Virtual image of human heart with cardiogram

Heart failure has been in the news a lot lately. It used to be the disease of older people, but younger ones (40-50) are gaining. The negative trend for younger people is mostly related to lifestyle. For us older (and wiser?) people, nearly 10 percent of those over 65 are afflicted with some form of congestive heart failure (CHF). As a side note, my mother died from CHF. Inspired by memories of what she went through, I did some research on using home telemonitoring to prevent readmissions to the hospital, a phenomenon which, unfortunately, accompanies CHF. My doctoral dissertation about the research is here.

More than 25 million people around the world have CHF. It is a costly chronic disease. CHF has a variety of causes but it is usually the result of the heart being unable to pump blood effectively through the body. Detecting the disease early and efficiently can have a large impact on the total cost of healthcare. A lot of the cost is associated with tests. In the long run, I believe the solution will revolve around AI and data.

The good news is there is a growing amount of data. The introduction of Apple Watch and other mobile/wearable health devices are collecting continuous streams of data from millions of people. If the data is anonymized, meaning stripped of any personally identifiable information, and accumulated in publicly available databases, great progress can be made.

Medical research in Europe gives a clue as to the potential. If you read Robot Attitude: How Robots and Artificial Intelligence Will Make Our Lives Better, you know about artificial intelligence (AI). A subset of AI is machine learning (ML), which I explained in the book. One of the algorithms used in the field of ML is called convolutional neural networks (CNN). What the researchers have demonstrated with CNN is mind boggling. They have been able to identify CHF almost instantly by applying the algorithm to just one heartbeat from ECG data. The accuracy of the detection was measured across a very large database of known CHF patients and those without. The accuracy was 100%.

New Atlas, a nearly 20 year old technology website, reported,

Even more interesting is the possibility of wearable health monitoring devices being able to help doctors identify at-risk patients without having to examine them in clinical contexts. Using short ECG recordings to detect CHF, could pave the way for health wearables that constantly monitor patients in real-world conditions.

The research I have described was published in the journal Biomedical Signal Processing and Control and reported in New Atlas as “100% accurate AI detects heart failure from single heartbeat“.

I mentioned at the beginning of the article detecting CHF early and efficiently can have a large impact on the total cost of healthcare. In my opinion, AI tools are going to have a huge impact. Some studies have suggested the cost of unnecessary tests and procedures in American healthcare is as much as $1.5 trillion. Visit the waiting room at a Florida cardiology practice or a radiology imaging center and you will see rooms full of seniors waiting to get tests.

Consider the impact. If there are 50 million people without healthcare insurance or who are under-insured, and if the cost per year of their care would be $10,000 (the average for a Medicare patient), the cost to give them healthcare, would be $500 billion or just one third of the unnecessary cost. This does not include the cost of fraud, the billions spent on TV advertising which add no benefits to our health, the over-charging of medications, and other inefficiencies.

I am not suggesting we give free healthcare. I believe everyone should pay some fair portion of the cost, if possible. I am simply making the point the real problem with our healthcare system is not the insurance, who is in and who is out, etc. The #1 problem is the excessive cost of our healthcare compared to other developed countries. AI is coming to the rescue.

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Two topics I have gotten a lot of feedback on in the medical field have been arthritis and hearing impairment. Hearing can be impaired for various reasons. In my case, I vividly recall using a backpack leaf blower in November 1995 at our summer home in Pennsylvania. Hearing protectors were not as common then as now. After blowing leaves for a couple of hours, the leaf blower ran out of gas. When it stopped, both of my ears were ringing. They have been ringing ever since, 24×7. I have learned to live with the ringing, and annual hearing tests confirm I am able to hear adequately.

Another reason for hearing impairment is aging. An article published by The University of Rochester Medical Center (URMC) reported, “Hearing impairment has long been accepted as a fact of life for the aging population – an estimated 30 million Americans suffer from some degree of hearing loss.” Count me and most of my friends in.

I have written here about various technology solutions such as cochlear implants and advanced technology to replace conventional hearing aids. Another bright spot is the Apple Research app. In partnership with the University of Michigan, Apple is examining factors which impact hearing health. The Apple Hearing Health Study is the first of its kind to collect data over time in order to understand how everyday sound exposure can impact hearing. The study data will be shared with the World Health Organization (WHO) as a contribution toward its Make Listening Safe initiative.

