To find out which breakthroughs are set to reshape healthcare in the coming year, Cleveland Clinic asked 100 of its top experts — people who focus on patient care very day — to offer insight.
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These are their answers, the top 10 innovations for 2014:
10. Targeted therapy for cancer
There’s new hope for people with chronic lymphocytic leukemia (CLL), a cancer responsible for 4,400 American deaths per year. After promising clinical trial results, the first-in-class oral drug ibrutinib is expected to be approved by the U.S. Food and Drug Administration for treatment of CLL. The drug targets malignant cells while sparing a patient’s immune system.
9. Heart risk through the gut
In 2013, researchers added a new biomarker to the hunt for heart disease: TMAO. Your body produces TMAO (trimethylamine N-oxide) when your gut bacteria digest choline, which is found in egg yolks, red meat and dairy products. Choline is thought to promote hardening of the arteries. TMAO provides an accurate screening tool for predicting future risks of heart attack, stroke and death.
8. Personal sedation station
Novel, personalized “sedation station” technology will allow healthcare professionals other than anesthesiologists to deliver the light sedation required for life-saving colonoscopies. The technology could help bring the nationwide cost of this crucial test down by an estimated $1 billion per year.
7. Hope for acute heart failure
Heart failure accounts for 55,000 deaths annually in the U.S. There had not been a major treatment breakthrough in two decades — until serelaxin. This synthetic version of a human hormone gained “breakthrough” status from the FDA in 2013. Serelaxin study results reported a 38 percent reduction in death rates after six months in patients with acute heart failure, compared with those who received standard therapy.
6. Fecal transplant restores balance
In fecal microbiota transplantation, doctors transfer a liquid suspension made from a healthy person’s fecal matter into a sick person’s colon. The goal is to restore bacterial balance and fight infections and diseases. This approach could become a primary therapy not only for treating deadly and difficult C.diff infection, but also for inflammatory bowel disease.
5. Decision support for smarter surgery
A new anesthesia management system helps surgeons, anesthesiologists, nurses and others make smarter decisions in the operating room. The system not only records everything that happens before, during and after surgery, it also has an alert system — inspired by technology used in jets — that highlights potential problems in real time.
4. Breakthrough for hepatitis C
Until 2011, there were no proven medicines for patients who didn’t respond to traditional therapy for hepatitis C. But two drugs, telaprevir and boceprevir, made the top 10 innovations list that year. Now, another — sofosbuvir, the first all-oral therapy — further expands the list of treatment options. The drug promises the highest cure rates ever, reduced treatment time and fewer side effects.
3. Device disrupts seizures
The seizures that come with epilepsy disrupt life — but a new neurological device can disrupt seizures. For patients with intractable epilepsy, in which treatment fails to control seizures, the experimental technology is especially promising. The surgically implanted device can detect triggers of an impending seizure and deliver short electrical pulses to interrupt them before symptoms occur.
2. Genomic tests for managing cancer
Genomic-based tests have brought a new age of cancer diagnosis and precision medicine. These tests analyze the genes in an individual’s tumor to predict how it will behave. Past tests have improved management of breast and colorectal cancers, and in 2013, the FDA approved a similar test for prostate cancer. The goal of these tests is to avoid aggressive treatment when it is not needed — and save lives when it is.
1. The bionic eye becomes reality
In the past, there was no effective treatment for late-stage retinitis pigmentosa (RP), a disease that causes most patients to be legally blind by age 40. A new technology featuring a retinal prosthesis — commonly called the “bionic eye” — changes everything. This technology does not restore complete vision. But it does allow people to detect light and dark in the environment and identify the location or movement of people and objects.