S3.E4. 時間的問題 A question of time

在73歲時，來自德國瓦爾多夫的Wolf-Henning Knoblauch中風。電腦程式幫助醫生於迅速做出正確的決定並診斷，因此減輕了之後嚴重的後遺症。

不幸中的大幸，Wolf-Henning Knoblauch 的中風及早發現並成功治療，他因此重獲了健康和積極的生活機會。百靈佳殷格翰與歐洲腦中風協會合作，一起致力於確保更多的患者能在將來也受益於這種最佳的治療機會，百靈佳殷格翰的合作夥伴Brainomix，是一家專門開發醫療相關自學軟體的公司，他們共同合作幫助醫生快速評估腦損傷的性質和程度，並選擇正確的治療方式。

「中風」是歐洲最致命的疾病之一，其治療的關鍵因素在於快速與準確；中風導致成人死亡的第二大常見原因為「腦部血管栓塞」，也是造成永久殘疾最常見的因素。如果中風患者能夠得到及時治療，這些風險都將大大降低。

如果大腦供血中斷，每分鐘大約會有190萬個神經細胞死亡，這種對大腦有害的過程，通過藥物和特殊治療方式，是可以被阻止的。腦中風中心內經過特殊訓練的醫生會立即對大腦進行CT掃描。其目標是根據從大腦斷層掃描中獲得的訊息，在中風後4小時內開始給予正確的治療。

但其中有個問題在於，沒有太多的腦中風中心或是在這方面經驗豐富的神經科醫生可進行腦部掃描評估。醫生經常花太多時間在做決定， 這是因為他們需要從更有經驗的同事中獲得相關評估經驗。

因此，醫療軟體公司Brainomix，目標是為每位醫生提供能自我學習的「數位助手」即人工智慧，來評估病患的CT掃描。

數位助手在CT掃描完成後的幾分鐘內，會將其診斷影像直接發送給醫生的智慧型手機。E-ASPECTS的分數會顯示中風的嚴重程度，而圖像上的顏色標記則顯示了大腦受影響的區域。Brainomix的CEOMichael Papadakis解釋：這套軟體優勢在於，它不單純只是依賴過去經驗和醫學發現，而是從每位新增的中風患者中自我學習。因此，越多的醫生和醫院使用我們的軟體，其評估就越準確。新患者將從中受益，且在新發現中得到最佳的治療方式。

Brainomix的演算法(規則系統)已經在許多歐洲國家的診所和腦中風中心使用。百靈佳殷格翰財務投資總經理Frank Kalkbrenner博士說：像Brainomix這樣為醫生和患者開發智能化數位工具的新創企業，是百靈佳殷格翰重要且令人振奮的合作夥伴，英國的創投基金更在2018年初開始投資。Kalkbrenner補充說到：數位工具幫助我們建立全面性的疾病管理計劃，進一步為患者提供最好的治療及照顧。

(本文單純報導百靈佳殷格翰在國外的科技創新與應用，目前台灣並沒有該應用的導入，同時呼籲：中風的預防與治療都應與專業醫療人員配合，尊重專業意見，不宜自行判斷。)

Wolf-Henning Knoblauch was fortunate in misfortune – his stroke was recognised quickly enough, analysed and successfully treated without delay. He thus gained the opportunity to fight his way back into a healthy and active life. Together with the European Stroke Organisation, Boehringer Ingelheim is committed to ensuring that as many patients as possible benefit from such optimal treatment in future. The self-learning software of the medical technology start-up and Boehringer Ingelheim partner Brainomix helps doctors to rapidly assess the nature and extent of brain damage and to select the right therapy.

Faster and better treatment is the key to combating one of the most lethal diseases in Europe: stroke. Disturbance of the flow of blood to the brain is the second most frequent cause of death and the most frequent cause of permanent disability in adults. But the risk can be reduced very considerably if stroke patients are treated quickly enough.

If the supply of blood to the brain is interrupted, around 1.9 million nerve cells will die every minute. This destructive process can be halted by means of medicines and special treatment methods. Specially trained physicians in stroke centres therefore perform a CT scan of the brain as quickly as possible. The goal is for the right treatment to begin no later than four hours after the stroke, on the basis of the information gained from the tomography of the brain.

The problem is that there are not many specialized stroke centres and experienced neurologists that can evaluate brain scans. Physicians frequently take too long to decide – often because they need to obtain ;a second opinion from more experienced colleagues.

The medical software company Brainomix therefore aims to provide every physician with a digital stroke expert as an assistant. Self-learning software, i.e. artificial intelligence, evaluates CT scans.

This digital assistant sends its diagnosis directly to physicians’ smartphones in just a few minutes after the completion of the CT scan: an “e-ASPECTS”score indicates the severity of the stroke, while colour markings on the attached images pinpoint the affected region of the brain. “The key advantage of our software is that it does not rely on past experience and previous medical findings alone but rather adds to its learning with each new stroke patient,” explains Michael Papadakis, CEO of Brainomix.

“So the more physicians and hospitals use our software, the better its assessments will be.” New patients will thus very rapidly benefit from new findings in relation to treatment methods and their outcomes.

Brainomix’s algorithm is already being used in clinics and stroke centres in many European countries. “Innovative start-ups such as Brainomix, which develop intelligent, digital tools for physicians and patients, are important and exciting partners for Boehringer Ingelheim,” says Dr Frank Kalkbrenner, Managing Director of the Boehringer Ingelheim Venture Fund. The venture capital fund invested in this British start-up in early 2018. Kalkbrenner adds: “Digital tools help us to establish holistic, integrated disease management programmes – and thus to offer patients the best possible care.”