Precision medicine in neurodegeneration: the IHI-PROMINENT project

Abstract

Neurodegenerative diseases are one of the most important contributors to morbidity and mortality in the elderly. In Europe, over 14 million people are currently living with dementia, at a cost of over 400 billion EUR annually. Recent advances in diagnostics and approval for new pharmaceutical treatments for Alzheimer’s disease (AD), the most common etiology of dementia, heralds the beginning of precision medicine in this field. However, their implementation will challenge an already over-burdened healthcare systems. There is a need for innovative digital solutions that can drive the related clinical pathways and optimize and personalize care delivery. Public-private partnerships are ideal vehicles to tackle these challenges. Here we describe the Innovative Health Initiative (IHI) public-private partnership project PROMINENT that has been initiated by connecting leading dementia researchers, medical professionals, dementia patients and their care partners with the latest innovative health technologies using a precision medicine based digital platform. The project builds upon the knowledge and already implemented digital tools from several collaborative initiatives that address new models for early detection, diagnosis, and monitoring of AD and other neurodegenerative disorders. The project aims to provide support to improvement efforts to each aspect of the care pathway including diagnosis, prognosis, treatment, and data collection for real world evidence and cost effectiveness studies. Ultimately the PROMINENT project is expected to lead to cost-effective care and improved health outcomes.

Computerized decision support is an effective approach to select memory clinic patients for amyloid-PET

“…Once the diagnose is made, the subsequent step will be to define eligibility. In a new EU-project, we will further develop this stepwise approach to identify potential eligible patients [ 49 ]. This approach will encompass other patients as well, such as those with mild cognitive impairment (MCI) and DLB, to address the relevant question whether they have underlying AD or not.…”

“…We developed a data-driven approach using patient’s data and show that restricting the ordering of amyloid-PET to 21% of patients without compromising diagnostic performance. Future studies focusing on implementing tools like this into clinical practice, to efficiently guide stepwise diagnostic testing, are the next step [ 49 ].…”