App as treatment support for immune diseases

Development of an information system for the treatment of immune-mediated diseases

© Fraunhofer CIMD

The therapeutic landscape of immune-mediated diseases is changing rapidly, due to the development of therapies with targeted disease-modifying mechanisms such as biological therapies and synthetic DMARDs (Disease-Modifying Antirheumatic Drugs). It can be assumed that the number of therapeutic options will continue to increase in the future and that physicians will have a multitude of treatment options at their disposal. It is thus difficult to keep track of the advantages and disadvantages of the different therapeutic options and this influences the clinical decision-making process for the best possible individualized and targeted therapy for each patient.

Doctor and patient information system

One immune-mediated disease is psoriasis arthritis, which can present with a broad variety of symptoms. These include joint complaints due to arthritis, inflammation of entire fingers or toes (dactylitis), and involvement of tendons (enthesitis) and/or the spine. A doctor and patient information system with fast access would make sense here, to allow fast and efficient information retrieval about prevalent expert opinions. This information can then be combined with the doctor’s own knowledge from experience, guidelines and from study data, enabling long-term improvement of the patient’s therapy. An interactive user interface shall allow the patient's individual needs and disease pattern to be taken into account when retrieving information.

Flexible design

Prior to implementing the therapy information system for psoriasis arthritis, a framework shall be created that can be used flexibly for other diseases as well. As the increasing number of drugs leads to potential knowledge gaps in the context of other diseases (e. g. bronchial asthma, multiple sclerosis, etc.) as well, for example, regarding the efficacy of drugs with different manifestations, the information system should be modular and, if possible, adaptable to other diseases without in-depth programming knowledge. System maintenance and updating with new information should also be taken into account during development of the framework. In single modules, the framework will combine all functions for the visualization of the information of interest, thus providing the user interface of the application. Another component of the framework will be the development of a generalized format to represent knowledge from different sources (e.g. guidelines, scientific publications, red list, grey literature etc.) and adaptation of the modules of the user interface for information presentation to this format.

Validation of the information system in clinical routine

Once the internal validation will have been completed, the psoriasis arthritis information system will be rolled out. Interested users will be involved, using the system as beta testers in clinical practice and providing feedback about their experience with its use. To this end, the user feedback function will be implemented directly in the system. The user feedback will be used to further improve and optimize the system. In a further step, it will be evaluated how the software can be used in clinical studies.

Outlook

A goal of developing the framework for information presentation is to enable its flexible and intuitive adaptation for further use cases from the field of immune-mediated diseases. In this project, the information system shall be developed for psoriasis arthritis, but also for other diseases. The aim is to demonstrate that prototype development is possible even without programming knowledge of the underlying software. Another disease candidate for an information system is bronchial asthma, since the clinical picture and its therapy as well as the information about therapeutic options are of similar complexity here as for psoriasis arthritis.