Public Funding for Ixico Technologies Limited

"The London Medical Imaging & Artificial Intelligence Centre for Value-Based Healthcare will improve NHS patient care and health outcomes, reduce healthcare costs and support the growth of companies, supporting the economy. It will do this by applying artificial intelligence technologies to medical imaging (for example MRI scans, CT scans PET scans and ultrasound). Artificial intelligence will enable faster and earlier diagnosis, automation of reporting, improved patient screening for disease, and identification of the best treatment for each person. We will create a powerful, dynamic Centre bringing together industry, small and medium sized enterprises (SMEs), world-leading researchers, healthcare professionals covering many areas of practice, and experts in data science/governance. The Centre is a collaboration between three excellent universities (King's, Imperial and QMUL), four leading NHS Trusts (Guy's & St Thomas', King's College Hospital, South London & the Maudsley and Barts Health), multinational industry (Siemens, NVIDIA, IBM, GSK), 10 UK-based SMEs and the Health Innovation Network. The Centre will have a physical hub embedded in St Thomas' Hospital, in the heart of one of the UK's top-performing NHS Trusts with specialist services and one of the UK's largest critical care units. It will be underpinned by the existing Wellcome/EPSRC Centre for Medical Engineering, a flagship investment in medical imaging. The Centre will deliver well-governed, controlled access to high-quality NHS imaging and patient data for academic researchers, SMEs and industry partners. This will be done while preserving patient privacy as the first requirement. We will add dedicated expertise in health economics & statistics, care pathway design and clinical implementation to create an environment where products can be created and tested. Recognising this is a new development in healthcare, patients, the wider public and policy makers will all have opportunities to input and shape priorities for the Centre. The Centre will drive progress through a selection of 12 exemplar projects, specifically chosen, with public input, to illustrate the breadth of opportunity-- covering early life (fetal diagnosis) to old age (dementia), various organ systems including heart, brain and lungs, and diseases such as heart failure, headache, congenital conditions and cancer. In addition to the direct benefits of the Centre, this activity will act as a beacon to attract multinational companies, venture capital investment and AI talent from across the world, creating jobs, broader economic benefit and contributing to the UK's prosperity."

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Most of the 700,000 people in the UK with dementia have not received a formal diagnosis, so are denied access to benefitial treatments. The current NHS approach is slow (often more than 12 months) and often of low quality. This project will further develop a novel digital healthcare system, allowing dementia diagnoses to be made quickly, cost effectively, and earlier in the disease course. The focus of this work is on the combination of general imaging biomarkers for dementia with biomarkers specifically developed to assess a patients vascular burden to dementia. The advanced decision support tool will provide input on a differential diagnosis between the two most prevalent types of dementia, Alzheimer's disease and vascular dementia.

Recent expensive failures in drug development to treat Alzheimer’s disease, the most common dementia, mean new efforts are needed to support those suffering without the hope of a cure. Several academic and industrial research collaborations are commencing, including the MRC Dementia Platform (UK), IMI-EPOC (EU), and DIANE (US). These projects are focused on basic science and facilitating studies of new AD treatments. While these research goals are important, they are part of a strategy that will not impact patients for >15 years. This proposal aims to establish a digital healthcare platform (a) to collect standardized data from a large sample of symptomatic patients presenting with memory concerns (b) for post-diagnosis collection of progression with facilitated care model (c) for cost effective evaluation for interventions. The patient group will include those with Mild Cognitive Impairment (MCI) and mild dementia, from multiple causes (AD, vascular, lewy body, FTLD) and will provie standardized assessment and follow-up, plus access for those patients who wish, to intervention studies in order to provide opportuntiesto improve outcome for those patients involved.

There are currently no drugs for Alzheimer’s Disease, AD, available that stop or cure the disease. Results from recent clinical trials, where the drug has been shown not to work, suggest that many of those enrolled in the trial did not have AD at the start. While patients with AD are expected to deteriorate over the course of a trial in terms of their memory recall and ability to look after themselves, many enrolled subjects did not show this deterioration. The inclusion of a large portion of patients who were not declining confounds the results and possibly hides any real affect of the drug. The difficulty in diagnosing patients correctly is not just a problem for drug trials. Patients visiting their GP are even less likely to get an accurate diagnosis as the patient visit in trials is more thorough than in primary care, or even than in most memory clinics. A correct diagnosis can have significant positive impact on patients even in the absence of drugs but will be critical to ensure patients get early access to drugs as they become available. In this project, we will develop a dementia prognosis tool that uses data collected in clinics (MRI scans, cognitive tests, demographic data), to help diagnose patients by predicting their outcome and expected rate of decline. We have demonstrated proof-of-principle on a relatively small amount of data and in this project we will work closely with some large pharmaceutical companies and Imperial College to develop better methods and test it on many 1000s of patients from a global population including 100s of patients from each of N America, Europe, China, Australia, Japan.

Timely and accurate Dementia diagnosis is a huge unmet need globally. As the population ages, the health and social care costs will rapidly become unsustainable. China may become the world's largest market for dementia diagnosis: China is estimated to have 25% of the world's dementia cases but ~80% of the dementia population remain undiagnosed, and the one child policy means individuals may have 4 grand parents to care for. While there are no cures for dementia, there are effective drug and non-drug interventions which can extend independent life and save society costs. There is a pressing need for technology to support diagnosis in a community setting if China is to make these treatments available to the patients that need it. This feasibilty award enables IXICO to explore the opportunity to create a focused product which is adapted to the Chinese population and healthcare system and identify the partners needed to enter this market.

Most of the 700,000 people in the UK with dementia have not received a formal diagnosis, so are denied access to benefitial treatments. The current NHS approach is slow (often more than 12 months) and often of low quality. This project will develop a novel digital healthcare system that will allow dementia diagnoses to be made quickly, cost effectively, and earlier in the diease course. It makes a novel combination of computer-based tests of memory and thinking and computerized analysis of MRI brain scans, which have been used in research for several years. It will provide support in diagnosis, making available the quality of information currently only available in highly specialist centres to doctors treating all patients, with the aim of reducing time to diagnosis to 3 months. We will build and test a prototype and demonstrate its value before developing a refined prototype that can be rolled-out nationally.

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