SystemMedicine clinical decision support for COPD patients

Chronic obstructive pulmonary disease (COPD) claimed 3.2 million lives in 2015, making it the third cause of death worldwide. Its impact will increase even further in coming years due to aging populations. COPD constitutes an enormous socio-economic burden due to loss of lives, disability and associated loss of productivity and health care cost. Diagnosis of COPD is currently based on the assessment of lung capacity and clinical symptoms. However, only a sub-set of patients diagnosed with COPD respond to treatment, and even those mostly develop more severe symptoms over time. We believe the reason for the failure of treatments and prevention of disease progression is that the broad diagnosis neglects the complex, multi-component, and heterogeneous pathophysiology, as well as manifold comorbidities (cardiovascular, metabolic etc.) of COPD. Therefore, improved COPD diagnosis and classification constitutes an urgent medical need for improved and personalized prevention measures and treatments strategies. The main aim of our proposal is to develop a tool that will enable effective preventive measures of disease progression and personalize treatment strategies for COPD. This transnational and interdisciplinary project combines clinical scientists, experimentalists, computational and systems biology researchers, as well as a medium sized company. We will develop a computational model of COPD that takes into account all aspects affected by the disease, from molecular, cellular and organ constructed on (i) machine learning clustering of two comprehensive patient cohorts (COSYCONET, CIRO) providing long-term clinical observations, systematic outcome evaluation, biomaterial collections, multiple laboratory measurements, and extensive imaging data of more than 6,000 patients, complemented by (ii) an iterative systems biology framework of modeling and experimental analysis. Based on this multi-scale systems medicine model, we will generate a novel Clinical Decision Support (CDS) software that can be implemented in the existing IT infrastructure of hospitals and private practices for routine application. As a prototypic demonstrator of applied systems medicine, our tool will enable i)individual and comprehensive treatment and prevention measures for COPD patients ii) significant reductions of socio-economic costs due to less mortality and disability. iii)novel insights in the dysregulation of metabolism, immunology and aging in COPD from the underlying model.