Open MS BioScreen: Research Support An Open-Access MS management - - PowerPoint PPT Presentation

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Open MS BioScreen: Research Support An Open-Access MS management - - PowerPoint PPT Presentation

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2/15/2018 DISCLOSURES Open MS BioScreen: Research Support An Open-Access MS management tool for patients and providers Riley Bove, MD Scientific Advisory Boards Assistant Professor Roche Genentech Genzyme Sanofi Novartis

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Open MS BioScreen:

An Open-Access MS management tool for patients and providers

Riley Bove, MD Assistant Professor

DISCLOSURES

  • Research Support
  • Scientific Advisory Boards
  • Roche Genentech
  • Genzyme Sanofi
  • Novartis

GOAL OF PRECISION MEDICINE FOR MS (A DATA PROBLEM): THE PATIENT, CLINICIAN AND NEXT-GEN DATA ON THE SAME PAGE

Gourraud PA, et al. Precision medicine in chronic disease management: The multiple sclerosis BioScreen. Ann

  • Neurol. 2014 Nov;76(5):633-42. PMID: 25263997
  • Open Access
  • No commercial interests
  • Free
  • Fast (web)
  • Patient facing
  • Outside of UCSF

GOALS

www.openmsbioscreen.org

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  • Near term: Monitor adoption of the site
  • Who, where, how often, what for
  • Longer term: Disease monitoring
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prEDSS and EDSS:

  • Not equivalent
  • But similar:

Correlation of 0.9 between EDSS and pr- EDSS

Keeping MS-relevant information in one place (especially with multiple providers)

  • Replaces hours of chart digging
  • Satisfaction with doctor-patient relationship
  • Can focus the clinical encounter on managing the patient
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CONTEXTUALIZATION – A Modern, Virtual Case Load

Cree BAC et al. ANN NEUROL 80:499–510; 2016 London Ontario Lyon France British Columbia Nova Scotia

Time to Cane Dependency (EDSS=6)

The EPIC Study at UCSF - Expression, Proteomics, Imaging, Clinical

A modern, treated, cohort Followed annually since 2004 Low rates of progression

CONTEXTUALIZATION – A Modern, Virtual Case Load

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Focus on what is actionable Start medication? Intensify rehabilitation strategies?

TOWARDS PERSON-CENTERED CARE

x x x x x x 13 19 11 8 17 12

2500 5000 7500 10000 12500 15000 17500 0−1.5 2−3.5 4 4.5−5.5 6 6.5

EDSS Daily Step Count, Averaged Across Days, for All Patients

EDSS vs Daily Step Count

(Range: 1070 – 7150) (Range: 2300 – 18,600)

MORE TAILORED FUNCTIONAL GOALS

Block et al, J Neurology 2016

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  • 1. Upload MRIs to a linked vendor site
  • 2. MRIs are processed
  • 3. Visualize MRIs over time

Visualizations to Explore

  • Risk vs. Benefit
  • Early vs. Delay Start
  • Short term vs. Long Term
  • Risk Tolerance

SUMMARY – CLINICAL UTILITY

  • MS-relevant information in one place
  • Virtual Caseload as ‘second opinion’
  • Towards Patient-Centered Care
  • Person-centered functional goals
  • Educational modules to explore risks, benefits, short vs. long term
  • utcomes
  • Caveats (not all patients and not all doctors will want this)
  • Next steps: Other Conditions
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ADVANCED RESEARCH DATA IN THE CLINIC A tool that launches and pulls directly from

  • ur Epic EMR and research data

UCSF MS BioScreen

EXPAND ACCESS BEYOND THE INSTITUTE An Open Access, web-based version for patients and external collaborators

Open MS BioScreen UCSF MS BIOSCREEN iPAD

WHAT ABOUT UCSF CLINIC PATIENTS?

Research EHR Patient

COMING TO THE CLINIC: UCSF’S WEILL MS BioScreen

EHR

Disease Severity (e.g. EDSS, SDMT, etc)

Research

Labs and Vaccines

Research Research

Home-based Test – e.g. Daily Steps (Fitbit) Patient Mean

Scan from EHR, Research processing

Patient

Advanced MRI Analytics

Genetics and other Biomarkers

NATALIZUMAB OCRELIZUMAB GLATIRAMER

EHR

MS BioScreen Team