EPSRC Centre for Doctoral Training in Digital Health and Care

社会正在与需要长期管理的健康状况的爆炸性增长作斗争。这些慢性疾病在各个年龄段都会发生：英国儿童的哮喘和1型糖尿病的水平是世界上最高的；英国三分之一的学龄儿童离开小学时患有肥胖症，所有年龄段的人都非常担心2型糖尿病；在任何一年，英国处于工作年龄的男性和女性都有12%的几率被诊断为精神健康问题，如焦虑、抑郁和产后抑郁症；痴呆症、帕金森氏症和虚弱等疾病在晚年迅速增加。低成本、联网的数字技术越来越被视为对社区数月乃至数年来了解、预防、诊断和管理这些疾病至关重要。这些数字技术，如智能手机应用程序、可穿戴设备、血糖监测仪，以及不久的未来的物联网(IoT)设备，如智能家居系统(如Echo)、智能仪表和联网电器，提供了前所未有的机会，可以在他们的社区内监控患者的病情。通过人工智能处理的数据，它们将为卫生保健专业人员提供决策支持；预测或检测患者的症状恶化；支持独立生活；提供行为干预，甚至药物干预；并允许监测治疗的效果。对于博士教育来说，这不可能是一如既往的事情，因为数字医疗技术可能需要对横跨软件工程、微电子、数据通信、信号处理、机器学习和可视化的技术有高度的多学科理解。要实现真正的患者利益，需要以用户为中心/驱动的设计，对健康和护理、心理学、生理学、伦理学、监管、健康经济学和临床试验的设计有广泛的理解。为了迎接挑战和抓住机遇，英国需要培养跨越这个巨大的多学科空间的领导力-将技术深度与对健康前景的广泛欣赏结合在一起；同情患者的需求，着眼于支持采用的商业模式；雄心勃勃地加速创新，并对伦理、包容性、监管、数据安全和隐私做出原则性承诺。该中心在数字健康和护理方面的博士培训(CDT)的机遇和挑战将大于其各部分的总和；将工程与计算机科学和健康与生命科学的学生实际放在同一群人中；弥合学科差距，与关键的外部合作伙伴合作，促进更好的理解，并在该群人本身内部启动点对点学习。布里斯托尔是在这一学科界面上培训未来领导者的完美地点，该校自2013年以来开展了3000万GB的数字健康研究。我们提议的CDT将培养具有与其他学科的专家、患者和公众有效合作的技能的团队合作伙伴。在一个信任、隐私、透明度、责任和包容性问题绝对至关重要的领域，CDT不仅将拥抱负责任的创新，而且将影响和引领国内和国际的最佳实践。CDT将建立在各种已建立的关系基础上；与中小型企业、科技公司、大型制药公司、慈善机构、大学、英国最大的公共科学中心之一(WeTheCurious)、布里斯托尔市议会和公众建立联系。因此，CDT被设想为一个由学生和学者组成的多学科社区，将创造令人兴奋的研究项目，并将在所有级别上建立学术界、工业界和NHS的个人网络。它将为未来的合作研究和商业化活动播下种子。

Society is battling with an explosion of health conditions that need long-term management. These chronic conditions occur at all ages: UK children have some of the world's highest levels of both asthma and type 1 diabetes and, with a third of the UK's school children leaving primary education obese, there are huge concerns over type 2 diabetes at all ages; in any year, working age men and women in the UK have a 12% chance of a diagnosed mental health issue such as anxiety, depression and post-natal depression; conditions including dementia, Parkinson's disease and frailty are rapidly increasing in later years. Low-cost, connected, digital technologies are increasingly seen as vital to the understanding, prevention, diagnosis and management of these conditions for months and years in the community. These digital technologies, such as smartphone apps, wearables, blood sugar monitors - and a near future of Internet of Things (IoT) devices such as smart home systems (e.g. Echo), smart meters and connected appliances - offer an unprecedented opportunity to monitor a patient's condition within their community. With the data processed by artificial intelligence they will deliver decision support to health and care professionals; predict or detect a patient's symptoms worsening; support independent living; deliver behavioural and even pharmaceutical interventions; and allow the efficacy of treatments to be monitored. This cannot be business as usual for doctoral education since a digital health technology is likely to require a highly multidisciplinary understanding of technologies spanning software engineering, microelectronics, data communication, signal processing, machine learning and visualisation. Achieving actual patient benefit requires user-centred/driven design, a broad understanding of health and care, psychology, physiology, ethics, regulation, health economics and the design of clinical trials.To meet the challenge and seize the opportunity, the UK needs to nurture leadership that will span this hugely multidisciplinary space - combining technological depth with broad appreciation of the health landscape; empathy with the patient's needs with an eye to business models that underpin adoption; ambition to accelerate innovation with a principled commitment to ethics, inclusivity, regulation, data security and privacy. The opportunity and the challenge for this Centre for Doctoral Training (CDT) in Digital Health and Care is to be bigger than the sum of its parts; to physically co-locate a cohort of students from Engineering & Computer Sciences and Health & Life Sciences; to bridge the disciplinary gaps, work with key external partners, foster better understandings and activate peer-to-peer learning within the cohort itself. Bristol is the perfect place to train future leaders at this disciplinary interface, building on £30M of digital health research at the University since 2013. Our proposed CDT will develop team-players with the skills to work effectively with experts from other disciplines, with patients and with the public. In a space where issues of trust, privacy, transparency, accountability and inclusion are absolutely fundamental, the CDT will not only embrace Responsible Innovation but influence and lead best practice nationally and internationally.The CDT will build on a variety of established relationships; with small and medium sized businesses, technology companies, big pharmaceutical companies, charities, universities, one of the UK's largest public science centres (WeTheCurious), Bristol City Council, and with the public. This CDT is therefore envisaged as a multidisciplinary community of students and academics that will create exciting research projects and will build networks of individuals across academia, industry and the NHS at all levels. It will sow the seeds of future collaborative research and of commercialisation activities.