All articles by Amit Thadani
Amit Thadani
Put to the test
When it comes to accurate Covid-19 testing, PCR is the acronym on most people’s lips. It’s for a good reason – after all, the test earned the accolade of “gold standard” diagnostic by having the highest sensitivity and specificity in the marketplace. But the laboratories that process these tests weren’t prepared for the sort of volume the pandemic brought, and the reality for many has been at least a two-day wait to find out whether they’re Covid free. Peter Littlejohns looks at how diagnostic technology has developed in response to the pandemic and speaks to some of the innovators behind it to understand how we can be better prepared to control another wave.
Contactless care
The pandemic has been a challenge for health systems globally, including the dilemma of how to continue meeting the needs of patients with underlying conditions while ensuring safety. Chronic wounds require constant management and in-person treatment, raising the question: what has been the impact of Covid-19 on this essential service? Mae Losasso speaks to Dr Ammar Al Rubaiay, foot and ankle surgeon at North Shore Foot & Ankle Associates; Dr Alisha Oropallo, medical director of the Comprehensive Wound Healing Center and Hyperbarics at Northwell Health; and Kevin Keenahan, co-founder and CEO of Tissue Analytics, to find out about the telemedicine-based strategies that are changing the future of wound care.
Dressed for success
When choosing the most appropriate treatment for chronic wounds, healthcare professionals need to consider a range of different factors, including the nature and severity of the wound, ease of changing and removing the dressing, risk of infection and patient preference. Allie Anderson speaks to Alison Schofield, tissue viability team lead and clinical nurse specialist at North Lincolnshire and Goole NHS Foundation Trust, about how clinicians can ensure they make the right decision.
New blood
The almost total shutdown in invasive cancer diagnostics during the first wave of Covid-19 focused attention on the need for alternatives. Now, all eyes are turning to liquid biopsies. Tim Gunn talks to Naureen Starling, consultant medical oncologist at The Royal Marsden NHS Trust in London and a clinical senior lecturer at the Institute for Cancer Research, about how simple blood tests could save lives.
The invisible enemy
Where there’s a chronic wound, there’s probably a biofilm. Where there’s wound care, however, there isn’t necessarily a strategy for addressing it. Natalie Healey talks to Karen Ousey, professor of skin integrity at the University of Huddersfield, about the role of biofilms in interrupting wound healing, new diagnostic tools for detecting them, and the measures that practitioners can implement today.
Trust in the machine
Although AI diagnosis aids have made tangible differences to patient outcomes, recent technological developments in the operating room have focused more on manual dexterity than its mental equivalent. But, as deep learning gets wiser, it’s time to look at the limits and possibilities of our non-human assistants in the operating room. Mae Losasso considers what AI can and can’t do for surgeons with help from Ferdinando Rodriguez y Baena, co-director of the Hamlyn Centre of Robotics at Imperial College London.
High intensity
The equipment is the easy part. Beds are an important measure, but ICUs wouldn’t be needed at all if frames and mattresses alone saved lives. Unlike the people working around them, they don’t keep the system from toppling, nor will their shelter count for much if it does. Unfortunately, minds can’t be laundered like sheets. Sarah Graham asks Tim Cook, consultant in anaesthesia and intensive care medicine at Royal United Hospitals in Bath, UK, and Greg Martin, president of the US Society of Critical Care Medicine, about the impact of the pandemic on ICU doctors and nurses.
Personal touch
Given the heterogeneity of patients and the broad definition of conditions like acute respiratory distress syndrome and sepsis, precision medicine is as applicable in the ICU as anywhere else. Radhika Holmström speaks to Kiran Reddy of Beaumont Hospital, Dublin, Cecilia O’Kane, clinical professor at Queen’s University Belfast, and Imperial College London’s Anthony Gordon – authors of a recent review article on the topic – about how biomarkers can be used to identify subphenotypes of each condition and tailor treatment to improve patient outcomes.
True positives
When they work, Covid-19 tests are good for one yes or no question. If only deciding how to use them were so simple. Repeatedly, mass testing programmes using lateral flow tests have foundered on the risks of false negatives, but the more reliable PCR tests remain too costly to implement on a wide enough scale. Abi Millar speaks to Niraj Jha, co-founder of AI company NeuTigers, Timothy Plante from the University of Vermont and Melanie Ott, director of the Gladstone Institute of Virology, about using machine learning, wearables and even CRISPR to find a middle path out of the pandemic.
Time management
It’s been decades since developers realised workflows dominated by hours of repetitive pipetting were market opportunities for pipetting robots, but automation has not impacted all clinical laboratories equally. Now, as even complex, heterogeneous microbiology begins to reap the benefits, Isabel Ellis asks Felix Lenk, head of the SmartLab systems research group at TU Dresden, and Nate Ledeboer, medical director for clinical microbiology and molecular diagnostics at the Medical College of Wisconsin, how ‘total’ automation might reinvent laboratory medicine.