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Editor’s  Corner
Would you like to know the health state of your 

brain? Have you ever assessed your intelligence 
quotient (IQ)? Soon, in addition to measuring your IQ we 
will also be able to determine your brain’s health with 
quantification just like those used in the assignment of 
IQ levels. This depends to a large extent on how many 
resources, including clinical engineers, will focus on 
the research about the intricacies of the human brain.

In the book “The Tell-Tale Brain,” a New York Times 
bestseller, Ramachandran, director of the Center for 
Brain and Cognition at the University of California in 
San Diego investigates the working of the mind through 
malfunctions of the brain. He states that in the 50s we 
were able to decipher the human genetic code, but by 
comparison, the science of the mind languishes and 
that, for most of the 20th-century neuroscience, was 
still young upstart. “As heady as our progress has been, 
…we have only discovered a tiny fraction of what there 
is to know about the human brain.” 

To help initiate, last October, the celebration of the 
2019 Global Clinical Engineering Day, I invited distin-
guished faculty members to share with me in the pro-
gram hosted in China. Recognized experts such as Tobey 
Clark from the University of Vermont, Ilir Kullolli from 
Stanford/Children’s Hospital and currently ACCE Pres-
ident, Dr. Kallirroi Stavrianou from Warwick University 
in the UK, and Dr. Howard Derman, a neurologist chief 
of the Concussion Center at the Methodist Hospital in 
Houston, Texas. Each member of the faculty shared their 
unique expertise, and all were received with roaring 
success https://www.youtube.com/watch?time_con-
tinue=16&v=yQ1DuSlSfvQ&feature=emb_logo. It was a 
perfect set-up for the initiation of the global celebration 
recognizing all that clinical engineers do every day around 
the world to better patient care outcomes! 

Specifically, I wanted to include physician/neurolo-
gist to our Global Clinical Engineering program because 
not too many clinical engineers know of the specific 
neurology based challenges healthcare practitioners 
face in the management of brain conditions. Dr. Derman 
did an excellent job of connecting a wide spectrum of 
clinical needs with expectation that future technological 
tools will meet. 

Over years of working with neurology based research-
ers, I personally observed how much they struggled to 
overcome the inability to quantify changes in the health 
state of the brain when they were faced with the chal-
lenge of managing or diagnosing brain injury, trauma, or 
diseases. In several studies, where I joined as a clinical 
engineer with a team that included pediatric neurolo-
gists and other scientists, we all experienced firsthand 
the difficulty of developing and applying experimental 
technological tools to diagnose and quantify brain func-
tions. Not only such instrumentation was rare but more 
often the interpretation of the results produced by these 
tools set a new frontier for wide interpretation of new 
brain mapping data. These studies included instruments 
such as near-infrared spectroscopy to measure cerebral 
blood flow (“Correlation of Near Infrared Spectroscopy 
Cerebral Blood Flow Estimations and Microsphere 
Quantitations in Newborn Piglets” https://www.karger.
com/Article/Abstract/14056), and scalp temperature 
sensors that measured and correlated with predicted 
brain decay (“Rectal-Scalp Temperature Difference 
Predicts Brain Death in Children, Pediatric Neurology 
April 1999; 20(4);267–9) https://www.academia.
edu/6751649/Rectal-scalp_temperature_difference_pre-
dicts_brain_death_in_children, and cortical electrodes in 
“Computer-Controlled Electrical Stimulation for Quan-
titative Mapping of Human Cortical Function,” https://
www.ncbi.nlm.nih.gov/pubmed/19061348.

http://www.globalce.org
http://www.globalce.org
https://www.youtube.com/watch?time_continue=16&v=yQ1DuSlSfvQ&feature=emb_logo.
https://www.youtube.com/watch?time_continue=16&v=yQ1DuSlSfvQ&feature=emb_logo.
https://www.karger.com/Article/Abstract/14056
https://www.karger.com/Article/Abstract/14056
https://www.academia.edu/6751649/Rectal
https://www.academia.edu/6751649/Rectal
https://www.ncbi.nlm.nih.gov/pubmed/19061348
https://www.ncbi.nlm.nih.gov/pubmed/19061348


J Global Clinical Engineering Vol.2 Issue 2, 2019  2

The pharmaceutical field is in a similar situation. The 
cover story in The Scientist, December 2019, “Markers of 
Alzheimer’s,” Michelle Mielke, a neurologist at the Mayo 
Clinic in Rochester, Minnesota, who studies cognitive 
decline states, “At this point, I do not think we have the 
best idea in term of what biomarker is exactly going to 
be used for what”. Essentially suggesting that pharma-
ceutical industry and the technological solutions are at 
the same situation. 

However, Dr. Derman’s presentation directed at clin-
ical engineers described the physiology of injured brain 
following with observed symptoms from such injuries 
suffered in combat, motorbike accident, or during contact 
sport. His message was that engineers need to focus on 
solving how to equip healthcare providers with tools that 
help form a quantified diagnosis so that they can know 
how to better manage the patient condition/progress. 
As reported in a study by geriatrician Sharon Inouye at 
Hebrew SeniorLife and Harvard Medical School “20–30% 
of patients over the age of 70 who have a major surgery 
will experience delirium that is associated with long-
term cognitive decline and increased risk for developing 
Alzheimer’s disease.” Again, still a non-quantified condi-
tion. (Wall Street Journal, December 10, 2019, page A12).

Improving the arrival at the correct diagnosis is a key 
aspect of good health care. It provides an explanation of a 
patient’s health problem and informs proper subsequent 
health care decisions, states the Institute of Medicine’s 
report, September 2015, on “Improving Diagnosis in 
Health Care.” One way to achieve that is through closer 
collaboration between clinical engineers, physicians 
and researchers to guide and enable the focusing of 
technological innovation on addressing challenges not 
only in neurology but in every medical/surgical and 
rehabilitation discipline. 

It is important to insert scientific exchanges such as 
Dr. Derman’s presentation within clinical engineering 
meetings and this Journal will continue to facilitate that 
as reflected by the membership of the Global Clinical 
Engineering Journal Editorial Board. Having neurologist, 
orthopedic surgeon and anesthesiologist reviewing 
submissions together with clinical engineers. What do 
you think can increase clinical engineers’ participation 
in finding and evaluating tools to quantify the health 
status of our brains? 

Together we can do it better and I am-
looking forward to your feedback!

Dr. Yadin David

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