Depicted in films, books, and science fiction stories as a means to bring doom to humans, Artificial Intelligence (AI) actually can significantly change medicine and healthcare.

In a report, the World Health Organization (WHO) describes how leveraging AI for healthcare holds great promise or potential. This potential is exactly what Harvard Medical School Assistant Professor of Ophthalmology Dr. Paolo Antonio Silva and his team are exploring with their current project on diabetic retinopathy.


Under the Newton Agham Program of the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD) and the United Kingdom Medical Research Council (UK-MRC), Dr. Silva’s team launched the UK-Philippines Remote Retinal Evaluation Collaboration in Health: Diabetic Retinopathy or REACH-DR.

On September 21, 2021, the REACH-DR team shared the first successful implementation of a validated AI algorithm in the clinical setting for ophthalmology in the country. Following this significant achievement, Dr. Silva shares their motivation and vision in pursuing the project, and their plans moving forward.


Establishing a telemedicine program for diabetic retinopathy

Building on AI technologies, the REACH-DR project aims to establish the very first inclusive telemedicine screening program for diabetic retinopathy in the country.


"Diabetic retinopathy is the most common complication of diabetes. Despite the availability of highly effective treatment, diabetic retinopathy remains the most common cause of visual loss and blindness among people with diabetes. This emphasizes the need for retinal evaluation.” Dr. Silva explains. “While screening for the disease early on is especially relevant, in-person retinal evaluation in the Philippines is not always possible, due to lack of access to medical facilities that is worsened by geographic, social and cultural constraints.”

Deriving inspiration from the success of a DR screening program in the UK, Dr. Silva’s team set out to launch a similar project here in 2019.
“One of the greatest success stories in diabetes eye care is the United Kingdom's National Diabetic Retinopathy Screening Programme. In 2014, for the first time in five decades, diabetic retinopathy was no longer the leading cause of legal blindness in the working-age population in England and Wales, due to the early detection of diabetic retinopathy by screening, along with improved control of blood sugar levels.”

The team aims to implement a national DRSP in the country by completing three phases: 1) developing the necessary infrastructure by analyzing and validating existing telemedicine technology, 2) adapting the selected technologies into the Philippine setting, and 3) completing the technology transfer to the Philippine stakeholders.


If successful, “
the UK REACH DR program will help to identify eyes at high risk for losing sight, and this will have a direct benefit for individuals,” Dr. Silva says. “An additional benefit will be the promotion of awareness for the need for eye evaluations which will significantly improve the overall level of eye care and reduce the risk of diabetes-related visual loss among people with diabetes,” he added.


The first validated AI algorithm in the clinical setting for ophthalmology in PH


Now in its third year of implementation, the project achieved a significant milestone last week. “
September 21, 2021, marks the first use of a validated artificial intelligence (AI) algorithm in a clinical setting for ophthalmology in the Philippines,” Dr. Silva shares. “Our REACH-DR team with the use of AI has successfully performed and completed diabetic retinopathy screening in a target community in Nueva Ecija to identify diabetic retinopathy and other vision-threatening retinal diseases.”





This development is a step closer to increasing access to retinal screening, which will pave the way for timely and accurate diabetic retinopathy detection.

“Evaluating retinal images is a highly skilled process, which requires training, continuous quality control, and maintenance of a specialized skill set. As trained retinal image readers are costly and difficult to train with limited numbers worldwide, it has become a necessity to seek automation processes in ocular telemedicine to increase throughput while maintaining cost-effectiveness and accuracy.”

The project will run until next year, June 2022, with the completion of the screening of the target population and is expected to provide the framework for the future implementation of diabetic retinopathy screening programs in the Philippines.

With the nearing completion of the project, Dr. Silva highlights how conducting health research provides “opportunities to answer dilemmas unaddressed for many years.”

“Health research changes lives and makes the world we live in much better than it is,
” he says.
__________________________________________________________________________________________________

Dr. Paolo Antonio S. Silva is a staff ophthalmologist and the chief of telemedicine at the Beetham Eye Institute of the Joslin Diabetes Center. He is an Assistant Professor of Ophthalmology at Harvard Medical School and a research collaborator and faculty at the Philippine Eye Research Institute.

