healthcare in the age of disruption - promedica international · 1 healthcare in the age of...
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6 Accelerating Computing Power
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80% of what physicians do might be replaced in the future
Vinod Khosla, Founder Sun Microsystem
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17 Baumol’s Cost Disease
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19 AWAKE-HF Does sacubtril/valsartan (Entresto) increase activity and improve sleep in patients with systolic heart failure?
Baseline Secondary endpoint
Secondary endpoint
Secondary endpoint
Primary endpoint
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21 AWAKE-HF OUTSTEP-HF Objectives Determine:
• Effect of initiation of sacubitril/valsartan treatment versus enalapril on physical activity during the waking hours
• Effect of initiation of sacubitril/valsartan treatment versus enalapril on subjects’ sleep
Demonstrate the superiority of sacubitril/valsartan over enalapril in increasing non-sedentary physical activity in HFrEF patients
Duration • 2 weeks current HF therapy • 8 weeks sacubitril/valsartan or enalapril • 8 weeks sacubitril/valsartan
• 2 weeks current HF therapy • 12 weeks sacubitril/valsartan or enalapril
Patients, n 136 600
Patient population
Outpatient male and female subjects, between 18 - 80 years of age, with HFrEF NYHA class II or III
18 Years and older male and female subjects, chronic symptomatic HF (NYHA class ≥ II) with reduced ejection fraction, defined as known LVEF ≤ 40% AND one of the following two criteria: • Plasma NT-proBNP level of ≥ 300 pg/mL or BNP ≥ 100
pg/mL (measurement may be recorded no longer than past 12 months) OR
• Confirmation of a heart failure hospitalization last 12 months.
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Combining AWAKE & OUTSTEP Data
Can actigraphy data predict
• Clinical events such as HF hospitalizations?
• Quality of life scores (KCCQ)?
• Left ventricular ejection fraction?
• Naturietic peptide levels?
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Major Problem: Most Days of Heart Failure Management Are Not Clinic or Hospital Days
HF Clinic Device Clinic
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