Top 10 Medical Breakthroughs for 2014

Bionic eyes for restoring sight in people with severe eye disease, a medical implant that prevents seizures, and the first all-oral treatment for hepatitis C—these are among the incredible advances that made the list of Top 10 Medical Innovations for 2014. Physicians and researchers at the Cleveland Clinic make the selections for this annual list, bringing together the breakthroughs they believe will “shape healthcare” in the coming year.

Making the list—which is announced at the clinic’s yearly Medical Innovation Summit—is no easy feat. To receive consideration, a new treatment or medical device must provide a significant benefit to patients, improve the delivery of healthcare, have a high likelihood of success, and be currently available or expected to be available within the year. In addition, the human impact of the innovation must be foreseeable—these breakthroughs need to be intended to improve people’s lives.

Curious to see what else made the list of game-changing medical advances for 2014? Here’s a closer look at the Cleveland Clinic’s full top 10:

#10. A New Treatment for Blood Cancers

Newly-developed drugs called “B-cell receptor pathway inhibitors” have been  highly effective in treating low-grade B-cell lymphomas and leukemias in clinical trials. A 2013 study published in the New England Journal of Medicine (NEJM) showed an overall response rate of 71 percent for patients with chronic lymphocytic leukemia (CLL) who were treated with the new drugs. These drugs kill malignant B cells while having little effect on healthy cells, thus producing fewer side effects than chemotherapy and allowing the patient to remain healthier during treatment.

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#9. A Novel Biomarker for Heart Disease

When assessing a patient’s risk for heart disease, physicians test for certain biomarkers—such as cholesterol levels—that may foretell the potentially lethal health condition.

Scientists have now discovered what may be an important new biomarker, called trimethylamine N-oxide (TMAO), which could be a useful screening tool for people who don’t have traditional risk factors. TMAO is a byproduct of intestinal bacteria, and a study in NEJM reported this year that those with the highest levels of TMAO had double the risk of cardiovascular events. This research indicates that the microbes that live in our digestive tracts may be able to give us important clues about the risk of stroke and heart attack. Experts suggest that doctors may soon be able to personalize diets for their patients to best prevent heart disease based on levels of TMAO.

#8. Computer-Assisted Sedation Without an Anesthesiologist

Colonoscopies are the most expensive screening test that Americans receive, and costs are increased when anesthesia services are provided. The solution may be a new computer-assisted personalized sedation device, which is expected to be introduced on a limited basis in 2014. The device , which administers the drug propofol, can be monitored by a non-anesthesia professional during colonoscopies, among other procedures. It’s been estimated that eliminating anesthesiologist services could cut costs by over $1 billion a year.

#7. Relaxin for Acute Heart Failure

More than 55,000 people die of heart failure in the U.S. each year, while over 500,000 new cases are diagnosed. Serelaxin—a synthetic version of a natural human hormone—may be the first breakthrough in two decades in the treatment of this debilitating condition. The drug, a type of vasodilator, helps during episodes of acute heart failure by improving blood flow throughout the body. It may also reduce inflammation, which could otherwise cause damage to the kidneys, liver, and heart.

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#6. Fecal Microbiota Transplantation

To this point, treating Clostridium difficile, or C. diff., has focused on one of two antibiotics—vancomycin or metronidazole. But gastroenterologists are now using human stool transplants in patients who do not respond to traditional drug therapy. The process involves the transfer of healthy fecal matter into a sick person’s colon, which restores bacterial balance. Reportedly, some patients who suffered through multiple episodes of C.diff were cured of their symptoms within 24 hours thanks to the bacteriotherapy.

#5. Decision Support System for Anesthesia

Most of the 51 million surgical procedures performed annually in hospitals across the U.S. are not possible without anesthesia. In an effort to meet the demands and improve outcomes, a new electronic anesthesia management system has been developed which creates, in real time, a full anesthesia record of events, drugs, and procedures. The system is meant to help ensure anesthesia best practices are followed, in turn reducing the risk of serious errors.

#4. New Era in Hepatitis C Treatment

Though treatment for hepatitis C has greatly improved since the 1990s, many patients endure regimens that are both lengthy (up to 48 weeks) and require difficult-to-tolerate drugs. A new drug, Sofosbuvir, might be the answer. The drug is the first all-oral treatment for hepatitis C, and it’s in the latter stages of becoming FDA approved. It has been shown to improve treatment response rates to 90% or higher, while producing fewer side effects.

#3. Responsive Neurostimulator for Intractable Epilepsy

Roughly 30 percent of Americans with epilepsy are unable to bring their seizures under control with medication or other treatments. And while surgery for epilepsy is possible, it carries risks and is often unhelpful. This year, a new treatment option earned the unanimous support of an FDA neurological device advisory panel. It’s a surgically-implanted neurological device that can considerably reduce the occurrence of epileptic seizures. The device, implanted in the skin, records electrocorticographic (ECog) patterns via electrodes that are placed in the patient’s brain. When it detects an oncoming seizure, short electrical pulses are delivered which can stop the impending seizure.

#2. Genomic-Based Tests For Cancerous Tumors

Aggressive treatments for cancerous tumors are often pursued (by both doctors and patients) even when they are not required, using a “just in case” approach. But now, genomic-based tests can help avoid unnecessary (and unpleasant) treatments like chemotherapy and radiation when they are not warranted. Several genomic-based tests are now available that can analyze the genes in a patient’s tumor and predict the aggressiveness of the cancer, making treatment decisions easier.

#1. Bionic Eyes For Severe Eye Disease

Retinitis pigmentosa (RP) is a group of inherited eye diseases that affects more than 100,000 Americans and often results in legal blindness by the age of 40. Backed by two decades of development and testing, and more than $200 million in funding, there may now be a treatment for RP. It’s a new FDA-approved technology that consists of a surgically-implanted 60-electrode retinal prosthesis which decodes wireless transmissions from a pair of glasses equipped with a video camera. A video processing unit must also be worn or carried. The retinal implant, or “bionic eyes,” don’t completely restore vision; however, patients can sense light and dark, movement, and the location of people and objects.

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