On September 21, 2021, the Philippine Eye Research Institute (PERI), in collaboration with the Queen's University of Belfast of the United Kingdom (UK), successfully deployed a validated artificial intelligence (AI) algorithm for diabetic retinopathy screening, marking the first use of AI in ophthalmology in the Philippines.

This is a significant milestone in Philippine ophthalmology and is a step towards establishing an inclusive program for diabetic retinopathy screening that has the potential to eliminate diabetes-related blindness. The UK-Philippines Remote Retinal Evaluation Collaboration in Health: Diabetic Retinopathy or REACH-DR is a Newton-Agham program that aims to establish a diabetic retinopathy screening program (DRSP) here in the country. Establishing a local DRSP will help in the timely identification of eyes at risk for diabetes-related blindness and visual loss. 


To achieve this, REACH-DR pursues the following targets: 1) the development of the necessary infrastructure for a local DRSP by analyzing and validating existing telemedicine technology, 2) adaptation of the selected technologies into the Philippine setting, and 3) completion of technology transfer to the Philippine stakeholders. 


If we succeed in establishing a DRSP locally, we can help treat patients on time, save their eyesight, and help them remain socially active,” project leader and Harvard Medical School Assistant Professor of Ophthalmology Dr. Paolo Antonio Silva says. “Ultimately, we want to reduce the incidence of blindness and visual impairment caused by diabetic retinopathy, which will allow the patients to live independently,” he adds.


We, at the DOST-PCHRD, are proud of the achievement that the REACH-DR team has achieved,” DOST-PCHRD Executive Director Dr. Jaime C. Montoya says. “This project is an example of how we build on research to make healthcare services more accessible for the Filipino people, and ultimately, help make their lives better,” he adds. 


Currently, the REACH-DR team is conducting retinal screening among underserved communities in the National Capital Region (NCR) and Region 3. The screening is expected to be completed by June 2022.

The project is funded under the Newton Agham Program of the DOST-PCHRD and the UK Medical Research Council.


 

The Department of Science and Technology with the Philippine Council of Health Research and Development (DOST - PCHRD), in partnership with the University of the Philippines – Manila (UPM) MD-PhD in Molecular Medicine program, welcomed the 12
th Batch of MD-PhD scholars into the fold last 11 September, 2021 through a virtual get together. DOST – PCHRD Executive Director, Dr. Jaime Montoya, the Dean of the UPM College of Medicine (UPCM), Dr. Charlotte Chiong, and the Chairperson of the Vaccine Experts Panel, Dr. Nina Gloriani were present to send their greetings and offer inspirational messages not only to the new batch but also the ones still in the running to become doctor-researchers.

Hiraya

With the theme Hiraya Tungo sa Bagong Umaga, the two-hour event was filled with warm stories and words of encouragement from the ates and kuyas of the program for their bunsos.

Hiraya—which is an ancient Filipino word for the fruit of one’s hopes, dreams, and aspirationsdoes not only apply to the hope these doctor-researchers bring to the future of healthcare in the country but to the scholars, as well, as the program opens a vast array of opportunities for them career-wise and even life-wise.Research Professor Jose Nevado, Jr. and the graduates of the program shared the avenues available to MD-PhD graduates. Other than the obvious medical and research tracks that the program promises, Dr. Nevado shares that MD-PhD graduates can also be catalysts of change as educators, administrators, politicians, entrepreneurs, or even a combination of some or all of these possibilities. However, he warns them that though they might be tempted to take on a lot once they realize what they are capable of once they finish the program, they should practice prudence. “Just be enough in order to still be capable of producing significant impact [to] society. Do not forget that at the end of the day, you should be a servant for humanity.”

Long and Tedious Journey

The MD-PhD in Molecular Medicine is an eight-year double doctorate degree program offered by UPMC and supported by DOST – PCHRD, and is the first and only one of its kind in the country. DOST currently monitors 94 scholars, 21 of which have already finished the program and are working in different sectors of society—a significantly small number compared to the country’s need for physician-scientists, especially now that the country is racing against the spread and further mutation of COVID-19.

