ESC TV Today – Your Cardiovascular News Season 4 - Ep4: Extended interview on The future of guidelines in an era of big data and AI
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Mar 5, 2026 Thomas F. Luescher, cardiology expert and long-time clinician, explores AI, big data and the future of guidelines. He discusses datasets from imaging, wearables, genomics and registries. He covers continuous updates versus safety, validation and portability of prediction models, and the data skills clinicians will need. Practical ideas on streamlining guideline content and avoiding clinician alert fatigue are highlighted.
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Large Data Unlocks Personalized Prediction Scores
- AI needs very large datasets to validate algorithms for clinical use and guideline development.
- Thomas F. Luescher highlights prediction scores built from hundreds of thousands to millions of patients enabling personalized radar-plot phenotyping and comparison of real-world versus trial outcomes.
ESC Digital Twin Project With 100 Biomarkers
- The ESC received a grant to build a digital twin using 100 biomarkers and parameters to deepen patient phenotyping.
- Luescher describes the twin 'talking' to patients, prompting them to check numbers and consult their physician as part of guideline implementation.
Only Update Guidelines For Practice Changing Evidence
- Only implement guideline changes for breakthrough data that directly affect clinical practice or for trials showing safety signals.
- Thomas F. Luescher argues urgency is required when a new effective therapy appears or when evidence reveals harm, so clinicians get timely recommendations.