Harward medical school Archives - InnoHEALTH magazine

World’s First AI powered Ayurveda Protocol

InnoHEALTH Magazine — Wed, 26 Dec 2018 08:24:41 +0000

World’s First AI-powered Ayurveda Protocol launched in India; prospects of its linkage of AYUSH grid brighten up

Boarding a wobbly roadways bus, a dhoti-kurta clad young man, with protuberant vermillion dash on forehead, used to head for mythological twin city of Mathura and Vrindavan in Uttar Pradesh, clutching tightly his voluminous bag, stuffed with Ayurvedic medicines in tiny folded paper pouches for distribution to patients at ISKON center every weekend in early nineties.

But, recently, sporting a brick colored shirt and creamy Nehru jacket and matching black tight trousers, Ayurveda medicines practitioner Dr. Partap Chauhan unveiled world’s first Artificial Intelligence (AI) powered protocols modeled on the basis of a mind-boggling database of patients and their successful cure.

Moved by the protocols’ apparent efficacy, India’s AYUSH Secretary, Dr. Vaidya Rajesh Kotecha, has minced no words for exploration of a possibility to have a link of the protocols with the Ministry’s recently floated grid for the popularization of India’s traditional medicines at international fora.

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The world over, he said, moves are underway to reduce the cost of quality treatment. Recently, Amazon, Berkshire Hathaway, and JP Morgan have announced a company with an Indian American Dr. Atul Gawande as its CEO to work out healthcare of US employees. It might be typical of disrupting the healthcare industry whale cost, a conundrum is raging madly. The new company will be headquartered in Boston and will operate as an independent entity that is free from profit-making incentives and constraints.

Dr. Gawande is a globally-renowned surgeon, writer, and public health innovator. He practices general and endocrine surgery at Brigham and Women’s Hospital and is a Professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School.

“I’m thrilled to be named CEO of this healthcare initiative,” said Dr. Gawande, “I have devoted my public health career to building scalable solutions for better healthcare delivery that are saving lives, reducing suffering, and eliminating wasteful spending both in the US and across the world”. This work will take time but must be done. The system is broken, and better is possible.”

He is the Founding Executive Director of the health systems innovation center, Ariadne Labs. He also is a staff writer for the New Yorker magazine, has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and Being Mortal, and has received numerous awards for his contributions to science and healthcare.

“Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should”. Says Dr. Gawande in his book “Being Mortal”.

Dr. Kotecha envisions Indian traditional medicines’ colossal potential in ensuring cheap and best treatment and country’s values, coupled with such medicines, have answers of all these emerging challenges. He spoke briefly about the “Being Mortal” book and the newly formed company.

The AYUSH Secretary was of the view that Indian traditional medicines should be included in ICD -11 as Chinese medicines have entered the classification already. The International Classification of Diseases (ICD) is the international “standard diagnostic tool for epidemiology, health management, and clinical purposes.” Its full official name is International Statistical Classification of Diseases and Related Health Problems and is maintained by WHO.

Amid these developments, the protocols have been framed. Dr. Partap Chauhan, Director Jiva Ayurveda, narrated his arduous journey and said India’s traditional medicines efficacy was being recognized the world over, and his protocol would help according to it a scientific explanation on various parameters.

He had started his journey from a small dispensary in a garage in Haryana in 1992, and now a globetrotter is interacting with world-famous universities for deeper scientific researches on country’s 5000 years old traditional medicines.

The personalized treatment syndrome is catching up and researchers are underway on how to promote personalized treatment for more accuracy. He said the World’s first Diagnostic Protocols for Ayurveda would turn this ancient healing tradition into a data-and evidence-driven system of medicine and JIVA Health App.

These protocols, meant to standardize the practice of Ayurveda, have taken four years to develop after analyzing the consultation records of more than two lakh patients; the protocols have been successfully run on 20,000 patients till now, with dramatic results. This system will create a wealth of data and evidence that will go on to validate Ayurveda as a legitimate science of treatment, boosting its acceptability worldwide. The JIVA health app will provide authentic and actionable health and wellness information with content exclusively curated by Dr. Partap Chauhan.

JIVA group President Rishi Pal Chauhan has said the JIVA’s unique protocols are like an operating system for Ayurveda practice that structures the practice of Ayurveda and creates the wealth of data. It is well known that unlike Allopathy, which is focused on symptoms and standardized drug choices, Ayurveda is fundamentally a personalized system of medicine.

Even though thousands of years old, this traditional system of healing, conceptually, is a far more evolved science. For instance, personalized medicine (based on genomics) and the “systems view” of human health is only now beginning to come into fashion in allopathy, when Ayurveda has been built around these very concepts.

The reason is that the scientific community asks for data and evidence – on what basis are the medicines given and how is their effect proven? This data and evidence Ayurveda does not have. The big question is: “How do you standardize a system of medicine that is fundamentally personalized, with patients being given different treatment based on the root cause, even if the symptoms are the same?”

This is the challenge of mapping intuitive Eastern systems of medicine over objective Western frameworks. Data Analysis of Consultation Records of two lakh patients four years ago, Jiva Ayurveda began a huge data analytics project, reviewing the consultation records of two lakh patients that its doctors had treated over the decades.

