Cleveland Clinic’s 2009 medical innovation predictions… some hits, some ‘not there yets’

At their annual innovations summit in 2008, Cleveland Clinic doctors, researchers and other professionals announced their third annual list of medical technologies they thought would be hot in the coming year. Some of the predictions were hits; others were ahead of their time.

CLEVELAND, Ohio –  At their annual innovations summit in 2008, Cleveland Clinic doctors, researchers and other professionals announced their third annual list of medical technologies they thought would be hot in the coming year.  

According to the Clinic’s own accounting, let’s see how the prognosticators did:

10. National health information exchange: A comprehensive system for electronic health records that link consumers, doctors, hospitals, insurers and other health services providers. We’re not there yet, though the federal government is encouraging electronic health record systems with stimulus grants, and such records are gaining public interest.

9. Doppler-guided uterine artery occlusion: Experimental procedures that use things like tiny plugs and sound waves to starve fibroid tumors in the uterus so they get smaller or disappear. Again, not there  yet. This experimental procedure is undergoing pivotal trials in North America and Europe.

8. Integration of diffusion tensor imaging: Technology that creates two- and three-dimensional color images of the fiber pathways in the brain — the “wiring” that connects the brain to functions like moving your hand. This technology is providing neuroscientists information about fiber pathways in the brain that they couldn’t get before from a living brain. This is especially important for neurosurgeons as they map patients brains prior to surgeries.

7. LESS and NOTES applications: Single-incision and no-incision surgeries for procedures like gallbladder removal. Laparoendoscopic single-site surgery (LESS) pairs minimally invasive surgery with a single incision in the patient’s belly button. Natural orifice transluminal endoscopic surgery (NOTES) is incision-less surgery through a natural orifice, such as the mouth, vagina or colon. Both techniques are being used in several clinical areas, including surgery of the digestive tract, urology and gynecology.

6. New strategies for creating vaccines for avian flu: Scientists are working to engineer effective vaccines against killer bird viruses, such as H5N1. Avian flu vaccine is being tested in several human clinical trials. A novel H1N1 — “swine flu” — vaccine recently was created in fewer than 12 weeks.

5. Percutaneous mitral valve regurgitation repair: Repairing a leaky mitral valve in the heart — the one-way valve that connects the left atrium to the left ventricle — from the inside out. A clip is threaded through a catheter in the groin to the heart. The clip is clamped on the center of the mitral valve “leaflets,” holding them together and restoring normal blood flow. Preliminary results from a randomized trial of the EVEREST II (Endovascular Valve Edge-to-edge REpair STudy) suggest that the valve clip procedure can enable three-quarters of patients to avoid open-heart surgery for at least three years.

4. Multi-spectral imaging systems: Time- and money-saving imaging systems that when attached to standard microscopes enable pathologists to see up to five stained proteins at a time. Pathologists look at protein distributions to understand cancer tumors and other abnormal tissues. Now, scientists must look at one protein at a time. Several multi-spectral imaging systems have been developed in the last few years that have clinical applications now and are expected to help develop more effective therapies in the future.

3. Diaphragm pacing system: An electric device that stimulates the diaphragm to contract and relax, enabling paralyzed patients to breathe without the help of bulky mechanical ventilators. These devices can help paraplegics lead more normal lives and reduce rates of ventilator-induced pneumonia, which kills half of the people who get it. The U.S. Food and Drug Administration has approved a handful of diaphragm-pacing systems for sale in the United States, including NeuRx DPS made by Synapse Biomedical in Oberlin, Ohio.

2. Warm organ perfusion device: Developed in Europe and being tested in the United States, these are devices that pump warm blood through a donor heart, keeping it viable for up to 12 hours. The heart naturally starts beating when the blood is pumped through it. The world’s first warm-blood perfusion system for the heart has been approved in Europe and is undergoing pivotal trials in the United States. Systems for transporting lungs, livers and kidneys also are being developed.

1. Use of circulating tumor cell technology: A technology that measures tumor cells that circulate in the blood. Results can help doctors understand how a cancer is progressing and how to adjust treatments in patients who have repeat cancer. The FDA has approved has approved the use of this technology to monitor treatment effects in breast, colorectal and prostate cancers. Other applications are being developed.