Håvard Danielsen. Photo: DoMore Diagnostics.  

Research based on artificial intelligence and deep learning at the Institute for Cancer Genetics and Informatics has resulted in technology that can analyse cancerous tumours. This method gives the correct recommendation for treatment in 80% of cases of cancer within three minutes. The research behind it is now being commercialised through DoMore Diagnostics AS, and great things are expected of the company.

‘We already have five product candidates that we wish to offer through the new company, DoMore Diagnostics AS. Inven2 is in the process of commercialising two of them in cooperation with us, and we’ll be able to offer the other three during 2021,’ says Håvard E. Danielsen.

See discussion of the first product ‘Automated analyses of pathological samples’ in Inven2’s overview of licencing opportunities.

Danielsen is Director of the Institute for Cancer Genetics and Informatics (ICGI) at Oslo University Hospital.

In 2016, Danielsen and ICGI applied to the Research Council of Norway for funding for DoMore! They were granted NOK 60 million over five years to establish new technology that could give each cancer patient a better and more personalised diagnosis, and thus, with treatment, a better prognosis.

DoMore Diagnostics was established in the autumn of 2020 based on the results of the research project.

‘It’s great that we’ve come so far and managed to set up a company that’s going to bring out real products based on our research and development. These are products that can potentially make a big difference to cancer patients throughout the world,’ says Danielsen.

The technology developed at DoMore! has been shown to have the ability to prevent over- and under treatment of cancer patients. More about that shortly.

Automated pathology gives a better prognosis

Pathology is essential for correctly diagnosing cancer patients. Pathologists look at tissue samples of the cancerous tumours under the microscope. Based on their observations, they are able to diagnose the cancerous tumour, give an indication of the patient’s prognosis and rate their chances of a return to health on a scale from good to bad.

The prognosis is closely linked to the type of treatment that the oncologists offer the patient: A good prognosis means that the patient may have less intensive treatment, while a serious prognosis means that the patient will need more aggressive treatment to kill the cancer cells as quickly as possible.

However, most cancerous tumours are so heterogeneous, i.e. their composition is so different, that depending on which tissue sample of the cancerous tumour is taken, you can end up with a different diagnosis and, subsequently, the wrong recommendation for treatment.

The prognostic test that Danielsen and his colleagues have developed currently gives a cancer patient an accurate prognosis in 88% of cases within three minutes.

By comparison, a pathologist’s assessment will be accurate in 20% of cases.

These specific figures apply to patients with colorectal cancer, i.e. cancer of the large intestine and rectum. At DoMore!, they are working on expanding prognoses to apply to other types of cancer.

Deep learning based on 17 million images

‘Deep learning for prediction of colorectal cancer outcome: a discovery and validation study’ is a scientific article that was published in The Lancet in February 2020. The Lancet is one of the leading medical journals in the world.

In this article, Danielsen and his colleagues describe how they digitised tissue samples from 4,500 cancer patients and then compared the 17 million images they created from the samples with registry data to see how the individual patient did.

In this way, they were able to train a computer to see the connection between a tissue sample and a less serious type of cancer and between a tissue sample and a more serious type of cancer, etc. The researchers here have used advanced mathematical bioinformatics, deep learning, machine learning, artificial intelligence and neural networks.

‘Based on deep learning and the connections we found, we have developed algorithms that predict a prognosis for a patient with colorectal cancer: The tissue sample is scanned on a scanner that is used in all hospitals or laboratories that are hospital sub-suppliers and analysed by the software we have developed. The doctor gets the result of the sample within three minutes and can consider what type of treatment this patient should receive,’ says Danielsen.

When this news became known, Danielsen made the front page of the Aftenposten newspaper. The headline read:
‘New Norwegian trial: A computer diagnoses bowel cancer more accurately than researchers in three minutes!’ (‘Ny norsk studie: På tre minutter stiller datamaskinen mer presis tarmkreftdiagnose enn forskerne’ – in Norwegian only).