An alternative to new electronic technology may turn out to be biological. Researchers at the University of Rochester Medical Center (URMC) Department of Neuroscience. In a new study published in the European Journal of Neuroscience, scientists have been able to regrow the sensory hair cells found in the cochlea. This critical part of the inner ear converts sound vibrations into electrical signals which enables us to hear.

Scientists have known for a long time other animals such as birds, frogs, and fish have been shown to have the ability to regenerate lost sensory hair cells. For some unknown reason, humans cannot perform this regeneration. However, researchers are now discovering it is possible to activate and proliferate stem cells to become new sensory hair cells.  Repairing hearing is a complex problem and requires a series of events at a cellular level, but researchers now believe it is possible.

Despite the complexity, the progress seems stunning to me. I visited an expert in tinnitus (from the leaf blower) at Yale some years ago. He said, “There is no cure and there never will be.” I am 100% certain he is dead wrong. The progress in all aspects of medical research is stunning. I have been saying for years the medical progress in the next ten years will exceed what has been accomplished in the last 100 years. I continue to believe this.

Source: Study Points to Possible New Therapy for Hearing Loss – Newsroom – University of Rochester Medical Center

I hope everyone had happy and healthy holidays with friends and family. I look forward to sharing stories in the weekly e-brief beginning next week. One of my goals this year is to expand readership of the e-brief. Feedback is very positive and I hope you agree it would be nice to share it with more people. I will be making some changes to the e-brief format to make it easier to share. Happy New Year!

Hobby Attitude is the one! The final tally came in with 63% of the votes for Hobby Attitude. I have started an outline for the book and will update you from time to time on my plans and progress. Thanks for your interest.

One of Elon Musk’s companies, Tesla, is on a roll. There have been many skeptics and short sellers of the Tesla stock. 2019 was predicted by many to be a disastrous year for Tesla, but it wasn’t. Shares of the electric-car maker have gained almost 30 percent year to date. The market capitalization of Tesla is $78 Billion, more than twice that of Ford. Model 3 consumer demand and profitability are looking good. When I first drove my wife’s Model 3, I was sure it would be a winner. It accelerates like a jack rabbit and has a range of more than 300 miles. The amazing thing about it is all the things it doesn’t have. No transmission. No fluids except for windshield wiper. No engine with hundreds of parts. No muffler or tailpipe. Etc. The profitability of a $50,000 Model 3 has got to be impressive. Analysts are now saying Tesla should easily make its target of between 360,000 and 400,000 vehicles for 2019. That would mean a 45 percent to 65 percent increase from last year.

Apple has now reached a market capitalization of $1.3 Trillion. Who would have thought Apple would become worth ten times the market cap of IBM?

The next Meet the Author event will be February 6 in Palm Coast, Florida. Additional author events will be held in Florida during the 1st quarter of 2020 and then more back in Connecticut in the Spring. The table below shows events scheduled so far. Details on upcoming events will follow.




May 15, 2020

1:00 PM

Founders Hall
193 Danbury Rd, Ridgefield, CT 06877

March 19, 2020

11:30 AM

AdventHealth Palm Coast Community Forum
60 Memorial Medical Pkwy
Palm Coast, FL 32164

February 14, 2020

8:30 AM

Senior Provider Information Network
2 Corporate Dr.
Palm Coast, FL

February 6, 2020

1:00 PM

Hammock Dunes Club
Palm Coast, FL
Private event: Request invite
Mail to [email protected]

November 14, 2019

1:00 PM

New Fairfield Senior Center
33 CT-37
New Fairfield, CT

October 9, 2019

5:30 PM

Crowne Plaza Hotel
18 Old Ridgebury Rd
Danbury, CT

August 29, 2019

5:30 PM

The Boiler Room
Hawley Silk Mill
8 Silk Mill Drive
Hawley, PA

The gift giving season is over but still a good time to buy books from the attitude series. All are available on Kindle and Paperback. Health Attitude and Election Attitude are available as Audible. Amazon now has two Series pages featuring “It’s All About Attitude”. The Kindle page is here and the paperback page is here. Take a look!

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