Section of Cardiology, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas, USA.
Department of Computer Science, Kent State University, Kent, Ohio, USA.
Can J Cardiol. 2022 Feb;38(2):185-195. doi: 10.1016/j.cjca.2021.11.011. Epub 2021 Nov 30.
Clinical databases, particularly those composed of big data, face growing security challenges. Blockchain, the open, decentralized, distributed public ledger technology powering cryptocurrency, records transactions securely without the need for third-party verification. In the health care setting, decentralized blockchain networks offer a secure interoperable gateway for clinical research and practice data. Here, we discuss recent advances and potential future directions for the application of blockchain and its integration with artificial intelligence (AI) in cardiovascular medicine. We first review the basic underlying concepts of this technology and contextualise it within the spectrum of current, well known applications. We then consider specific applications for cardiovascular medicine and research in areas such as high-throughput gene sequencing, wearable technologies, and clinical trials. We then evaluate current challenges to effective implementation and future directions. We also summarise the health care applications that can be realised by combining decentralized blockchain computing platforms (for data security) and AI computing (for data analytics). By leveraging high-performance computing and AI capable of securely managing large and rapidly expanding medical databases, blockchain incorporation can provide clinically meaningful predictions, help advance research methodology (eg, via robust AI-blockchain decentralized clinical trials), and provide virtual tools in clinical practice (eg, telehealth, sensory-based technologies, wearable medical devices). Integrating AI and blockchain approaches synergistically amplifies the strengths of both technologies to create novel solutions to serve the objective of providing precision cardiovascular medicine.
临床数据库,特别是那些由大数据组成的数据库,面临着越来越多的安全挑战。区块链是一种开源的、去中心化的、分布式的公共账本技术,为加密货币提供了安全的交易记录,而无需第三方验证。在医疗保健环境中,去中心化的区块链网络为临床研究和实践数据提供了一个安全的互操作网关。在这里,我们讨论了区块链及其与人工智能(AI)在心血管医学中应用的最新进展和潜在的未来方向。我们首先回顾了这项技术的基本概念,并将其置于当前知名应用的范围内。然后我们考虑了心血管医学和研究领域的具体应用,如高通量基因测序、可穿戴技术和临床试验。然后我们评估了有效实施的当前挑战和未来方向。我们还总结了通过结合去中心化区块链计算平台(用于数据安全)和 AI 计算(用于数据分析)可以实现的医疗保健应用。通过利用能够安全管理大型和快速扩展的医疗数据库的高性能计算和 AI,区块链的采用可以提供有临床意义的预测,帮助推进研究方法(例如,通过强大的 AI-区块链去中心化临床试验),并在临床实践中提供虚拟工具(例如,远程医疗、基于传感器的技术、可穿戴医疗设备)。人工智能和区块链方法的协同整合放大了这两种技术的优势,为提供精准心血管医学的目标创造了新的解决方案。