Periodic Reporting for period 2 - MES-CoBraD (Multidisciplinary Expert System for the Assessment & Management of Complex Brain Disorders)
Période du rapport: 2022-10-01 au 2024-03-31
Millions of Europeans of all ages live with brain disorders that threaten their quality of life and impact the sustainability of health systems. Contributing to this field, the EU-funded MES-CoBraD project aims to improve the diagnostic accuracy and therapeutic outcomes of complex brain disorders, such as epilepsy, dementia, and sleep disorders. To do this, it will combine real-world data from diverse populations through thorough, cost-efficient, and fast protocols. The project will draw on expertise in medicine, engineering, and computer science, amongst others, to ultimately help improve the quality of life of those living with such disorders, as well as caregivers and society.
The Multidisciplinary Expert System for the Assessment & Management of Complex Brain Disorders (MES-CoBraD) is an interdisciplinary project combining real-world data (RWD) from multiple clinical and consumer sources through comprehensive, cost-efficient, and fast protocols towards improving diagnostic accuracy and therapeutic outcomes in people with Complex Brain Disorders (CoBraD), as reflected in neurocognitive (dementia), sleep, and seizure (epilepsy) disorders and their interdependence. It brings together internationally recognised experts in medicine, engineering, computer science, social health science, law, and marketing and communication from across Europe, and combines clinical information and scientific research in CoBraD with technical innovation in secure data-sharing platforms, artificial intelligence algorithms, expert systems of precision and personalised care, and advanced data analytics, with a primary focus on improving the quality of life of patients, their caregivers, and society at large. It leverages RWD from diverse CoBraD populations across cultural, socioeconomic, educational, and health system backgrounds, with special attention on including vulnerable populations and minorities in an equitable manner and engaging key stakeholders to maximise project impact.
The Multidisciplinary Expert System for the Assessment & Management of Complex Brain Disorders (MES-CoBraD) is an interdisciplinary project combining real-world data (RWD) from multiple clinical and consumer sources through comprehensive, cost-efficient, and fast protocols towards improving diagnostic accuracy and therapeutic outcomes in people with Complex Brain Disorders (CoBraD), as reflected in neurocognitive (dementia), sleep, and seizure (epilepsy) disorders and their interdependence. It brings together internationally recognised experts in medicine, engineering, computer science, social health science, law, and marketing and communication from across Europe, and combines clinical information and scientific research in CoBraD with technical innovation in secure data-sharing platforms, artificial intelligence algorithms, expert systems of precision and personalised care, and advanced data analytics, with a primary focus on improving the quality of life of patients, their caregivers, and society at large. It leverages RWD from diverse CoBraD populations across cultural, socioeconomic, educational, and health system backgrounds, with special attention on including vulnerable populations and minorities in an equitable manner and engaging key stakeholders to maximise project impact.
During the second reporting period M19-M36 (01/10/2022 – 31/03/2024), the MES-CoBraD project expanded upon the implementation of its ambitious use-cases. With a multi-layered and parallel approach to performing research and developing innovations, ranging from the most practical results to the most ambitious, the consortium has been working towards implementing its research protocols, collecting data from multiple sources, integrating and harmonising them based on scientifically and ethically sound commonly agreed-upon rules, and designing research hypotheses. At the same time, to meticulously implement the requirements collected and prioritised, and to be able to test these hypotheses, the MES-CoBraD platform was designed, including its various components and modules, to support the development of a technology that will be sustainable and expandable. The aim is to create a robust, secure, and integrated platform with a single UI and an innovative approach to incorporating research and clinical protocols with business processes, analytics, and Artificial Intelligence. The development of the platform has progressed greatly at this stage, with most features already implemented and able to present very promising tangible results. At the same time, taking into account the complexity of such an implementation, the project’s medical partners have been performing research based on the MES-CoBraD protocols, both within and outside the platform. Alongside medical and technical work, ethics and legal work was performed to ensure there is no misuse of resources on several levels, while dissemination and stakeholder engagement activities have kept all the interested parties in the loop regarding the project’s progress. Planning for the future, the project’s exploitation and innovation strategies are following and documenting the project’s results to make them available to the various stakeholder communities as soon as they become formalised.
During the second 18 months of the study, we have continued to effectively collect data for our MES-CoBraD Biobank through the novel MES-CoBraD diagnostic protocol from daily RWD applied in clinic or at home, including follow up assessment data. This allows data to be accessible through FAIR principles through the platform, and establish also prognostic hypothesis testing. Published results from this period and funded through the MES-CoBraD project have already revealed several findings in CoBraD. Specifically, (a) Plasma glial fibrillary acidic protein and neurofilament light chain is useful in diagnostic and prognostic evaluation of frontotemporal dementia, (b) there is a potential predictive value of repetitive transcranial magnetic stimulation before chronic cortical stimulation for epilepsia partialis continua. With regards to prognostic objectives, (a) dementia prior to ischemic stroke does not impact the efficacy or safety of thrombectory or t-PA for acute ischemic stroke. With regards to protocols that assess therapeutic intervention efficacy and safety in CoBraD, we have completed out study on 50 participants that (a) Cognitive Behavioural Therapy for Insomnia is helpful in improving insomnia in people with Mild Cognitive Impairment, while at the same time allowing for tapering of central nervous system sedatives. Our study, with a year’s follow up, did not reveal that it also helps in delaying cognitive decline over time. During the second 18 months of the project, we have provided technical partners with the scientific operations that an Expert System is required to perform for guiding the Assessment and Management of CoBraD. This is a representation of methodological operations identified in our hypothesis testing protocols (D4.2 D4.3 D4.4 D4.5) and whose high-level outputs are assessed through a defined validation framework and end-user feedback, including test-case executions, to examine if Platform modules are assessed as-intended. We anticipate, as planned from the start of the project, to start assessing this key objective from M24 onwards.