Truth and Lies about Latency in the Cloud, Jelle Frank v.d. Zwet, Interxion
Alzheimer's disease biomarkers - OECD Lovestone.pdf · 2016-03-29 · Pieter Jelle Visser...
22
Alzheimer's disease biomarkers An essential requirement for clinical trials; the need for datasharing
Transcript of Alzheimer's disease biomarkers - OECD Lovestone.pdf · 2016-03-29 · Pieter Jelle Visser...
Alzheimer's disease biomarkers
An essential requirement for clinical trials; the need for datasharing
Adapted from Sperling et al (2011) Alzheimer’s and dementia 7 280-92
Trials are conducted too late
Adapted from Sperling et al (2011) Alzheimer’s and dementia 7 280-92
Biomarkers for secondary prevention
Stratification markers
Progression markers
Biomarkers for dementia – CSF Ab and tau; PET amyloid ligands
Biomarkers and preventative trials in AD; a proposal
Stratification markers
Progression markers
High specificity, high intervention markers
e.g. CSF or PET markers of pathology
Best combination of markers
e.g. slope measurement in as short a time frame as possible
High sensitivity, low intervention markers
e.g. blood based markers discovered by targeted
endophenotype design
Unbiased, data-driven discovery
e.g. wide range of assessments; short assessment period
Biomarkers for dementia – alternative approaches
-
Albumin
Automated regional analysis of structure
AD subjects, the color represents thickness in mm.
Blue <1 mm and red=5 mm
Atlas defined on
template brain, in
stereotaxic
space“Louis Collins”
Association between inflammatory proteins levels measured in
plasma versus ventricular volume.
Leung R, Proitsi P, Simmons A, Lunnon K, et al. (2013)
Inflammatory Proteins in Plasma Are Associated with
Severity of Alzheimer’s Disease. PLoS ONE 8(6):
e64971. doi:10.1371/journal.pone.0064971
http://www.plosone.org/article/info:doi/10.1371/journal.p
one.0064971
NA-ADNI
J-ADNI
WW-ADNI
AIBL
C-ADNI AddNeuroMed
EMIF Project Vision
To enable and conduct novel research into human
health by utilising human health data at an
unprecedented scale
• Access to information on 40 million patients
• AD research on 10-times more subjects than ADNI
• Metabolics research on > 20,000 obese & T2DM subjects
• Linkage of clinical and omics data
• Development of a secure (privacy, legal) modular platform
• Continue to build a network of data sources and relevant research
EMIF – platform for modular extension
EM
IF -
Me
tab
olic
EM
IF -
AD
Data Privacy
Analytical tools
Semantic Integration
Information standards
Data access / mgmt
IMI Structure and Network
Research Topics
EMIF governance
Pre
ven
tio
n a
lgo
rith
ms
Pre
dic
tiv
e s
cre
en
ing
Ris
k s
trati
ficati
on
Call 5 Call 5
Ris
k f
acto
r an
aly
sis
Pati
en
t g
en
era
ted
data
TBD
EM
IF -
Pla
tfo
rm
Metabolic CNS
User
admin
User
admin
User
admin
TTP
TTP
TTP
Q
Q
Q
R
R
R
archive
archive
archive
EMIF systems view
User
Remote
user 1
Remote
user 2
Remote
user 3 cohorts
Site
1
Site
2
Site
3
Transactional
environment
Local EMIF solution Cloud-based EMIF solution
Security
Infrastructure
Transient
data-pool
Analytical
tools
Data
access
Module
Data
access
Module
Data
access
Module
Data
access
Module
Data
access
Module
Com
mo
n o
nto
logy
Com
mo
n o
nto
logy
Co
mm
on o
nto
logy
extract
extract
1:1
catalog
catalog
catalog
Value from clinical informatics
EMR – Patient Journey System
• Single integrated clinical record
• Covers all areas of specialist MH care – initial referral to full service discharge
• Total of 190,000 records with 35,000 active patients
• 5,000 unique users log-in per month
• 300,000 documents created per month
CRIS – EMR research tool
• Complete clinical data – structured, semi-structured and unstructured
• Extracted, pseudonymised and deidentified, including free text
• Searchable repository
• Pseudonym attached to samples
• Linked to imaging and biological datasets
-10
12
3
16 18 20 22 24
time(years)
MMSE score
Response to cholinesterase inhibitors
Four years of data
Real world patients
3500 patient years of treatment
treatment
Trust Electronic
Patient Record
ePJS
Research
Information System
CRIS
S
e
c
u
r
e
N
e
t
w
o
r
k
Data Interchange with
GP and other health
care systems
Personal
Health Record -
HealthVault
…including Patient Reported Outcome
Measures, trials information,
engagement ….
Mobile Device
Connection
Center
‘My SLaM’ Portal…..
Partner Devices
BioResource
Consent for
consent
Page 18
Page 19
Big data and pervasive computing;
hypothesis driven translational research
• There is a signature in blood, in CSF and in brain
• Adding complexity adds value but adds complexity!
• Sorting this out will require sample sets bigger than are likely to be
collected by single studies
• Sorting it out is worthwhile because
- It may reveal new therapeutic targets
- It almost certainly is essential for experimental medicine
• We need to collaborate, to re-utilise data, to innovate in study design, to
use multiple platforms, to solve the governance, security and
interoperability issues ….
….and have very big computers and smart people !
Biomarkers and mechanisms in AD
More info
EMIF general
Bart Vannieuwenhuyse ([email protected])
Simon Lovestone ([email protected])
Johan van der Lei ([email protected])
EMIF-Platform
Johan van der Lei ([email protected])
Patrick Genyn ([email protected])
EMIF-Metabolics
Ulf Smith ([email protected])
Dawn Waterworth ([email protected])
EMIF-AD Pieter Jelle Visser ([email protected])
Simon Lovestone ([email protected])
Mike Krams ([email protected])
www.emif.eu (coming soon)
