Development of Registry Data to Create Interactive Doctor-Patient Platforms for Personalized Patient Care, Taking the Example of the DESTINY System

Abstract

“Real-world evidence (RWE)” is becoming increasingly important in order to integrate the results of randomized studies into everyday clinical practice. The data collection of RWE is usually derived from large-scale national and international registries, often driven by academic centers. We have developed a digitalized doctor–patient platform called DESTINY (DatabasE-assiSted Therapy decIsioN support sYstem) that is utilized by NeuroTransData (NTD), a network of neurologists and psychiatrists throughout Germany. This platform can be integrated into everyday practice and, as well as being used for scientific evaluations in healthcare research, can also serve as an individual, personalized treatment application. Its various modules allow for a timely identification of side-effects or interactions of treatments, can involve patients via the “My NTC Health Guide” portal, and can collect data of individual disease histories that are integrated into innovative algorithms, e.g., for the prediction of treatment response [currently available for multiple sclerosis (MS), with other indications in the pipeline]. Here, we describe the doctor–patient platform DESTINY for outpatient neurological practices and its contribution to improved treatment success as well as reduction of healthcare costs. Platforms like DESTINY may facilitate the goal of personalized healthcare.

Expanding access to veterinary clinical decision support in resource-limited settings: a scoping review of clinical decision support tools in medicine and antimicrobial stewardship

“…Of the CDS tools for humans, 13 targeted general patients in hospitals ( 15 , 17 , 18 , 54–57 ), healthcare facilities ( 21 , 36 , 58–60 ), or primary healthcare ( 61 ), while 5 tools targeted pediatric patients ( 23 , 26 , 62–64 ) ( Table 2 ). The remaining CDS tools assisted with decision-making for pregnancy ( 65 ), diabetes ( 66 ), critically ill patients ( 67 ), older adult patients with polypharmacy ( 68 ), patients with syncope ( 69 ), drug allergies ( 25 ), diarrhea ( 70 ), neurological disorders ( 71 ), urinary tract infections ( 72 ), dermatology symptoms ( 22 ), obstructive sleep apnea ( 73 ), hypertension ( 74 ), systemic lupus erythematosus ( 75 ), as well as patients requiring joint replacements ( 76 ) and oncology surgery ( 77 ). The CDS tools for animals were for cattle ( 36 , 80 , 81 ), swine ( 31 , 85 ), companion animals ( 29 , 82 , 83 ), and a CDS tool for dogs, cats, cattle, horses, sheep, goats, swine, birds, and poultry ( 84 ).…”

Overall and patient-specific comparative effectiveness of dimethyl fumarate versus teriflunomide: A novel approach to precision medicine applied to the German NeuroTrans Data Multiple Sclerosis Registry

“…The NTD network and NTD MS registry Founded in 2008, the NTD is a physician network of approximately 66 practices and 133 members across Germany in the field of neurology and psychiatry, gathering healthcare data to improve physician-patient interaction and optimize the treatment of individual patients. 5 Information on demographics, medical history, patientrelated outcomes, and clinical variables are recorded regularly via a web-based patient management platform 6 during outpatient office visits, with 3.7 visits per year on average. 7 A comprehensive manual and automated data control framework has been established to ensure high data quality.…”

PHREND®—A Real-World Data-Driven Tool Supporting Clinical Decisions to Optimize Treatment in Relapsing-Remitting Multiple Sclerosis

“…Because PHREND® is based on data extracted from the routinely used ongoing NTD MS registry ( 13 ), there is a steady increase of information (~1.3% increase of patient numbers per quarter in the year 2020, data not shown here). Therefore, PHREND® is updated on a quarterly basis and prediction quality over time is monitored.…”

“…The presentation needs to integrate options to reflect upcoming questions in the shared decision process regarding their impact on choices between DMTs. PHREND® can be used as a standalone solution with clinical data being entered manually per patient or as part of the patient management platform DESTINY ® ( 13 ) with automated data transfers.…”