Great benefit to society

Elin Melby, Technology Strategy Manager for DoMore Diagnostics in Inven2, is very confident about the company’s potential.

‘The ability to offer cancer patients more accurate prognoses sooner is extremely important for both the individual patient and society: The patient is spared the consequences of the wrong type of treatment and has a better quality of life after treatment. In addition, the hospitals make big savings in relation to the treatment itself and by automating some of the pathologists’ work,’ says Melby.

Digitisation of the pathology process is in an early phase, but this is set to change radically within a few years. Then, DoMore Diagnostics will be able to offer its services directly to hospitals throughout the world.

‘But first, a selected service provider that provides laboratory services to hospitals in a number of countries will offer analysis of cancer samples using the DoMore procedure for diagnosing colorectal cancer,’ says Melby.

Melby is joined by IPR Manager Eivind Roverud, Lawyer Helle Thorsen and Executive Fund and Business Developer Kristin Sandereid on the project team at Inven2.

Elin Melby, Technology Strategy Manager in Inven2.

Enthusiastic head of division

Sigbjørn Smeland, professor and Head of the Division of Cancer Medicine at Oslo University Hospital is enthusiastic about commercialisation of the research that is being carried out through DoMore!

‘What Håvard and his colleagues are proving is that artificial intelligence using deep learning has a clear application within pathology. The algorithms they have developed are better at making a cancer prognosis than the pathologists, and the potential for the global application of this method is tremendous,’ says Smeland.

He adds that the differences between pathologists and between laboratories in making a prognosis are too great and that their method significantly improves this process.

‘It’s really interesting; the algorithms that DoMore! have developed are better at distinguishing between patients with colorectal cancer who should be given gentler or more aggressive treatment, which means that the group in the middle, about which there is uncertainty, is much smaller. Up to now, this group has been given more treatment than was necessary, as both pathologists and clinicians seek to ensure that patients are guaranteed treatment that will cure their cancer. But in reality, many patients were overtreated, and this resulted in unnecessary side effects and an unnecessary use of healthcare resources,’ says Smeland.

Global potential

Another aspect that Smeland believes is very important is that the method they have developed uses standard tissue samples and standard staining that are used and available throughout the world.

‘This standardisation means that the application of this method has enormous potential. In addition, we have worked with large cancer groups with lung cancer, prostate cancer and colorectal cancer in the project, so huge numbers of patients can be helped globally,’ says Smeland.

‘The method’s capacity is another important point. It means that we can analyse far greater areas within the tumour and deal with heterogeneity in a cancerous tumour in a different way than we currently do or that is practically possible for a pathologist,’ says Smeland.

He says that their method can be used in screening, and will soon be used for colorectal cancer screening in Norway.

‘With colorectal cancer, there are lots of tissue samples to be analysed. If you have a good algorithm, you can quickly pick out the patients who have cancer/suspected cancer and so cut down on huge amounts of pathology work,’ says Smeland.

He is adamant that pathologists will not become superfluous when the new technology is introduced.

‘There is, and there will continue to be, a great need for pathologists. They’re extremely skilled at making diagnoses, and they rarely make mistakes. The pathologists’ work and the standardisation process for diagnosing and categorising cancerous tumours has been central to improved medical treatments over the last 150 years,’ says Smeland.

However, he knows that this technology will change the pathologists’ work and that their work will shift to other tasks that we know are increasing and this will include the integration of results from different types of analyses such as molecular diagnostics.

The five products

The procedure for diagnosing colorectal cancer is the first diagnostic service that DoMore Diagnostics will offer.

­‘We’re currently in the process of developing similar diagnostic services for lung cancer and prostate cancer using the same approach as for colorectal cancer. We have made good progress with lung cancer, and are in the early stages with regard to prostate cancer,’ says Danielsen.

The other two products that DoMore Diagnostics is working on are polyp screening and mitotic index respectively; the latter is a measure of the number of cells undergoing cell division in a tissue sample.

‘This index gives an indication of how active a particular cancer is and can be an important addition to current diagnostics and treatment options for most types of cancer,’ says Danielsen.

