EPSRC Digital Health Hub for Antimicrobial Resistance

抗菌素耐药性数字健康中心（AMR）旨在利用创新的数字技术，最终改变抗菌素单一健康监测和抗菌素管理，认识到抗菌素耐药性在人类、动物和环境之间的相互联系。世界卫生组织宣布，AMR -也被称为“沉默的流行病”-是人类面临的十大全球公共卫生威胁。AMR也在英国内阁办公室风险登记册上排名，但尽管得到了这一认可，对AMR预防的关注和资金水平仍然低得惊人。2016年奥尼尔抗菌素耐药性综述强调，到2050年，除非采取行动减少AMR，否则每年将有1000万人的生命和累计100万亿美元的经济产出面临风险。来自动物、人类和食物的耐药病原体可以交叉传播，环境宿主是一个潜在的重要领域，耐药基因在其中发生动员和转移。因此，需要一种综合的“一个健康”方法来进行AMR监测和采取公共卫生行动。此外，人们越来越担心气候变化可能会增加新出现和重新出现传染病的风险。人们越来越认识到数据科学和数字医疗技术在对抗AMR方面的重要性，尽管该领域仍处于起步阶段。在前所未有的需求推动下，COVID-19大流行极大地加速了数字医疗技术的进步，利用这些进步进行AMR的机会巨大。然而，仍然存在许多挑战：对单一卫生需求的认识不足;数据链接、孤岛和差距阻碍了监测;缺乏快速检测，公众缺乏对抗生素耐药性的认识;数字干预措施往往不优先考虑用户主导的设计，也不以改变行为为基础;将大型数据集汇集在一起的数据隐私、安全和道德问题;卫生不平等和数字鸿沟;早期研究与AMR需求之间的脱节，以及对数字技术如何商业化、监管和整合到卫生系统和患者路径中缺乏了解。AMR数字健康中心汇集了大量跨AMR传统学科的Co-I，包括计算机科学、生物医学工程、行为社会科学、环境科学、数据可视化以及临床和公共卫生研究，来自五所大学、NHS、英国卫生安全局、生态和水文中心、慈善机构和行业合作伙伴。我们的枢纽愿景将通过五个目标实现：1.系统级需求：培养跨部门参与的新文化，以加速创建和采用数字健康创新，用于AMR单一健康监测和抗菌药物管理。2.技能和能力：发展跨学科技能、能力、知识共享和领导力，以提供世界领先的数字卫生战略来对抗AMR。重大挑战：针对AMR的两大挑战共同创建数字健康解决方案：i）抗生素使用和AMR的数字化单一健康监测，将人类，动物和环境数据联系起来ii）通过决策支持算法，数字诊断可穿戴设备和传感器进行数字抗菌管理4。伙伴关系基金：通过在工业界、学术界、卫生和社会保健之间开展跨学科试点研究，发展临界质量和创新中心。影响和参与：通过我们的沟通策略、患者和公众参与、一年两次的会议和活动，最大限度地发挥中心的影响力和EPSRC的投资。

The Digital Health Hub for Antimicrobial Resistance (AMR) aims to harness innovative digital technologies to ultimately transform antimicrobial one-health surveillance and antimicrobial stewardship, recognising the interconnectedness of AMR between humans, animals and the environment.The World Health Organization declared AMR - also known as the 'silent pandemic' - a top 10 global public health threat facing humanity. AMR also ranks on the UK Cabinet Office Risk Register and yet despite this recognition, there remains alarmingly low levels of attention and funding for AMR prevention. The 2016 O'Neill Review on Antimicrobial Resistance highlights that by 2050, 10 million lives a year and a cumulative US$100 trillion of economic output are at risk unless action is taken to reduce AMR. Resistant pathogens from animals, humans and food can be cross-transmitted and environmental reservoirs are a potentially important domain in which the mobilisation and transfer of resistant genes occur. Thus, an integrated One Health approach to AMR surveillance and public health action is needed. Moreover, there is growing concern that climate change could increase the risk of emerging and re-emerging infectious diseases.There is growing recognition of the importance of data science and digital health technologies in the fight against AMR, though the field remains in its infancy. The COVID-19 pandemic has dramatically accelerated advances in digital health technologies, driven by unprecedented need, and there is a huge opportunity to leverage these advances for AMR. However, there remain many challenges: poor understanding of one-health needs; data linkage, silos and gaps hinder surveillance; the lack of rapid tests, the lack of public awareness of AMR; digital interventions often do not prioritise user-led design and are not grounded in behaviour change; data privacy, security and ethical issues of bringing together large datasets; health inequalities and the digital divide; the disconnect between early stage research and AMR needs, and lack of understanding of how digital technologies can be commercialised, regulated and integrated into health systems and patient pathways.The Digital Health Hub for AMR brings together a critical mass of Co-Is working across traditional disciplines for AMR, including computer science, biomedical engineering, behavioural social science, environmental science, data visualisation, and clinical and public health research, from five universities, NHS, UK Health Security Agency, Centre for Ecology and Hydrology, charities and industry partners. Our hub vision will be achieved through five objectives:1. Systems-level needs: To nurture a new culture of cross-sector engagement to accelerate the creation and adoption of digital health innovations for AMR one-health surveillance and antimicrobial stewardship. 2. Skills and Capacity: To grow interdisciplinary skills, capacity, knowledge sharing and leadership needed to deliver a world-leading digital health strategy for combatting AMR.3. Grand Challenges: To co-create digital health solutions for two AMR grand challenges: i) Digital one-health surveillance of antibiotic use and AMR, linking human, animal and environmental data ii) Digital antimicrobial stewardship via decision support algorithms, digital diagnostics wearables and sensors4. Partnership Fund: To grow critical mass and a hub of innovation by seeding interdisciplinary pilot studies between industry, academia, health and social care.5. Impact and Engagement: To maximise hub impact and EPSRC's investment through our communications strategy, patient and public engagement, biannual conferences and events.