Traditional medicine has been using vital signs as tools for guidance in clinical decision making. With the development of precision medicine, we have recognised the need for the usage of genetic / molecular and other lab-related specific biomarkers and of course, digital biomarkers.
As the defying force against the one-solution-fits-all pragmatism in medicine, precision medicine was created and has been expanding as a standard in several specialties.
Precision medicine is described as the medical care created with the principle of customisation of medical practice, decision making and treatment. Generally using tools such as genetics, molecular diagnostics, imaging and analytics, with or without artificial intelligence, precision medicine continues to add value to modern medicine.
This innovative type of medical care is, therefore, using accurate medical information in the form of biomarkers, including molecular, genetic and other lab-related markers, which are key to its further development.
In recent years, due to the broader usage of analytic solutions, algorithms, artificial intelligence and machine learning, and the increased patient data acquisition opportunities, precision medicine has been granted the usage of another type of biomarkers, created from data itself, these markers are known as digital biomarkers.
Digital biomarkers are a new type of data-package that can cover several use cases in medicine with considerable precision, allowing the medical decision-making to be data-driven.
These analysed pieces of data have to be quantifiable and objective. These two qualities allow these data packages to give us precise information about the onset of a specific disease, the worsening or regression of a crisis or exacerbation, the efficacy or effect of a pharmacologic treatment, among other possible, objective, feedback.
It is not enough to have a precise, quantifiable and objective piece of information related to a medical condition or usage, the challenge of digital biomarkers is finding a real medical relevance that convinces Doctors of using them as tools in the day-to-day medical duties.
As an example of the challenges ahead in terms of the usage of Digital Biomarkers in medicine, we could mention the expectations in wearable devices and PPG (Photoplethysmography) data related to atrial fibrillation and its impact in population outcomes.
The grounds have been explored several times, we can cite this article from a team of researchers in biomedical engineering from the University Hospital Bern in Switzerland, in their article, they explore the opportunities of using contact free and wearable sensors as new digital biomarkers for cardiovascular diseases.
Knowing of the existence of this opportunity, many companies, such as Fitbit or Apple, have tried to use the momentum to introduce their biomarker into conventional cardiology.
However, as this article mentions, the technology and the usage of the biomarker, doesn’t yet fit the conventional clinical needs of cardiologists.
In juxtaposition, the usage of artificial intelligence and voice recognition (or speech recognition) has been developing interesting tools that are being welcomes by psychologists and psychiatrists, this opening to the usage of such tools by these professionals can be explained mostly because of the lack of molecular (or more established) biomarkers in such fields.
The market readiness is not yet complete in some specialties, but digital biomarkers are starting to revolutionise certain modalities that will provide patients better quality of life.
In a world that continues to look towards precision medicine as the right approach in clinical medicine, digital biomarkers have and will continue to have a special place in the development of medical solutions, from screening to diagnostics, from treatment to chronic monitoring.
The usage of digital biomarkers will be decided by doctors readiness. Digital biomarkers based on accepted medical information sources (such as ECG, EEG, Continuous Blood Preasure and so on) will have an easier fit in clinical medicine for the years to come and will open the door to the next batch of digital biomarkers.
The future of medicine is precision-based, tailored according to each patient, their physiology, gender, ethnicity, genetics and so on. Building technology for everyone means building for each one of us, in an individualised, precise way.
