Researchers at the University of Dundee and NHS Tayside have developed the ‘iLFT system’, a system for linking patient sample analytes with clinical data which can then cascade appropriate additional tests and populate algorithms t8263_IPo deliver earlier identification of treatable liver disease. The iLFT system has the capability to become more powerful by the integration of patient genetic data and to develop for further diseases.
Despite advances in research concerning the impact of certain environmental factors, demographics and clinical histories on an individuals’ disease risk and prognosis, such information is not currently used for diagnostic or prognostic purposes but only as a research tool to understand disease mechanisms.
Technological advances in genetic sequencing and analysis are now making individual patient genetic analysis both rapid and relatively cheap. There have also been significant technological advances in the handling of patient samples within blood science laboratories. Patient samples are now passed between analysers using computer controlled, micro rail, systems that allows a sample’s journey to be changed, in real time, based on the preceding results for that sample. It can also pull results into Clinical Decision Support (‘CDS’) tools/ platforms to calculate prognostic or diagnostic indices. The integration of patient genetic test information into a sample handling system has already been tested within the remit of the NHS Research Scotland ‘SHARE’ initiative (https://www.registerforshare.org/), which involves intercepting routine blood samples from NHS systems on selected patients for subsequent genetic analysis and related research. However, this doesn’t currently feed into CDS systems for individual patients. The next step is therefore to use similar techniques to return real time, genetic and clinical results for an individual patient.
Intelligent Liver Function Test (‘iLFT’) success
The ability to link patient sample analytes with clinical data, cascade additional tests and populate algorithms that are then returned to requesting clinicians, has been demonstrated by research teams at Dundee in their iLFT system. The rationale for focusing on liver disease is that it is common, commonly fatal and can be altered with early intervention. It is diagnostically complex with multiple causes, and requires multiple sources of clinical, biochemical and imaging data to be integrated. The iLFT system uses existing blood science laboratory technology, combined with bespoke algorithms, to deliver earlier identification of treatable liver disease. The iLFT system resulted in reduced GP consultations and increase management in primary care meaning that the iLFT system is now standard care in NHS Tayside, with plans to roll it out globally with a commercial partner.
- iLFT System integrated into routine blood sciences laboratories
- Real-time management of disease diagnosis for primary care
- iLFT gives 43% increase in detection of previously undiagnosed liver disease
- iLFT leads to increased length and quality of life iLFT ready for integration of genetic test information
- iLFT applicable for other diseases
The iLFT system is currently limited to liver disease, but the tools, software and interfaces already developed for iLFT are suitable for the additional integration of genetic data. The Dundee team is looking to collaborate with an industry partner to take the mass of genetic, environmental, demographic and prescribing information surrounding liver disease into a new, more powerful version, of iLFT. The algorithms developed would also establish the most efficient methodology and techniques to use for future diseases