In Sweden, more than 18,000 people suffer an acute ischaemic stroke every year. With correct and rapid treatment of stroke, both lives are saved, and the affected person can avoid lifelong disability, something that both provides increased quality of life for the patient and saves big money for society. The new treatment options that have emerged over the past decade require more knowledge in healthcare, which is one reason for the new course offered through MedTechLabs.
The course “Acute stroke, diagnostics and treatment” organised by MedTechLabs started in October 2023. The course is aimed at residents and specialists who want to train in this area to better follow the national recommendations and guidelines for examination and treatment of stroke and TIA. The new course was offered to doctors in Region Stockholm as well as in other parts of the country and was quickly oversubscribed.
We spoke with Håkan Almqvist, senior physician and neuroradiologist at Capio St Göran, who is responsible for the course. Håkan has worked almost all his professional life with stroke, first at SÖS and later as a neuroradiologist at Karolinska and has followed the modern development of how to find and eliminate thrombi/embolisms since the late 90s.
Hi Håkan, can you tell us a bit about the course and why it is given?
“The course aims to provide knowledge about the benefits of acute reperfusion therapy within 24 hours in several patient groups, including those with relatively large established infarcts. The management and assessment of TIA is also included in the course. “The biggest problem with stroke care is still that patients come in too late, so it’s important that everyone in the community knows that help is available and picks up the phone if they have symptoms. But we in the healthcare chain also need to be on our toes and know what is needed for the patients. We must dare to be rational and inclusive, even if there is a low probability of stroke. Because it can be difficult to know whether your judgement is correct. Doctors need to see many cases to become skilled in their judgement and that takes time, especially in a smaller hospital.”
How do you deliver the course?
“In the first round, we offer it free of charge to 40 participants who receive around 30 video lectures and case study material with commentary, which we distribute using Collective Minds Radiology and their radiological imaging system. It is up to the student how much time they spend on that part, but I would say it is about two and a half days, at their own pace. In addition to this, we have a mandatory physical meeting in the form of a seminar in Stockholm where case studies are discussed. The knowledge check takes place at this seminar and active participation is required to obtain the course certificate.”
Who came up with the idea for this course?
“Many of us realised early on that there was a lack of continuing education for the new forms of examination and treatment that have emerged in the field. When MedTechLabs started, it was realised that there was a need for training in the region. Professor Staffan Holmin, together with KTH professor Mats Danielsson, saw an opportunity for the centre to contribute to and provide training. “As early as 2018, we started recording parts of the material that is now used in the course, along with new material in 2023. The pandemic and questions about which platform to use have meant that it has taken some time.”
What do you think has made the course so popular?
“The course only corresponds to a few days where you choose when for about 1 month. That certainly has an impact. But it is up to the student how much time they spend. I think long courses are becoming more difficult to attract. That we have a hybrid approach with self-study with lectures and being able to browse cases combined with a physical seminar with the teachers. A course must also be able to provide both a course certificate and an ST certificate. This is probably exactly what many doctors are looking for in terms of continuing education.”
When will you hold the course next time?
“This is the first time we have held it, and we will of course further develop it based on the feedback we receive from the course participants. Then we will see how many times a year is reasonable. It is also a question for Region Stockholm, which this time allowed doctors from other regions to attend free of charge. But hopefully we will also organise the course in 2024.”
MedTechLabs has granted SEK 35 million for two new medical technology research programmes. The first will develop a new method for monitoring fetal oxygenation during labour. The second programme will develop a new method for early diagnosis of brain diseases using MR elastography.
This year’s call from MedTechLabs was launched in the spring and the decision to adopt two new research programmes was taken by the centre’s steering committee in early October. Johan Schuber, Executive Director of MedTechLabs, says that the approved programmes strengthen the centre’s focus on conducting clinically relevant research.
Current fetal monitoring methods have weaknesses and the researchers in this new programme aim to improve them to reduce the risk of organ failure in the baby during delivery. This is an important area of research that affects many patients and maternity services, not only in Sweden but also worldwide.
