Each year, thousands of patients visit UPMC hospitals, outpatient centers and specialty and primary care offices – generating thousands of datasets in the process. Whether it’s demographic information, imaging, lab results, signs and symptoms, family histories or treatment outcomes, there are countless stories for the masses of de-identified data to tell – and physicians like Hemal Gada, M.D., president, UPMC Heart and Vascular Institute in Central Pa., are using artificial intelligence to unravel those narratives.  

“Applying machine learning and artificial intelligence to big datasets is a burgeoning field of medical research. In the next five years, we’ll use predictive modeling to precisely define the progression of diseases like cancer and heart disease,” Dr. Gada said.  

Certain geographic, demographic, cultural, genetic and generational factors contribute to how diseases develop, progress and affect our bodies. For example, the social and environmental factors that drive the development and progression of heart disease will vary between someone living in rural Appalachia and someone living in an urban or suburban environment.  

According to Dr. Gada, machine learning, a type of computer program, allows researchers to identify patterns in vast amounts of patient data. By identifying these trends in a specific subset of de-identified patient data from central Pennsylvania, Dr. Gada hopes to identify the precise factors that drive disease progression in the region – which could someday lead to specialized clinical trials and treatment approaches.  

Dr. Gada and his colleagues published a study in The American Journal of Cardiology that utilized this machine learning approach to understand more about the characteristics of the stages of aortic stenosis for people living in central Pennsylvania. Patients with this condition have a heart valve that doesn’t open fully, which reduces blood flow from the heart to the aorta and to the rest of the body. If left untreated, chest pain and shortness of breath can develop, along with a host of other cardiac challenges – including clotting, heart failure, and stroke.  

Historically, aortic stenosis patients have typically been assigned to three categories – mild, moderate, and severe. Severe patients typically undergo transcatheter aortic valve replacement (TAVR), but milder severity patients do not. Cardiologists have debated whether moderate aortic stenosis might benefit from a TAVR procedure due to their higher risk for poor outcomes. 

Using echocardiograms and patient data from more than 61,000 aortic stenosis (AS) patients at UPMC Heart and Vascular Institute in Central Pa, Dr. Gada and his colleagues developed an algorithm to study the medical histories of these patients over time — How long after diagnosis before they were readmitted to the hospital? What other co-occurring diseases did they have? What signs did the body give to signal that a poor outcome or hospital readmission could be imminent?  

The research team determined that moderate AS patients living in central Pennsylvania who have end-stage kidney disease or atrial fibrillation were at the highest risk for poor outcomes. According to Dr. Gada, these patients could need an intervention like the TAVR procedure, sooner rather than later.  

While these findings are intriguing, Dr. Gada said this research is hypothesis-generating, meaning it will lead to the development of clinical trials – some of which are already underway.  

Artificial intelligence-driven research often leads to more questions than it does answers, but the next time you’re at the doctor’s office and answering questions about your symptoms and health history, remember that you could shape the future of medicine simply by showing up and getting the care you need.  

“Your data, which is de-identified in the research process, is just one piece of a much larger puzzle,” Dr. Gada said. “This data doesn’t have to be stagnant; it can help us develop personalized approaches to medicine in our community and determine what health challenges the citizens of our region face. We’re just beginning to scratch the surface of how artificial intelligence can transform health care in central Pennsylvania.”   

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Donald Trump on Sunday used a speech in key swing state Pennsylvania to urge a “violent” police crackdown on crime in the United States, while his White House rival Kamala Harris emphasized the need for immigration reform at a rally in Nevada.

Pennsylvania is considered the most important of the seven toss-up states that will likely decide the November 5 presidential election, but Nevada is also one of the key battlegrounds.

The Republican former president and current candidate, who held a similar rally in swing state Wisconsin on Saturday, reprised his dark, racially charged message about an America crumbling under “invasion” by violent migrants and other criminals.

Recounting isolated – but widely publicized – incidents of thieves staging brazen daylight robberies of shops in major cities, Trump got a loud cheer when he said police should become “extraordinarily rough.”

Criminals, he said, “have to be taught” and this could be done “if you had one really violent day.”

“One rough hour – and I mean real rough – the word would get out and it would end immediately,” Trump said.

“The police aren’t allowed to do their job” because “the liberal left won’t let them.”

Harris, the vice president and Democratic candidate, addressed the “serious problems” of border security at a rally in Las Vegas later in the day, where she reeled off her usual stump speech, emphasizing the economy, health care and the need for immigration reform.

“As president, I will double the resources for the Department of Justice to go after the transnational cartels,” Harris said.

“We know Donald Trump won’t solve them. When he was president, he did nothing to fix our immigration system,” she added, calling for comprehensive reform but without offering details.

As on Saturday in Wisconsin, Trump spent much of his speech painting a picture of a failing United States, inundated by what he said was the “massive number of savage criminal aliens that Kamala Harris has allowed to invade.”

He claimed “terrorists are pouring into our country” and cited “a big prison in the Congo, in Africa,” as the source of “a lot of people” last week.

Insults

Anti-immigrant sentiment has been at the core of Trump’s appeal in economically depressed, majority-white parts of the country ever since his 2016 presidential victory, but the rhetoric is turning ever more extreme as election day nears.

Following record numbers of illegal border crossings earlier in President Joe Biden’s administration, a tightening of rules – to the consternation of immigrant rights and civil liberties groups – led to a plunge in numbers this year.

Crime, including murder, is also in steep decline nationwide, the FBI says.

Trump has long prided himself on his ability to coin insulting nicknames or slurs for his opponents and on Sunday, he repeated one that he aired on Saturday, calling Harris – a former top California prosecutor and US senator – “mentally impaired.”

“Crooked Joe Biden became mentally impaired. Sad. But lying Kamala Harris, honestly, I believe she was born that way,” Trump said to loud laughter from the crowd.

Harris did not address Trump’s comments during her rally in Vegas, instead focusing on her usual bread-and-butter issues – protecting access to abortion services and putting more money in the pockets of everyday Americans.

“When Congress passes a bill to restore reproductive freedom, as president of the United States, I will proudly sign it into law,” she told supporters.