How artificial intelligence is changing health care in treating stroke victims

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I am a neurosurgeon who specializes in the treatment of acute strokes, brain bleeds, and tumors.  Every second counts for my patients, and I am determined to help as many as I can.

This Thanksgiving dinner, I left my family to operate on a patient with a life-threatening stroke. This is what you need to know about strokes and how artificial intelligence is helping surgeons like me save even more patients.

Stroke is one of the leading causes of morbidity and mortality worldwide and has remained a formidable challenge in the realm of health care. 

WHAT IS ARTIFICIAL INTELLIGENCE (AI)?

Not only does stroke rob us of our loved ones and shatter families, the impact of stroke from a socioeconomic perspective is also staggering. The CDC estimates that between 2018 and 2019, the economic burden of stroke in the U.S. rose to approximately $56.5 billion. 

I have witnessed many advances in the diagnosis and treatment of patients with stroke with glacial progress over the years. However, with the advent of artificial intelligence (AI), we have a new powerful ally.  

Many of the AI tools physicians employ have drastically improved the fight against stroke, yet there is no substitute for the human element.

“Time is brain” is the rallying cry for health care teams treating stroke victims. It is not coincidence that we use the acronym FAST, which stands for Face drooping, Arm/leg weakness, Speech difficulty, and Time to remind people of the signs of a stroke and to seek immediate medical assistance. 

When I received the emergency stroke call this Thanksgiving, I sprang into action and left my home in a flurry, passing the baton of turkey carving to my eldest son. Why the urgency? Because early intervention is crucial for patient outcomes. 

While Thanksgiving dinner is my favorite family tradition, this patient needed help fast. Within minutes, the team and I brought the patient to the operating room to restore blood flow to his brain. His symptoms began to improve immediately.

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By coupling what we have already learned and developed, AI algorithms have demonstrated remarkable capabilities in expediting successful treatment. AI can analyze brain scans, such as computed tomography (CT) to not only detect the presence of a stroke but also classify its type. 

The ability to make such critical differentiations helps guide physicians and nurses to select the most appropriate course of action, whether it be administering clot-busting medications, performing a lifesaving intervention by retrieving the blood clot out of vessels, or preparing for open brain surgery.

F.A.S.T.

Moreover, AI assists in predicting the response to these specific interventions. This level of precision marks a significant departure from the one-size-fits-all approach, heralding a new era in stroke care where treatments are as unique as the patients themselves. This means, unfortunately, there are times I need to discuss with families that despite all our current neurosurgical advances, there are no effective interventions to be offered.

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While there is no question that AI has propelled effective treatment for patients with stroke, there are certainly some limitations. It is not uncommon that given constraints of medical imaging, the AI algorithm may interpret the data incorrectly.  

Not only have I been involved in cases where AI has indicated surgery should be performed when objectively there was nothing to operate upon, the opposite scenario also arises. It is a precarious situation to call a team for emergency surgery when the AI platform instructs no intervention is required. 

As a neurosurgeon, I am too familiar with the anxiety created when AI recommends no intervention, yet surgery is the best chance of salvation for the patient. Imagine the captain of a large commercial airplane performing an emergency maneuver against the recommendations of the flight AI, knowing that hundreds of passengers’ lives onboard hang in the balance. Decades of training and experience along with the degree of self-assurance required for these moments is surreal.

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Ethical considerations surrounding patient privacy and data security from using AI algorithms also require careful attention. Many of the AI platforms used in the treatment of acute stroke require a third-party software program outside of the hospital.  

In this world of malicious cyber-attacks committed against hospitals by terrorists aiming for financial gain, it is essential that patient data transfer is completely protected. Ensuring responsible use of AI in stroke care is essential.

The synergy between AI and physicians, nurses and physical therapists involved in stroke care is poised for further advancements. I am personally excited to witness how AI technologies become more integrated into the health care ecosystem, and how AI can facilitate, not replace, the human element. 

We must remember that, at the end of the day, we are humans treating other humans, not simply programs analyzing algorithmic equations.

Before I left my home on this Thanksgiving to treat the patient suffering a stroke, I reminded my boys that while I needed to leave, I would come home. And as promised, I returned home late in the evening. My boys and my wife sat with me and together we enjoyed a wonderful dinner. Once again, I was thankful for my beautiful, healthy family. 

CLICK HERE TO READ MORE FROM DR. PAUL SAPHIER

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