After analysis, running into thousands of hours using artificial intelligence, machine learning, and computer modeling, the Jiva analysts concluded that while the Ayurveda treatment cannot be standardized for every patient, Ayurveda practice can surely be standardized. In other words, the way Ayurveda practitioners diagnose patients can be standardized by laying down definite protocols. This methodology currently exists only in the mind of the Ayurveda practitioner and each arrives at the diagnosis in his own way. The result of this is that no consistent data can be generated, and the methodology cannot be validated. And so began at JIVA the painstaking process of writing diagnostic protocols around the practice of Ayurveda by scanning the consultation records of lakhs of patients.

India’s first-ever Protocols for Ayurveda: the protocols that have been created over the last four years by Jiva. These protocols, and the decision support system built over them, help Ayurveda practitioners anywhere in the world arrive at the correct diagnosis in a data-driven way. The system also categorizes the diseases in terms of severity, which has a direct bearing on prognosis. As the consultation protocol flows, based on patient answers, the system starts assigning weights to different diagnostic possibilities and makes calculations to arrive at an authoritative diagnosis. It helps avoid judgmental errors and the cost of the wrong diagnosis. It also suggests diagnostic clues that the doctor may have missed which may lead to a possible different line of treatment.

Narrating all these, Dr. Chauhan says these protocols to standardize the practice of Ayurveda, the first-ever to be attempted in India, signal a revolutionary shift. They are akin to Ayurveda’s operating system that is accessible to everybody. This system will create a wealth of data and evidence that will eventually go on to validate Ayurveda as a legitimate science of treatment, boosting its acceptability worldwide. The protocols have been run successfully on 20,000 patients so far, with dramatic results. Three international universities are collaborating with JIVA to validate this data.

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Rotating night shifts may trigger Type 2 diabetes

InnoHEALTH Magazine — Mon, 07 May 2018 09:16:00 +0000

If you work periodically on night shifts, it is more likely that you may develop Type 2 diabetics than those who only work during days.

A study of more than 270,000 people, published online recently in the journal Diabetes Care, also found that the more nights employees work, the greater their odds of having the disease, whether they are genetically predisposed to it or not.Healthcare workers, security guards and other employees who periodically work the night shift are significantly more likely to have Type 2 diabetes than workers who work only days, according to a sweeping new study by researchers from CU Boulder and Brigham and Women’s Hospital (BWH) in Boston.

“Work, particularly night shifts, disrupts social and biological rhythms, as well as sleep, and has been suggested to increase the risk of metabolic disorders, including Type 2 diabetes,” said co-first author Celine Vetter, Director of the Circadian and Sleep Epidemiology Laboratory ( CASEL) at CU Boulder. “Our study is one of the first to show a dose-response relationship, where the more often people work nights, the greater their likelihood of having the disease.”

About 15 million Americans work permanent night shifts, rotating shifts or shifts with irregular schedules. Recent studies have found associations between such shift work and cardiovascular disease, diabetes and cancer, but few have looked specifically at how different work schedule characteristics impact risk. For the study, Vetter worked along with co-first author Hassan S. Dashti and collaborators at BWH, the Broad Institute of MIT and Harvard, and Manchester University, to examine data from participants 38 to 71 years old in the UK Biobank.

Participants had provided detailed information on lifestyle, health status and present work schedule; 77,000 also provided in-depth lifetime employment information, and a subgroup of 44,000 provided genetic information. Participants also provided information about their “chronotype,” or whether they were a morning person or night person. Nearly 7,000 people had Type 2 diabetes.

The researchers found that those who worked irregular or rotating shifts that included night shifts were 44 percent more likely overall to have Type 2 diabetes than those who never worked nights. The odds of a person having diabetes rose with nights worked. For instance, those who worked eight or more night shifts per month were 36 percent more likely to have diabetes than day workers.

Notably, those who in their current schedule worked only at night showed no increased incidence of diabetes. This could be because those who tolerate nightshift work better tend to gravitate toward night jobs (permanent night-shift workers were twice as likely to have a “night owl” chronotype). But Vetter also notes that over time, some people may partially adapt to working nights. “If you rotate through a schedule that is always changing between day and night shifts it makes it hard to adapt and you can end up with a chronic misalignment between your lightdark cycle, your sleep-wake schedule, your meal timing, and your physical activity timing.”

Previous research at CU Boulder and by corresponding co-senior author Dr. Frank Scheer, director of the Medical Chronobiology Program and associate professor of medicine at Harvard Medical School, has shown that both sleepdebt and body-clock misalignment can impair glucose tolerance and insulin sensitivity—a precursor to diabetes.

Vetter notes that while people may not be able to avoid working nights, maintaining a healthy weight and diet, and taking care to get enough exercise and sleep, is likely to mitigate its health risks. This was the first study to look at the genetic predisposition to Type 2 diabetes and its potential modification by shift work, and more studies are needed to replicate those findings.

The authors hope that the research will also inform efforts by employers to help their workers be as healthy as possible.

“Our study findings represent another puzzle piece in this quest towards healthier work schedule design,” they conclude.

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