Upload
plan-de-calidad-para-el-sns
View
492
Download
0
Embed Size (px)
DESCRIPTION
Early Adoption of VPH Technology – Towards Realising more Personalised, Predictive and Integrative Medicine. Viceconti M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
Citation preview
WoHIT, Barcelona March 2010
Early Adoption of VPH
TechnologyTowards Realising more Personalised,
Predictive and Integrative Medicine
Marco Viceconti
VPH Network of Excellence
Outreach program
WoHIT, Barcelona March 2010
Synopsis
• What is the VPH?
• Examples of early adoption
© 2007 STEP Consortium
The human Puzzle
• The human body is currently investigated as if it is a jigsaw puzzle made of a trillion pieces
• We are trying to understand the whole picture by looking at a single piece, or at a few closely interconnected pieces
• We do need a frame, within which we can finally start to place the pieces all together, and the glue that connect them
• The frame is not the whole picture, but is the only way we might hope to see it one day
© 2007 STEP Consortium
Paradigmatic Shift in
Biomedical Research
Complement
Reductionism
With
Integrationism
© 2007 STEP Consortium
Integration across ….
Across organ systems
© 2007 STEP Consortium
Environment
Population
Integration across ….
Across
dimensional scales
Across
Temporal scalesOrganism
Organ System
Organ
Tissue
Cell
Molecule
Atom
C C
H H
H H
© 2007 STEP Consortium
Integration across ….
Across DisciplinesMedicine
BioEngineering
Biology
© 2007 STEP Consortium
Integrative Research
• The Integrative Research approach
requires a radical transformation on the
way biomedical research is conducted
• It is necessary to create a framework
made of technology and methods
• We call this framework
Virtual Physiological Human
© 2007 STEP Consortium
Virtual Physiological Human
• The Virtual Physiological Human is a methodological and technological framework that once established will enable the investigation of the human body as a single complex system
• This framework should be:
– Descriptive
– Integrative
– Predictive
© 2007 STEP Consortium
VPH Research Road Map
http://www.europhysiome.org/roadmap
The VPH constellation
Networking
NoE
Osteoporosis
IP
Alzheimer's/ BM &
diagnosis STREP
Heart /CV
disease STREP
Cancer
STREP
Liver surgery
STREP
Heart/ LVD surgery
STREP
Oral cancer/ BM
D&T STREP
CV/ Atheroschlerosis
IP
Breast cancer/
diagnosis STREP
Vascular/ AVF &
haemodialysis STREP
Liver cancer/RFA
therapy STREP
Security and
Privacy in VPH CA
Grid access CA
Heart /CV
disease STREP
Industry
ClinicsInternational
Related Research
WBM - neurovascular
12IMAG Futures meeting
Bethesda, December 2009http://www.aneurist.org/
Clinical Parameters: -weight- opportunistic infections and tumors-survival
Molecular DynamicsBinding Affinity
ProteinStructure& Binding Affinity
VIROLABDRUG RANKING
DECISION SUPPORT
Text Mining Drugranking 1st order logic
Complex Networks Epidemics
Agent-Based Entry
Simulation
CXCR4
CCR5
CD4+ Target Cell
HIV
Phenotype
CA Based Immune Response
Protease and RTmutations
Peter Sloot: Computational Science, University of Amsterdam, The Netherlands.
http://www.virolab.org/
Philips Research Europe - Aachen
euHeart – Integrated Cardiac Care Using
Patient-specific Cardiovascular Modeling
euHeart is about the development, personalization
and validation of computational models of the
heart to improve:
- Diagnosis,
- Treatment planning,
- Interventions and
- Design of implantable devices
5 clinical focus areas:
- Cardiac Resynchronization Therapy
- Radiofrequency Ablation
- Heart Failure
- Coronary Artery Diseases
- Valves and Aorta
Project coordination: Philips Research
Scientific coordination: The University of Oxford
17 partners (6 companies, 6 universities, 5 clinics)
Budget ~19M€ (~14M€ EU funding)
USFD, DKFZ
INRIA
UOXF
Philips Research
http://www.euheart.eu/
Kostas Marias – ICS FORTH
Modellingat the molecularlevel
Simulating tissuebiomechanics
Tumour imageanalysisand visualization
Modelling cancerat the cellularlevel N
SG
1
G
2
M G
0
A
time
Multi-level Modelling In Silico Optimal therapy planning
Simulating Therapy A
Simulating Therapy B
Multi-level data Multi-level modelling
Clinically Oriented Translational Cancer Multilevel Modelling
• ContraCancrum will integrate
molecular, cellular, tissue and
higher level modelling concepts
into a single technological entity
that will simulate therapy
outcome based on the individual
patient information.
• This could serve as a powerful
weapon to better understand and
fight cancer. The most important
IT challenge is to integrate
across different scales into an
integrated cancer
therapy/growth simulator.
• The primary clinical challenge is
to gather histopathology,
microarrays and multi-modal
imaging exams (e.g. DT-MRI,
CT, etc) of the same patient.
• A significant validation on lung and brain cancer cases will demonstrate the added value of
modelling assisted cancer therapy design and will pave the way for its future clinical use.
http://www.contracancrum.eu/
WoHIT, Barcelona March 2010
PreDiCT: Computational
Prediction of Drug Cardiac Toxicity
Drug/Ion Channel model
17.4 17.7 18 18.3 18.6-100
-80
-60
-40
-20
0
20
40
60
V (
mV
)
time (s)
Cellular model
Torsades de Pointes – ElectrocardiogramWhole-ventricular model
Action Potential
Aim: to identify new biomarkers of drug-induced cardiotoxicity using
computational modelling and simulation techniques
Partners
AstraZeneca
Aureus
CRS4 in Sardinia
Fujitsu
GlaxoSmithKline
Novartis
Pfizer
Roche
University of Oxford
University of Szeged
Universidad Politecnica
de Valencia
http://www.vph-predict.eu
Copyright © 2008-2012 VPHOP Consortium - All right reserved 17
Organ-level Model
Cell-levelModel
Constituent-levelModel
Tissue-levelModel
Body-level Model
Boundary Conditions
Bone
Rem
odellin
g
FailureCriterion
ConstitutiveEquation
VPHOP Technology to fight osteoporosisOsteoporotic Virtual Physiological Human
http://www.vphop.eu/
Models in clinical use
18IMAG Futures meeting
Bethesda, December 2009
1 month 7 months 13 months 29 months 36 months 44 months Pre-op
Copyright © 2008-2012 VPHOP Consortium - All right reserved 19
CBA of model-based diagnosis
• Preliminary CBA according to VHOP Technology assessment protocol largely favourable (21% cost reduction)
• Improving effectiveness of 1.3% is enough to break even
Cost of exam 100 patients
(€)
Cost 1 hip fracture
(€)
Effectiveness (% fractures prevented)
Total cost
x 100 patients
(€)
DXA € 30,000.00 € 70,000 82.5% € 1,255,000
CT + Model € 116,200.00* € 70,000 87.5%** € 991,203
Cost saving € 2,637 x patient
* Based on research tools** Estimated from preclinical tests
WoHIT, Barcelona March 2010
Thank You!!• Useful URLs:
– http://www.biomedtown.org
– http://www.vph-noe.eu
20