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ACCELERATING BRAIN HEALTH TECHNOLOGIES: A PUBLIC-PRIVATE PARTNERSHIP ACTION PLAN

Ara S. Khachaturian, Brittany Cassin, Glen Finney, Ting Shih, Jodi Lyons, Eric Klein, Michael T. Brown, Steven L. Carroll, Drew Holazpfel, Sudhir Sivakumaran, Louis Tripoli, Daniel Elswick, Paulo Pinho, Jacobo E. Mintzer, Malaz A. Boustani, Zaven S. Khachaturian

VM&E 2024;7:1-7

Chronic brain disorders, prevalent in aging populations, disproportionately impact marginalized and underserved communities. Introducing artificial intelligence/machine learning (AI/ML)-powered Clinical Decision Intelligence Applications (CDIAs) offers a promising solution to improve brain health and health equity. However, the sustained adoption of such technologies requires significant improvements in clinical workflows, personnel training, ethical considerations, financial models, regulatory compliance, and governance structures. To address these challenges, the Brain Watch Coalition advocates forming a public-private partnership to build trust and validate the effectiveness of AI/ML-powered CDIAs. This perspective outlines challenges and recommendations for establishing a purpose-driven public-private partnership: to demonstrate the long-term viability and ethical deployment of CDIAs within real-world healthcare settings and to establish a framework for ensuring equitable access to innovative brain health solutions. This initiative is a critical step towards enhancing patient outcomes, modernizing healthcare systems, and effectively managing the growing burden of chronic brain disorders across global populations.

CITATION:
Ara S. Khachaturian, Brittany Cassin, Glen Finney, Ting Shih, Jodi Lyons, Eric Klein, Michael T. Brown, Steven L. Carroll, Drew Holazpfel, Sudhir Sivakumaran, Louis Tripoli, Daniel Elswick, Paulo Pinho, Jacobo E. Mintzer, Malaz A. Boustani, Zaven S. Khachaturian (2024): Accelerating Brain Health Technologies: A Public-Private Partnership Action Plan. Vitality, Medicine & Engineering. http://dx.doi.org/10.14283/VME.2024.1

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THE IMPLICATIONS OF RESPONSE PATTERNS IN QUESTIONS OF EARLY LIFE ADVERSE EVENTS ON HEALTH STATUS AND COGNITIVE FUNCTION LATER IN LIFE IN THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA)

Margaret C. Culkin, Jordan E. Tanley, Timothy M. Hughes, Teresa Seeman, Sharon S. Merkin, Doris Molina-Henry, Kathleen M. Hayden

VM&E 2024;7:8-18

BACKGROUND: Research suggests that early life adversity (ELA) is associated with late life cognition; however, such studies may be influenced by response bias. OBJECTIVES: To evaluate response patterns for ELA questions by various sociodemographic characteristics and to examine whether ELA responsiveness was associated with cognitive performance and/or decline. DESIGN: Cross-sectional study. SETTING: The Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of subclinical atherosclerosis. PARTICIPANTS: 3,837 participants, averaging 59 (standard deviation [SD]=9.0) years of age, with 55% women and participants from diverse backgrounds (26% Black, 13% Chinese, 21% Hispanic/Latino, 40% White: 32% non-native, and 10% Spanish speakers). MEASUREMENTS: ELA responses assessed via a telephone survey (2018-2019) were used to examine response patterns and associated cognitive outcomes, measured using the Cognitive Abilities Screening Instrument (CASI) during MESA Exam 5 and Exam 6. RESULTS: Spanish speakers (odds ratio [OR] 2.15, 95% confidence interval [CI]: 1.38-3.36) and participants born outside of the United States (U.S.) (OR 1.66, 95% CI: 1.18-2.33) had higher odds of ELA refusal than U.S. born ELA completers who spoke English. There were no significant differences in change in CASI score from Exam 5 to Exam 6 (beta=-0.38, [SE] 0.54, p=0.490) or Exam 6 CASI score (beta=-0.68, [SE] 0.49, p=0.168) among those who refused the ELA assessment compared to those who completed the assessment. CONCLUSIONS: Sociodemographic factors predicted completion status on questions of ELA. There was no difference in cognitive function and change in cognition across ELA completion groups.

CITATION:
Margaret C. Culkin, Jordan E. Tanley, Timothy M. Hughes, Teresa Seeman, Sharon S. Merkin, Doris Molina-Henry, Kathleen M. Hayden (2024): The Implications of Response Patterns in Questions of Early Life Adverse Events on Health Status and Cognitive Function Later in Life in the Multi-Ethnic Study of Atherosclerosis (MESA). Vitality, Medicine & Engineering. http://dx.doi.org/10.14283/VME.2024.2

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