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PerMed-COPD

Implementing Personalized Medicine for COPD Prevention and Treatment

Chronic obstructive pulmonary disease (COPD) claimed 3.2 million lives in 2015, making it the third cause of death worldwide. It is predicted to increase due to aging populations and thus constitutes an enormous socio-economic burden. Existing strategies in clinical practice do not sufficiently account for the complex, multi-facetted, and heterogeneous pathophysiology, as well as manifold comorbidities (cardiovascular, metabolic, etc.) that cause significant morbidity and mortality. Therefore, translating recent research results into improved COPD diagnosis and classification in clinical practice constitutes an urgent medical need for personalized medicine. In this platform, we will implement a novel personalised strategy and compare a “usual care” group with an AI-driven, clinical decision support system integrating clinical diagnostics with CT imaging assessing lung disease as well as coronary calcifications, osteoporosis and sarcopenia. Based on these findings, personalized decisions with respect to further diagnostic and/or therapeutic procedures will be made. Molecular biomarkers (polygenic risk scores, exosomes, microbiome) will help to improve disease classification. The primary endpoint of the study will be the multi-dimensional assessment of quality of life by the St. Georges Respiratory Questionnaire (SGRQ) and the economic impact and patient perspective will be evaluated.

PerMed-COPD forms a multidisciplinary team of clinicians, experimentalists, computer scientists, patient representatives and a medium-sized company that will implement a Personalized Medicine platform for COPD treatment and prevention of disease worsening. We will make use of existing comprehensive cohort data and materials, an excellent study network and infrastructure. We will build on previous joint work on imaging and molecular biomarkers as well as clinical decision support systems and artificial intelligence to perform a prospective trial for the implementation of personalised medicine. Our main objectives are:

  • Clinical validation study and economic evaluation of a previously developed therapeutic decision aid based on objectified diagnostic assessment markers, i.e., imaging biomarkers focussing on comorbidities of COPD, in a prospective diagnostic study for the prognosis of the disease course and prediction of therapy response
  • "Deep genotyping and phenotyping" to define clinically relevant subgroups and the development of innovative integrated analysis tools, which allow new hypotheses on molecular disease mechanisms, development and progression of diseases as well as therapy
  • Implementation and optimization of innovative and user-friendly clinical decision support for medical professionals based on the interpretation of multifactorial and multi-modal data
  • Comprehensive integration of various data sources such as clinical data, medical imaging, and omics data as well as use of machine learning to create personalized treatment strategies

Project Partners:
LungenClinic Großhansdorf
Medizinische Hochschule Hannover
Universitätsklinikum Heidelberg
Ludwig-Maximilians-Universität München