular immunotherapies have been impressive. Some studies focusing on acute lymphoblastic leukemia (ALL) have reported a remission rate of 90 percent. Cellular immunotherapy could one day replace chemotherapy and its lifetime of side effects.

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4 Liquid Biopsises to Find Circulating Tumot DNA
Oncologists have long dreamed of avoiding the subjective nature of reported signs and the hit-or-miss nature of biopsies. Their dreams may be coming true. Tests known as “liquid biopsies” uncover signs of actual DNA, or cell-free circulating tumor DNA (ctDNA), which is shed from a tumor into the bloodstream. The advantage is that ctDNA is more than 100 times more abundant in the blood than tumor cells. The market is adjusting to make way for this revolutionary cancer test. Annual sales are forecast to be $10 billion, and several companies are developing testing kits to hit the market this year. Liquid biopsy is being hailed as a flagship technology of the federal government’s Cancer Moonshot Initiative. Experts believe it’s only a matter of time before catching and treating cancer is as routine as your annual checkup.

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5 Automated Car Safety Features & Driverless Capabilities
With 38,300 fatal car crashes in 2015, automobile accidents remain a leading cause of death and disability, with medical costs totaling nearly $23 billion nationwide. Innovators believe these types of numbers can be wiped off the books for good. New, automatic safety features promise to make a dent in dangerous car accidents. These range from collision warning systems to drowsiness alerts to adaptive cruise control. Safety technology is expected to surge in 2017, a year before the Department of Transportation mandates the inclusion of backup cameras in all cars. Meanwhile, there is a grander notion to remove all human error from vehicle transportation. The nation’s biggest software, private transportation, and auto manufacturing companies are making huge investments into driverless cars. Safety and legal questions remain, but 2017 is expected to be the year that driverless cars take a spin into the mainstream.

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6 Fast Healthcare Interoperability Resources
The inefficiencies of doctors’ appointments and hospital stays have been the butt of jokes for decades. While sorting through bills or waiting on hold with insurance companies, patients are likely to ask, “Why can’t these offices talk with each other?” or “Why can’t the machines in the same hospital talk to each other?” Digital interoperability is complex in healthcare, which must weigh privacy, security and accuracy concerns. But 2017 marks the year we finally make sense of the tangled web. FHIR (Fast Healthcare Interoperability Resources) is a new tool soon to be released by an international committee called HL7. It will essentially function as an interpreter between two healthcare systems or offices that have developed their own languages. The first release will focus on clinical data, like images and medications, while the second will focus on administrative data, like billing and demographics. There are huge implications for healthcare. Innovators and entrepreneurs everywhere can finally take a crack at building smart, data-driven technologies that can be built to a FHIR standard, allowing new technologies to be adopted anywhere. FHIR not only marks a potential end of the frustration, it paves the way for a surge of lifesaving health information technology.

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7 Ketamine for Treatment-Resistant Depression
A loss of hope is a classic symptom of depression. Drugs and therapies have been developed to help balance or trigger serotonin, norepinephrine and other neurotransmitters. But for one-third of depressed patients, the medications don’t really work. Alternatives include electroconvulsive therapy or other intensive treatment options. Too often, the last resort is suicide. In 2013, ketamine, a drug commonly used for anesthesia was studied for its ability to target and inhibit the action of N-Methyl-D-aspartate (“NMDA”) receptors of nerve cells. The results were overwhelmingly favorable. Initial studies indicated that 70 percent of Treatment-Resistant-Depression (“TRD”) patients saw an improvement in symptoms within 24 hours of being injected with a low dose of ketamine. For the first time, there was a fast treatment for the severely depressed. The studies triggered the FDA to grant Fast Track Status to the development of a new NMDA-receptor-targeting medications based on the ketamine profile. Some, like esketamine, received breakthrough status from the FDA, enhancing the probability that these new drugs will be available to patients in 2017. With nearly 43,000 suicides a year in the U.S., the need for effective treatment looms large. In the medical community, hope has never been higher.

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8 3-D Visualization & Augmented Reality for Surgery
For years, surgeons have relied on microscope oculars or other camera systems to operate. Even so, they typically depend on their own eyes and interpretations to execute the most precise of tasks with their heads down, peripheral vision limited, back and neck muscles strained. This past year, two of the most intricate surgical practices, ophthalmology and neurology, began experimenting with technology that keeps surgeons’ heads up while immersing them in a high resolution, 3D visual representations of their subject. These stereoscopic systems also use data to generate visual templates for surgeons to execute certain tasks within a surgery. Experts and surgeons who have piloted the technology say the added comfort and visual information allow surgeons to operate more efficiently and effectively. Plus, medical residents have a clearer picture of what the surgeon is seeing and doing. Along the same lines, software companies are building augmented reality glasses that display holographic images of human anatomy. Medical schools see the end of cadaver labs. While the market is still growing and imaginations running wild, several hospitals will be adopting virtual reality tools in 2017, pushing the boundaries of surgical reality.

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9 Self-administered HPV Test
In the mountains of Ecuador, over the rough terrain of Tanzania, or even in the rural communities in the US, there are women at significant risk of dying of cervical cancer and have no idea. Most sexually active woman contract the Human Papilloma Virus (HPV). Certain strains of HPV are responsible for 99 percent of cases of cervical cancer, the most common malignancy in women 35 years and younger. Despite great strides in HPV prevention and treatment, the benefits are restricted to a narrow population—-women with access to HPV tests and vaccines. In 2017, an ambitious approach to expand the care will be launched. Scientists have developed self-administered HPV test kits that include a test tube, a swab, and a mail-in box. Women can administer their own test, mail a sample back to a lab and be alerted to dangerous strains of HPV. Cervical cancer prevention is a “Millennium Development Goal” of the United Nations. 2017 could be the year these tests are deployed on a large scale, representing the greatest prevention strategy for cervical cancer to date.

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10 Bioabsorbable Stents
Every year, 600,000 people have metal coronary stents put into their chests to treat coronary artery blockage. Most of the time, that stent stays there forever, long after its mission is complete. The stents may inhibit natural blood flow and cause other complications, like blood clots. What if they could just disappear? That is a long-sought goal researchers have finally met. This past July, the first bioabsorbable stent was approved in the United States. Made of a naturally dissolving polymer, the stent widens the clogged artery for two years before it is absorbed into the body in a manner similar to dissolvable sutures. The disappearing stent leaves behind a healthy natural artery. The patient is free to go off blood clotting medication and qualifies for a broader range of medical treatments. Only one version of an absorbable stent has been FDA approved but more are coming. Experts believe the market potential will approach $2 billion in six years. While the full impact of vanishing stents is yet to be seen, 2017 is the year the technology becomes a game changer.

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FOR MORE INFORMATION AND FOR INTERVIEWS WITH EXPERTS ON SPECIFIC INNOVATIONS, CONTACT ROBERT SMITH: 216-445-1991, SMITHR5@CCF.ORG

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Written by hsandm

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