Dr. Nevado shared that the Philippines is one of the countries with lowest number of experts in contrast with the population, which is why their work as physician-scientists need to be of greater impact. Many of the batches shared similar aches and pain points as they wrestled the program and the tools and tip they have kept in their own survival kits to cope with moments of self-doubt, frustration, and fatigue.

Knowing their ‘why’s and taking care of one’s self are two of the most resonant pieces of advice among the mentors and the scholars present during the summit. Also, despite the already rigorous nature of the program, the MD-PhD scholars remind their younger siblings to “never settle for less” and “find better ways to serve the Filipino people.”

Everyone who testified during the summit also assured their younger siblings in the scholarship that though they have a long and tedious road ahead, their journey will be a noble and fulfilling one, and that they will not be on the journey alone.

Welcome to the Family

“You have a community to guide and help you through this journey.” Dr. Montoya said, and this sentiment echoed throughout the summit.

Though the program is undeniably tough, the MD-PhD ates and kuyas chose to focus on the highs of their stay as MD-PhD students.

Many of the MD-PhD ates and kuyas fondly impart that other than the chances given to them by the program and their DOST scholarship to travel and enjoy, make significant contributions to the scientific community and society, and foster collaborations abroad, they were also able to find and form lasting friendships with their fellow MD-PhD scholars. Their batchmates, many of them shared, are their best support system during their eight-year MD-PhD journey. “Celebrate with your batchmates. Celebrate your batchmates.” Batch 11 advises Batch 12. “They will be your family in this long journey. The very people who know exactly what you’ve gone through.”

Mentors were also instrumental in providing direction and guidance to the scholars as they navigate the program. Dr. John Carlo Malabad and Dr. Sheriah Laine De Paz-Silva, graduates of the MD-PhD program, guaranteed that chances are, the mentors they gain during their tenure in the program, like Dr. Chiong, Dr. Gloriani, and Dr. Montoya, will continue to help and guide them even when they have finished the program.
“There will always be people who will be willing to help you.” Dr. Joy Vanessa Perez from Batch 2 told her younger siblings. “So don’t be afraid to ask.” Doors will be opened for opportunities also to collaborate with scientists whose studies they have once cited for their dissertations, Dr. Malabad said.

Better Brighter Future Despite the Challenges

Virtual platforms seem limiting but also gave way to opportunities, as Christian Luke Badua and Karol Ann Baldo from Batch 10 (wittily called the Sampuguitas) observed during their presentation on local research dissemination. Online means provided wider reach for researchers as they did away with the limits set by budget constraints for travel and accommodations for international fora and conference, albeit less organic.

The MD-PhD Summit clearly would have been merrier had all the batches and the mentors congregated face to face, but the meeting never lacked warmth, and good intentions translated beyond the screen through the efforts put together by the different batches to welcome their youngest.

Dr. Sharon Yvette Angelina Villanueva of the College of Public Health in UPM thanked the different batches for their “interesting contributions” to the program during her closing remarks. She also wished that the Summit helped and inspired everyone present, not just the younger batch, to never give up and look forward to hiraya: a brighter and better tomorrow.

The Department of Science and Technology (DOST) and the University of the Philippines (UP) will inaugurate the Protein, Proteomics, and Metabolomics Facility (PPMF) as an addition to the existing genomic research capacities of the UP Philippine Genome Center (PGC) this October 4, 2021.

 

Initiated in 2018, the DOST provided a total of 175 million pesos of funding support for the provision of globally recognized tools and equipment units needed for the establishment of the PPMF. According to DOST Undersecretary for R&D Dr. Rowena Cristina Guevara, the PPMF is envisioned “as a platform for collaborative work on proteomics and metabolomics research and a training hub for those who are conducting OMICS-type researches”

 

With UP’s support on infrastructure development and DOST’s support in the acquisition of several laboratory equipment, the new facility is poised to serve R&D institutions both in the government and in the private sector in the coming months. Some of the laboratory equipment available at the PPMF includes a High and Ultra Pressure Liquid Chromatography System and a High-Resolution Mass Spectrometer, which are both used in identifying, quantifying, and purifying compounds.

