Tag Archive for: spleen size

What Is the Role of AI in Telemedicine for MPNs?

What Is the Role of Artificial Intelligence (AI) in Telemedicine for MPNs? from Patient Empowerment Network on Vimeo.

How does artificial intelligence (AI) fit into the myeloproliferative neoplasm (MPN) care toolbox? Dr. Kristen Pettit from Rogel Cancer Center explains the current role of AI, her hopes for the future of MPN care, and what she considers the ideal model for MPN care.

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Transcript:

Dr. Kristen Pettit:

I think the role of artificial intelligence and telemedicine in MPN fields is going to be evolving over the next few years. I think one thing that will be very interesting that I’m very interested in seeing is whether we’re able to incorporate things like data from wearable devices, for example, like your Apple Watch or those sorts of devices directly into your healthcare to be able to monitor you on a more continuous basis and virtually, I think more things of that nature will be coming over the next couple of years.

I think that incorporating telemedicine into MPN monitoring is a relatively safe thing to do for most patients, very rarely things will come up in an in-person visit that might not have been reported or caught on a telemedicine visit, for example, slight changes in spleen size that we may be able to feel in the office that might not be symptomatic to the patient at home or might not be noticed at home could happen. Other things like weight loss that a person might not necessarily have noticed at home, but that we would hopefully pick up on it.

An office visit might be another thing to think about, but both of these situations, I think are relatively uncommon, I think the most important thing is for a patient and their family members to know their body, know their symptoms, keep an eye out for any changes, while they’re at home, and as long as that’s being done, really, I think telemedicine is relatively safe to incorporate in MPN care. Ideally, I think that would be done sort of intermittently or alternating between virtual visits and in-person visits with an individual patient.

Should MPN Patients and Their Families Continue Telemedicine?

Should MPN Patients and Their Families Continue Telemedicine? from Patient Empowerment Network on Vimeo.

Can myeloproliferative neoplasm (MPN) patients still get value from telemedicine? Dr. Kristen Pettit from Rogel Cancer Center explains some of the pros and cons of telemedicine visits and ways to optimize MPN patient care.

See More From the MPN TelemEDucation Resource Center

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What Is the Role of Artificial Intelligence (AI) in Telemedicine for MPN

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Transcript:

Dr. Kristen Pettit:

I think telemedicine has been one of the few good things to come out of the COVID era. There are pros and cons, certainly, some pros are that patients can have increased access to their physicians and their medical teams, particularly the MPN specialty centers that might not be right in their backyard. It’s great, it’s a great way to be able to stay in touch with an MPN specialist.

The less travel, less waiting in a waiting room. Those are all great things, the cons, the downsides to keep in mind are that virtually we can’t feel for spleens, so it’s difficult to tell if the spleen is starting to get enlarged. There can also be some logistical challenges getting blood counts drawn and interpreted before a telehealth visit. But with those minor challenges, I think telemedicine is here to stay, and I think it’s an important part of the care for patients with MPNs. 

Remote monitoring is very important for patients with MPNs, really the most important thing, in my opinion, for patients with MPNs being monitored over time is for them to keep an eye on their symptoms over time, watching for any changes in their bodies that they may feel as far as their spleens feeling more enlarged or feeling more full, or losing weight unexpectedly, feeling more fatigued, any of their MPN symptoms getting worse. All of those are easy to monitor at home, virtually, and to report back to your physician over telehealth or at routine visits.

MPN Patient and Care Partner Tips for Utilizing Telemedicine

MPN Patient and Care Partner Tips for Utilizing Telemedicine from Patient Empowerment Network on Vimeo.

Myelofibrosis patient Summer Golden and care partner Jeff Bushnell have learned the ins and outs of telemedicine. Watch as they share some advantages of virtual visits, instances when in-person visits are used for MPN monitoring, and their tips for optimizing telemedicine visits.

