Medical Minutes

New Machines Measure Back Surgery Benefits

Researchers who have been using Fitbit data to help predict surgical outcomes have now come up with a new method to more accurately gauge how an individual may recover from spine surgery. Using machine learning techniques developed at the AI for Health Institute at Washington University in St. Louis, Missouri, the team developed a novel way to predict recovery more accurately from lumbar spine surgery.

This latest model has outperformed previous models for predicting outcomes. This is important because in lower back surgery and many other types of orthopedic operations, the outcomes vary widely depending on the patient’s structural disease. Also, outcomes vary significantly depending on physical and mental health characteristics.

Surgical recovery is influenced by both preoperative physical and mental health. Some people may have catastrophizing, or excessive worry, in the face of pain and that can make pain and recovery worse. Others may suffer from physiological problems that cause worse pain. If physicians can get a heads-up on the various pitfalls for each patient, that will allow for better individualized treatment plans.

“By predicting the outcomes before the surgery, we can help establish some expectations and help with early interventions and identify high risk factors,” said study investigator Ziqi Xu, who is with Washington University. Previous work in predicting surgery outcomes typically used patient questionnaires given once or twice in clinics.

Researchers have used mobile health data from Fitbit devices to monitor and measure recovery and compare activity levels over time but these latest findings show that activity data, plus longitudinal assessment data, are more accurate for predicting surgical outcomes.

Fitbit data can be correlated with multiple surveys that assess a person’s social and emotional state. That data via ecological momentary assessments (EMAs) employ smart phones to give patients frequent prompts to assess mood, pain levels and behavior over multiple times throughout the day.

Amazingly, the team has been able to combine wearables, EMA and clinical records to capture a broad range of information about a person, from physical activities to subjective reports of pain and mental health.

Walking Away from Cancer

A new, large study led by researchers at the American Cancer Society (ACS) is showing adults sticking to an exercise program of 15 or more metabolic equivalent hours (MET) of physical activity per week decreased their risk for cancer, including obesity-related cancers, compared with no intervention. This amount of exercise would be 300 or more minutes of moderate activity or 150 or more minutes of vigorous activity per week.

The results showed under no intervention, the estimated 14-year risk for any cancer was 25.6% and for obesity-related cancers it was 10.3%. Compared with no intervention, engaging in the minimum recommended was linked with a 0.3% reduction in the risk of any cancer and a 0.1% reduction in the risk of obesity-related cancers.

Researchers have found that walking can help improve your memory and brain function, regardless of your age. Further, it can protect against many chronic diseases and help with weight management. Walking in many studies has been shown to lower blood pressure, improve heart health, and improve the quality of sleep. Recent studies showed walking may help reduce feelings of anxiety and depression.

A study just published examined data from more than 10,000 Australian women and it showed a significant link between regular exercise during middle-age and physical health in later life, even when the exercise routine was not started until their mid-50s. In the new study, researchers used data collected at three-year intervals beginning in 1996 from 11,336 participants in the Australian Longitudinal Study on Women's Health. Women were born in 1946 through 1951, making them 47 to 52 years old at the study outset. The study showed significant benefits from regular exercise in adults 65 and older.

A New Way to Cut Down on Cocktails? 

A study by researchers at the Case Western Reserve University School of Medicine is suggesting that the popular diabetes and weight-loss drugs Wegovy and Ozempic may help reduce the incidence and recurrence of alcohol abuse or dependence. The team’s findings suggest a possible new treatment for excessive alcohol use, including alcohol-use disorder (AUD). This is a health condition that causes about 178,000 deaths in the United States each year, according to the Centers for Disease Control.

To date, the U.S. The Food and Drug Administration (FDA) has approved only three medications to treat AUD. The active ingredient in Wegovy and Ozempic is semaglutide, which belongs to a class of medications known as glucagon-like peptide-1 receptor agonists (GLP-1). GLP-1 helps regulate blood sugar in type 2 diabetes and reduces appetite.

The researchers examined electronic health records of nearly 84,000 patients with obesity. They found those treated with semaglutide, compared to those treated with other anti-obesity medications, showed a 50% to 56% decrease for both the initiation and re-occurrence of alcohol-use disorder in the year following.

“This is very promising news in that we may have a new therapeutic method to treat AUD,” said lead study investigator Rong Xu, a professor of biomedical informatics at Case Western School of Medicine, Cleveland, Ohio.

Collecting real-world evidence, the researchers previously published two studies showing that semaglutide is associated with a decrease in suicidal thoughts, and also is associated with a reduction in cannabis-use disorder. Similar findings were replicated when the team examined electronic health records for about 600,000 patients with type 2 diabetes. Again, they found consistent reductions in alcohol-use disorder diagnoses among those treated with semaglutide. While these findings are very promising. The researchers noted that prospective, randomized trials are warranted before using these agents for AUD and other conditions.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com