 

We are proud of the PGC for the role that they play in advancing genomics and proteomics research in the country.” Usec. Guevara says. “It is our hope that with the inauguration of this facility, we will be able to provide a platform for collaborative work, and open new opportunities for our researchers to further grow their expertise in the field.”

 

In line with UP’s partnership with DOST, UP PGC executive director Dr. Cynthia P. Saloma mentioned in a separate interview that “DOST has always been a champion of our local researchers, by providing the mechanism (funding support) to make available highly technical scientific tools – for the advancement of scientific research in the country”.

 

Stay tuned for the launch of the PPMF webpage at the official website of the PGC (https://pgc.up.edu.ph/) for more information and updates.

 

ABOUT THE PHILIPPINE GENOME CENTER

The Philippine Genome Center is a genomics-focused multidisciplinary research unit that offers a full range of DNA sequencing services from single-gene sequencing to high-throughput sequencing and a suite of Bioinformatics services from scripting to full project workflows. With the addition of a new core facility devoted to protein analysis, PGC is able to offer a diverse range of Omics services in one roof. Under the Office of the Vice President for Academic Affairs of UP System, the Center’s main headquarters is located inside UP Diliman Campus. The Philippine Genome Center Building houses the DNA Sequencing Core Facility, Bioinformatics Core Facility, Core Facility for Biobanking, Clinical Genomics Laboratory, and the soon-to-launch Protein, Proteomics and Metabolomics Facility. 

 

In late 2019, the PGC’s Mindanao Satellite Facility, or PGC Mindanao, located inside UP Mindanao Campus had its ceremonial launch while the Visayas Satellite Facility commonly referred to as PGC Visayas, inaugurated its research and service laboratory in the last quarter of 2020.


Visit www.pgc.up.edu.ph to know more about the Philippine Genome Center and follow @phgenome on Twitter and Facebook for the latest news and activities related to genomics.

The Philippine Council of Health Research and Development of the Department of Science and Technology (DOST – PCHRD), in partnership with St. Luke’s Medical Center – College of Medicine-William H. Quasha Memorial (SLMCCM – WHQM), officially welcomed four new scholars into its MS in Molecular Medicine Program through a virtual Memorandum of Agreement signing event last 1 September, 2021.

The two-year program trains current medical practitioners and allied health professionals in applying microbiology in the clinical setting. MS in Molecular Medicine students are expected to learn about the latest biotechnologies, such as cell-based therapies, gene therapies, targeted therapies, biomarker technology, molecular diagnostics, pharmacogenomics, and personalized medicine, and with the DOST – PCHRD scholarship, the four scholars can also expect financial support for their academic and research endeavors, such as monthly stipends, attendance to international conventions, and publications to international journals.

The event was brief but meaningful for everyone involved.

SLMCCM – WHQM and DOST – PCHRD are beginning to see the fruits of their partnership, which began in 2018, as the first graduates of the program entered a time where their skills are truly sought after. “Without the seeds we have sown years ago, our country would be helpless against the enemy we are currently facing,” Dr. Jaime Montoya, Executive Director of DOST – PCHRD, said in his message.

Dr. Susan Pelea Nagtalon, the Dean of College of Medicine at St. Luke’s, however, acknowledges that there are only a few students in the program, but she promises that they are all focused and dedicated to finish the program. Quoting Robert Frost’s The Road Not Taken, Dr. Mark Pierre Dimamay, Director of the MS Molecular Medicine Program of SLMCCM – WHQM, echoed Dr. Pelea Nagtalon’s sentiment, but he assured the scholars that taking the road less travelled will not only make a difference in their lives but also the lives of others.

After the signing, Dr. Dimamay also encouraged the scholars to take the pandemic as a challenge and an opportunity to work on numerous projects and programs that will ultimately benefit the country.

The new MS in Molecular Medicine scholars are Raphael Joshua De Guzman, Celeste Aleena Fariñas, Patrick Ian Jacinto, and Liza Matuloy.