Medical Tests & Procedures Archive

Machine learning may improve the way doctors detect heart disease.

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Imagine a world in which a photo of your eye — taken with your smartphone — could determine your risk of a heart attack, and your smartwatch could estimate your odds of experiencing a stroke. Sounds pretty futuristic, right?

In fact, preliminary studies showing the feasibility of both approaches have already been published. They're just two examples of the new wave of technology-based innovations (see "Transformative technologies") that are beginning to change health care as we know it.

Ask the doctor

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Q. I understand there's a genetic test that can tell you how well you might respond to antiplatelet drugs. Do you recommend this test?

A. The short answer is no, not yet. For now, I think it is best to wait for the results from studies looking at personalized antiplatelet therapy. Also known as tailored medical therapy, personalized therapy refers to treatments that are based on your own information, including genetics. But first, I will address two other relevant questions: (1) what is antiplatelet therapy, and (2) who needs it?

On call

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Q. I have recently been hearing a lot about getting tested for hepatitis C. I don't think I have any risk factors, but is this something I should consider?

A. Hepatitis C is a viral disease that causes inflammation of the liver. The CDC reports that 75% of all current cases of hepatitis C are in the baby boomer generation and many more are undiagnosed. The reason is that a vast majority of people have no symptoms, such as fatigue, muscle and joint pain, abdominal pain, and nausea.

Remember to take care of your hearing, like any other aspect of your health.

When you plan your next series of maintenance health tests, don't forget your ears. An ear and hearing exam is not something that needs to be done every year, but you should be aware of changes that could signal serious problems.

"At the very least, a baseline evaluation can help, so you can monitor changes if your hearing declines," says Dr. Stephen W. Hill, an audiologist at Harvard-affiliated Massachusetts Eye & Ear.

In the journals

Only a biopsy can determine for certain whether prostate cancer is present, but a new study suggests that using magnetic resonance imaging (MRI) can help to better identify patients who are more likely to need a biopsy versus those who aren't.

The study, published online Feb. 22, 2018, by JAMA Oncology included 651 men screened for prostate cancer with blood tests and digital rectal exams. Everyone underwent three procedures: an MRI scan, a biopsy guided by transrectal ultrasound (TRUS), and a biopsy guided by both MRI and TRUS.

But surveillance and other strategies — especially exercise — can limit the risk.

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Better treatments for breast cancer have contributed to the growing number of breast cancer survivors, now about three million in the United States. However, these women may face a heightened risk of heart disease from the cardiotoxic effects of chemotherapy and radiation, according to a statement from the American Heart Association in the Feb. 20, 2018, issue of Circulation.

Doctors have long known that certain cancer drugs can decrease the heart's pumping ability, especially doxorubicin (Adriamycin) and trastuzumab (Herceptin), two common treatments for breast cancer. Many women receive radiation therapy as well, which can cause heart tissue to scar or stiffen, possibly leading to valve disorders, coronary artery disease, or other heart problems. But specialists who focus on keeping the heart healthy during and after cancer treatment — known as cardio-oncologists — can offer strategies to both prevent and treat heart damage from cancer therapy.

Telomeres — made of your DNA — are biomarkers of aging.

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There's no crystal ball in medicine that can predict how fast you're aging or how long you'll live. But the latest trend in private screening tests claims to provide a tantalizing clue. The tests offer a snapshot of the length of your telomeres — the protective caps at the ends of chromosomes in your cells.

"The concept is very attractive. There's this visual idea of something acting like a clock counting down to the end, and that's why it's powerful. The problem is that just because it's appealing it doesn't mean it's true," says Dr. William Hahn, a Harvard Medical School professor and chief research strategy officer at Harvard-affiliated Dana-Farber Cancer Institute.

Catheter ablation, a procedure that destroys faulty electrical pathways in the heart, is gaining ground.

Atrial fibrillation — called afib for short — is a rapid, irregular heartbeat caused by errant electrical signals in the heart's upper chambers (atria). This heart rhythm disorder becomes more prevalent with age, affecting about one in 11 people ages 65 and older.

The chaotic heartbeat that characterizes afib usually comes and goes and may last anywhere from a few seconds to many hours — or much longer (see "Atrial fibrillation: Defined by its duration"). Although about 20% of people with afib don't notice any symptoms, it can trigger a range of unsettling problems. These include a fluttering or thumping sensation in the chest, breathlessness, dizziness, anxiety, weakness, fainting, confusion, and fatigue.

Research we're watching

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Your doctor may one day be able to use a simple blood test to find out if you have cancer. Researchers from Johns Hopkins University reported in the January 19 issue of Science that they have developed a blood test that can spot early signs of cancer.

The researchers screened blood for DNA and proteins related to eight different types of cancer. They were able to identify early cancers from more than 1,000 patients with different types of cancer that had not yet spread. Over all, the test found 33% to 98% of cancers, depending on tumor type.