AcceleRating the Translation of virtual twins towards a pErsonalised Management of fatty lIver patients (Artemis)

ARTEMIS项目旨在整合不同规模的现有计算机制和机器学习模型，以提供嵌入临床决策支持系统（CDSS）的“虚拟双胞胎”。CDSS将为临床医生提供有临床意义的信息，以便对代谢相关脂肪肝（MAFLD）的整个谱进行更个性化的管理。MAFLD的估计患病率约为25%，从未检测到的睡眠疾病发展为炎症（肝炎），发展为纤维化（肝硬化）和/或肝细胞癌（HCC），失代偿性肝硬化和HCC是疾病的最后阶段。然而，许多MAFLD患者不是死于肝病本身，而是死于心血管合并症或并发症。ARTEMI将有助于MAFLD患者的早期管理，通过监测更晚期疾病和心血管合并症的发展，促进对风险患者的积极监测。该系统将预测新药物治疗或程序的影响，或者只是更好的生活习惯。因此，该系统不仅可以作为临床决策辅助工具，还可以作为患者的教育工具，以促进更好的营养和生活方式行为。在更晚期的疾病形式中，治疗干预包括TIPPS以管理门静脉高压症、部分肝切除术、部分或完全肝移植。ARTEMI将在现有微循环血液动力学模型的基础上，有助于预测介入前后的心力衰竭。模型开发人员将受益于大型分布式患者队列和数据探索环境，以识别数据模式，绘制关于肝-心代谢轴的新理论，并验证其模型的性能。该项目包括一项概念验证可行性研究，评估集成虚拟双胞胎和CDSS在临床环境中的实用性。

The ARTEMIs project aims to consolidate existing computational mechanistic and machine-learning models at different scales to deliver ‘virtual twins’ embedded in a clinical decision support system (CDSS). The CDSS will provide clinically meaningful information to clinicians, for a more personalised management of the whole spectrum of Metabolic Associated Fatty Liver Disease (MAFLD). MAFLD, with an estimated prevalence of about 25%, goes from an undetected sleeping disease, to inflammation (hepatitis), to fibrosis development (cirrhosis) and/or hepatocellular carcinoma (HCC), decompensated cirrhosis and HCC being the final stages of the disease. However, many MAFLD patients do not die from the liver disease itself, but from cardiovascular comorbidities or complications. The ARTEMIs will contribute to the earlier management of MAFLD patients, by prognosing the development of more advanced forms of the disease and cardiovascular comorbidities, promoting active surveillance of patients at risk. The system will predict the impact of novel drug treatments or procedures, or simply better life habits. The system will therefore not only serve as a clinical decision aid tool, but also as an educational tool for patients, to promote better nutritional and lifestyle behaviors. In more advanced forms of the disease, therapeutic interventions include TIPPS to manage portal hypertension, partial hepatectomy, partial or complete liver transplant. ARTEMIs will contribute to predict per- or post-intervention heart failure, building on existing microcirculation hemodynamics models. The model developers will benefit from a large distributed patient cohort and data exploration environment to identify patterns in data, draw new theories on the liver-heart metabolic axis and validate the performance of their models. The project includes a proof-of-concept feasibility study assessing the utility of the integrated virtual twins and CDSS in the clinical context.