Final Report Summary - ETIME (Engineering Technology-based Innovation in Medicine) Background: Healthcare costs ~10% of GDP in the OECD, and grows an unsustainable 7-11% per year, driven by ageing populations and multiplied by exponential growth of chronic diseases, such as Type 2 diabetes, that consume ~1% of GDP each. Limited funding leads to an ‘equity gap’ in health, where more people go untreated, less treated (rationing), or rely on private insurance and care, creating and exacerbating inequality.A major villain in this drama is intensive care, which consumes ~7-15% of health costs or ~1% of GDP, and its interaction with aging demographics and chronic disease. Respiratory, metabolic and cardiac disease each cost 0.5-1.4% GDP, and are each leading causes of ICU admission, mortality and cost. Hence, addressing pressing needs to improve the productivity and quality of intensive care, will create generalisable platforms from which to improve care for the even larger out-patient cohorts with related chronic disease in the home and community.This research program conducted a coordinated joint exchange effort in the area of Model-based Therapeutics (MBT), which combines computer models of human physiology, clinical data and automation to solve clinical problems in diagnosis and treatment selection, as well as enabling the (hardware + software) automation of basic elements in the delivery of care. The final goal was an EU-NZ research consortium focused on creating innovative new technologies and solutions to improve quality and productivity (reducing cost) in intensive and acute care.The ultimate aims were: to create a sustainable consortium around MBT and innovative solutions to significant healthcare problems that have significant and increasingly unaffordable social and economic costs; to create the intellectual and international critical mass to address these issues effectively and in a readily transferrable fashion; to use these developments to expand our capacities to meet future and critical healthcare challenges facing the world; and to transfer these capabilities and outcomes to industry for commercialization and widespread uptake.Main Objectives: The research exchange and program supported three core objective project (COP) areas of research and consortia development in the application of engineering to ICU (intensive care unit) medicine. These areas were: - Glycemic Control (GC)- Mechanical Ventilation (MV)- Cardiovascular Management (CVS)Main research outputs:(1) A working and clinically tested accurate glycaemic control (AGC) protocol that is automated and provides improved care in multiple EU and NZ hospitals has been implemented. A commercial grade version is developed. It has been published in details in various scientific forums for the local ICU community aiming to be the introduction of the protocol as a standard of care throughout Hungary, as it is in Christchurch, and the NZ and EU units.(2) The first model-based MV protocol that is proven in initial human clinical trials in multiple EU and NZ hospitals has been developed. It was the center of a large randomized clinical trial in New Zealand, Christchurch Hospital, in 2016 – the first model-based MV method to be tested in such a major trial.(3) The first model-based CVS monitoring and diagnostic system has been developed and has been initially proven in animal trials. It is ready for initial human trials in multiple EU and NZ hospitals.This collaborative exchange has enabled the common use of techniques, equipment or resources, unavailable in some of the participating countries. Moreover, it made possible the adoption of new clinical and research methods in the participating institutions. The outcomes have led to new commercial linkages, opportunities and spin-out ventures.Publications:Over 4 years of exchange we have published:Totals: 327 total articles, comprising: 114 journal articles (14 invited) and 213 conference articles/abstracts (44 invited; 5 Best Paper Awards; 1 invited Plenary Talk):2016: 50 journal articles (5 invited) and 53 conference articles/abstracts (6 invited; 2 Best Paper Award)2015: 24 journal articles (0 invited) and 79 conference articles/abstracts (17 invited; 1 Best Paper Award; 1 Plenary Talk)2014: 25 journal articles (6 invited) and 54 conference articles/abstracts (18 invited; 2 Best Paper Awards)2013: 15 journal articles (3 invited) and 27 conference articles/abstracts (3 invited)The increase in publication performance over the project years well documents the effectiveness and success of the ETIME consortium enabled by EU funding.Grants submitted by the eTime consortium:The eTime consortium submitted 29 research grant applications to various sources in 2015 and 2016. 16 out of 29 were successful. Web presence:The eTime consortium has installed an internal web page to facilitate the communication between the project partners. The public home page of the project provides free access for most of the research outcomes: http://etime.iit.bme.hu/