The programme ‘Continuous lactate measurement and prevention of fetal hypoxia during delivery’ is led by Malin Holzmann, Karolinska Institutet (KI), and Saul Rodriguez Duenas, Royal Institute of Technology (KTH). Malin Holzmmann is a senior physician at the Unit for Pregnancy and Childbirth at Karolinska University Hospital in Solna, Sweden, and an associate professor at KI. Saul Rodriguez Duenas is a senior lecturer at the Division of Electronics and Embedded Systems at KTH. The goal is to achieve continuous lactate measurement during labour, which would represent a completely new technology in healthcare with the potential to fundamentally change fetal monitoring.
The second research programme focuses on understanding how brain tissue changes when exposed to diseases such as Alzheimer’s, Parkinson’s, MS, or brain tumours. With the increasing availability of drugs to treat these diseases, early detection of the diseases in time is becoming more important to slow down disease progression as effectively as possible.
The programme “Clinical application of next-generation brain magnetic resonance elastography for neurodegenerative diseases and brain tumours” is led by Rodrigo Moreno, KTH and Tobias Granberg, KI. Rodrigo Moreno is Associate Professor and Senior Lecturer at the Department of Biomedical Engineering and Health Systems at KTH. Tobias Granberg is Senior Lecturer at the Division of Clinical Neuroscience at Karolinska Institutet. MR-Elastography (MRE) is already used today to diagnose liver diseases, but its complexity has so far hindered its clinical use for the diagnosis of brain diseases. The main objective of this multidisciplinary programme is to enable MRE to be performed also for the brain and to evaluate its clinical utility in neurodegenerative diseases and brain tumours. The project covers MRE technology from image acquisition and analysis to its use and evaluation in clinical trials. The goal is to enable clinical implementation in Region Stockholm within five years, thus contributing to better treatment for patients.
Research in both programmes is expected to start in January 2024.
MedTechLabs is an interdisciplinary centre for patient-oriented research that will contribute to breakthroughs in the development of medical technology with significance for the important challenges of healthcare and our major public diseases. In all programmes, researchers and clinicians with both technical and medical expertise collaborate. The centre is run jointly by KTH, Karolinska Institutet and Region Stockholm.
For more information, contact:
Johan Schuber
Executive Director of MedTechLabs
Phone: 08-790 67 64
E-mail: jschuber@kth.se
Website: www.medtechlabs.se
LinkedIn: https://www.linkedin.com/company/medtechlabsstockholm
SVT – the Swedish national broadcasting company – highlights the impact of research on AI for breast cancer detection in mammography, conducted by MedTechlabs researchers Kevin Smith and Fredrik Strand. Also, Lancet published a scientific article on the study conducted at Capio Sankt Göran Hospital in Stockholm.
What differences in cancer detection and unnecessary recalls are the results of various combinations of AI and radiologists? Lancet Digital Health has published the results of a prospective clinical trial conducted in Stockholm.
MedTechLabs researcher Fredrik Strand is surprised at how accurate the AI was and says that the potential for AI to handle most of the screen-reading is huge.
Karin Dembrower is chief physician and medical director of the Mammography Department at Capio S:t Göran’s Hospital where the clinical study was conducted. She is very satisfied with the results.
– We found slightly more cancer and recalled fewer women who turned out to be healthy, so we made fewer women worried. And we freed up time for the radiologists to do other diagnostics than looking at mostly healthy women’s images. We have managed to cut the queues considerably so we are a queue-free breast centre now, she says in the feature.
The AI-assisted breast cancer detection system has been operational since summer 2023 at St Göran’s Hospital in Stockholm.
– We have shown that our AI technology works on St Göran and their equipment. But that doesn’t mean that any AI will work on all equipment, so it’s something you need to check before introducing it, says Fredrik Strand in the same feature.
Watch the tv-feature here (in Swedish)
Read the Article in Lancet Digital Health here (full text)
Do we have the right organisation for highly specialised care in Sweden, with seven university hospitals competing for highly specialised assignments?
That question was debated at the Almedalen seminar where Staffan Holmin and Mats Danielsson participated: “From frontline to routine care. How to create the cutting-edge healthcare of the future?”. The panel also included Acko Ankarberg Johansson, Minister of Health, Björn Zoëga, Hospital Director, Karolinska University Hospital, and Annika Östman Wernerson, President of Karolinska Institutet, Olivia Wigzell, Director General, National Board of Health and Welfare.
The seminar was organised by the Karolinska University Hospital and Dagens Medicin Sverige. Nina Hedlund was the moderator. Here is a web link to the seminar (which was held in Swedish): https://lnkd.in/gih5QWay