The DoMore! Project is also developing a technique for automated histological classification of bowel polyps in order to indicate whether the patient is at risk of developing cancer.

‘Bowel cancer screening has been successfully implemented in many countries. Bowel polyps are removed during endoscopy and are currently studied by pathologists who classify them according to their risk of becoming cancerous. The challenge for us today is that there is a limited number of pathologists who specialise in gastroenterology,’ says Melby.

CEO and investors sought

As of now, DoMore Diagnostics consists only of a board.

‘The board is seeking to appoint a CEO for the company. It is also seeking innovation funding from the Research Council of Norway as well as potential investors to raise initial private capital. After that, the plan is to acquire more funds when the products are ready to be launched on the market,’ says Danielsen.

Professor Emeritus Knut Liestøl, who has played a central role in the DoMore! project, is chair of the board. Ketil Widerberg, who is director of the Oslo Cancer Cluster, and Tomas Nordheim Alme are also on the board. Alme currently works as a paediatrician at Akershus University Hospital, but before that he was director of development and medicine at Dips, one of the largest providers of e-health solutions in Norway.

Danielsen cannot join the company because of his senior manager role at Oslo University Hospital, but he will definitely follow its progress closely. It is a project that he holds dear to his heart.

A huge amount of attention

The research and development behind DoMore Diagnostics has received a huge amount of attention in Norway:

• Prime Minister Erna Solberg, and, the then, Minister of Digitalisation, Nikolai Astrup, visited Danielsen and his colleagues in 2019, when the Government was launching a national artificial intelligence strategy (in Norwegian only).
• The DoMore! Project was cited as a good example in the 2020–2023 National Health and Hospital Plan, and Danielsen was also invited to make a presentation at the 2019 Government Conference. See video of the presentation here (in Norwegian only).
• We have already mentioned the front page of Aftenposten in February 2020: Shortly afterwards, Danielsen presented the research behind their publication in The Lancet at the 2020 Oslo Life Science Conference.

Danielsen is pleased with the attention because it means that the public, healthcare professionals and other relevant target groups understand the importance of the work that he and his colleagues are doing.

‘The technique we have developed involves a major change for patients and hospitals. The right treatment is incredibly important. When we applied for funding for DoMore!, we stated that we would provide good, original research and that we wouldn’t stop there, because that doesn’t help patients. Patients only benefit from research when it leads to a change in clinical practice. To achieve that, we’ve got to create a product that someone can buy, and we’re almost there now,’ says Danielsen.

Facts:

The Institute for Cancer Genetics and Informatics & DoMore!

• The Institute for Cancer Genetics and Informatics (ICGI) is part of Oslo University Hospital. In addition to clinical diagnostics, the institute is developing more accurate cancer prognoses based on, among other things, artificial intelligence.
  The institute is also behind the online encyclopaedias: kreftlex.no and Oncolex.no.
• ICGI, which unites the disciplines of medicine, genetics and informatics has now been in existence for 15 years. The institute is consciously developing a heterogeneous, interdisciplinary environment to ensure a dynamic, creative culture. The institute employs almost 80 people from 13 different countries whose backgrounds are in informatics, mathematics, biology, genetics, medicine, clinical practice, pathology and technology. The institute also has a separate communications section.
• In 2016, the Research Council of Norway granted ICGI NOK 60 million over five years for DoMore! as one of three Lighthouse projects. The Lighthouse projects were established for the purpose of using ICT and groundbreaking technology to solve major health challenges in society. The other two projects that received funding were BigMed, a Digital Platform for Precision Medicine and INTROMAT, ‘INTROducing Mental health through Adaptive Technology’.
• Håvard E. Danielsen is the director of ICGI and DoMore! Danielsen is a professor of medicine and informatics and was appointed visiting professor at Oxford University for his contribution to cancer research there.

