Rheumatology 4.0: big data, wearables and diagnosis by computer

Abstract

> We must dare to think ‘unthinkable’ thoughts. We must learn to explore all the options and possibilities that confront us in a complex and rapidly changing world. J. William Fulbright, US Politician. 9 April 1905–9 February 1995 > Nothing is unthinkable, nothing impossible to the balanced person, provided it comes out of the needs of life and is dedicated to life’s further development. Lewis Mumford, US historian, sociologist, philosopher and literary critic. 19 October 1895–26 January 1990 Let’s jump into the future, about 10 years from now. Sandy Myers (fictional name) is a 44-year-old female IT specialist. She is suffering from joint pain, morning stiffness, swollen finger joints and toes, as well as fatigue since 4 months. What should she do now? You would say, she should see rheumatologist as soon as possible and attend an early arthritis clinic. But will we have enough rheumatologists in 10 years, will this be common practice? Instead, she walks into the living room in the morning and addresses Alessia (fictional name), her cloud-based voice service machine. She tells Alessia about her health problems, and the machine takes a detailed history asking her several questions, which have been elaborated by a EULAR initiative (EULAR recommendations on core rheumatology questions in cloud-based voice service. Annals of the Rheumatic Diseases 2025): how can I help you?, where do you have your pain?, is it more pronounced in the morning?, do non-steroidals help?, do you feel like having an influenza? and some others. The answers are entered online into a structured patient history databank. Sandy is now asked by Alessia to perform a self-examination that is helped by a large screen on her living room wall. Showing examples of diseased joints and with the help of animated pictures, Sandy examines her painful joints and records if they are swollen. This is …