See More From the MPN TelemEDucation Resource Center

Related Resource:


Transcript:

Jeff Bushnell:

We are very fortunate to live in San Diego here where there are major medical centers and research universities and so on, but a lot of people aren’t… and these MPNs are very, very rare diseases. And there are not a lot of doctors that specialize in them, so telemedicine will allow you to contact a specialist.

I know when we see the Summer’s doctor in-person, she does a physical exam specifically to check her spleen size, which is an important aspect of almost all of these MPNs and without the ability to do that the doctor is working all solely from blood counts.

Summer Golden:

It’s just like Zoom, it’ll never go away, and I do believe telemedicine will be here forever, another technical advantage.

Jeff Bushnell:

I think, especially after COVID, people are more used to telemedicine, and in the MPN community anyway, because of the lack of large numbers of doctors that know much about it, like telemedicine will open up sort of a new, a new type of being able to treat MPNs, just because more people will be able to contact specialists.

Summer Golden:

A top tip I think, it’s sort of logical, but is to have the questions and issues written out because it’s a limited matter of time and to specifically jot down the answers.

Jeff Bushnell:

Another tip would be to ensure that you have the appropriate stuff on whatever device you’re using to talk to the doctor on. We’ve used about three or four different apps as it were on our phone to communicate with different doctors, and you need to make sure that that works ahead of time. Usually, the way they do it is they set up the appointment, they contact you ahead of time, and make sure that it’s going to work before they put the doctor online. But that’s very important that you have the technical ability to ensure that your equipment can support telemedicine. They’re making it pretty easy, but you still have to do it.

How Is MPN Treatment Effectiveness Monitored?

How Is MPN Treatment Effectiveness Monitored? from Patient Empowerment Network on Vimeo.

How is the effectiveness of MPN treatment determined? Dr. Naveen Pemmaraju describes key factors to monitor treatment effectiveness to ensure optimal patient care and to determine when it may be time to consider a change in therapy.

Dr. Naveen Pemmaraju is Director of the Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) Program in the Department of Leukemia at The University of Texas MD Anderson Cancer Center. Learn more about Dr. Pemmaraju, here.

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Transcript

Katherine Banwell:

Once on therapy, how is the disease monitored and how do you know if the treatment is working?

Dr. Pemmaraju:         

So, it differs from each disease, but let’s take polycythemia vera for a good example. So, let’s suppose you have polycythemia vera. I think there’s three markers here that you can check. One is the blood counts, right?

So, you want to make sure that the blood counts are controlled. New England Journal, five or six years ago now, our Italian colleagues published a very seminal paper which shows that the goal of therapy should be that the hematocrit should be below 45. So, that’s actually a very nice number to have. So, not just waiting for symptoms of the disease but keep the number low. And if you do that, that correlates with decreased cardiac events, thromboembolic events.

Number two, I think that, besides the blood count, the spleen. The spleen and liver size also is a nice surrogate for how the disease is doing. So, if that’s enlarging or getting out of control, that may be time to stop what you’re doing, reassess. The disease may be progressing to myelofibrosis, for example.

And then I think, lastly, the absence of stuff actually helps, too. So, the absence of major bleeding, the absence of blood clots, the absence of transformation to MF. I think if the quality of life is good, you’re decreasing blood clots and bleeding, you’re not going to a more advanced disease state, these are all wins for us with P vera.

Katherine Banwell:    

You touched on this briefly, but I’m wondering when a patient should consider changing treatments.

Dr. Pemmaraju:      

Yeah, changing treatments is more art than science, I would say. So, it does – that’s one of those that is kind of specific from patient to patient. In general, what we just talked about gives you that guidance. So, in polycythemia vera, since we brought that up earlier, uncontrolled blood counts despite maximum medication intervention, the phlebotomy requirement being untoward and impossible to keep up with, the spleen size growing out of control, the quality of life being impossible – these are some aspects to look into changing therapy and/or clinical trial.

But remember, it’s not a one-size-fits-all, right? So, some patients, the counts – some of these things may or may not actually play out. So, it has to be more of a gestalt, more of a total picture there.