Read more:

• ‘New Norwegian trial: A computer diagnoses bowel cancer more accurately than researchers in three minutes’ (‘Ny norsk studie: På tre minutter stiller datamaskinen mer presis tarmkreftdiagnose enn forskerne’ – in Norwegian only)
• ‘Involving cancer patients in AI research’ (‘Engasjerer kreftpasienter i AI-’- in Norwegian only)
• Artificial intelligence can reduce the malpractice of bowel cancer

You can find more information about DoMore! on the DoMore! website

• Also read more here about the project on Inven2’s website

The post Establishing DoMore Diagnostics AS appeared first on Inven2 2020.

Photo: Simone Mester.

Most protein-based therapeutics must be injected to be effective. That is both stressful for the patient and costly for the healthcare system. Researchers at the University of Oslo and Oslo University Hospital have recently published an article in the highly reputed journal Science Translational Medicine in which they show how their super albumin can solve the problem.

The post A UNIQUE BIOLOGICAL SUPER-TAXI HAS BEEN DEVELOPED appeared first on Inven2 2020.

Photo: Oslo University Hospital.

dHealth is a newly established company that will commercialise health apps developed at the Department of Digital Health Research at Oslo University Hospital. The aim of the apps is to help people with different health issues such as cancer, chronic pain or weight problems with life skills. ‘The apps have an enormous global potential, and we’ve already had a lot of interest in them,’ says Kristin Sandreid, business developer at Inven2.

‘Patients with acute or chronic disorders are receiving treatment or are in contact with the health service about 10% of the time. The remaining 90% of the time, the patient has to cope with the disorder on their own. Therefore, they need coping mechanisms. How do we help patients to live their best possible lives with their disorder? This question forms the basis of everything we do,’ says Lise Solberg Nes.

Solberg Nes is head of the Department of Digital Health Research at Oslo University Hospital. They work with partners on various projects to develop digital solutions or interventions such as a tool that helps patients to better manage their disorder.

The department, headed by Solberg Nes, has been in existence since 2002, but under different names. Its central focus has always been on the patients and how to help them manage their individual disorders.

One of the digital tools they have developed is the StressProffen app: See a video about the app here (in Norwegian only).

‘StressProffen was developed as a stress management tool for cancer patients. We’ve interviewed a number of people with cancer and asked them what they found stressful when faced with a serious illness like cancer. Then, our psychologists worked closely with the designers and technical developers as well as cancer patients and healthcare professionals on developing the content of the app,’ says Solberg Nes.

And the app works. Randomised, clinical trials have proven this; you can read more about this later in this article.

Lise Solberg Nes. Photo: Oslo University Hospital.

Pain, cancer, obesity and communication with sick children

The company, dHealth, was founded recently to commercialise StressProffen and three other health apps that were licensed from the Department of Digital Health Research, with the assistance of Inven2.

See a video about the four apps:

• EPIO is a digital tool for people suffering from chronic pain. Its aim is to help such patients cope with pain on a daily basis. The program provides psychoeducational information. It explains how pain can cause a negative mindset and how to break out of this. EPIO also has relaxation exercises and helps to create a balance between rest and activity.
• eCHANGE is a digital tool to help people who were previously overweight to keep their weight down over time, so-called weight stabilisation, after managing to lose weight. The biggest challenge for people who are overweight is not necessarily losing weight but maintaining the weight loss afterwards. As many as 75% of people struggle with this. eCHANGE is designed so that the users can focus on creating new, useful habits, and aims to motivate and support the users in their everyday lives.
• SiSom is a digital tool that has been developed for sick children. A game is played in which the child goes on virtual trips to five different islands and at the same time answers questions related to preparing for visits to the doctor/hospital. The child’s answers give the hospital staff useful information about how the child is really doing, both physically and emotionally.
• StressProffen is a digital tool designed to help cancer patients cope with the challenges of their situation. StressProffen explains what happens physiologically in the body when it experiences a stressful situation, and contains approved, psychoeducational information and exercises to improve the person’s understanding of and methods of coping with stressors related to their cancer.

Enormous potential and the time is right

Business Developer Kristin Sandreid and Technology Strategy Manager Eirik Løvbakken at Inven2 have worked with the Department of Digital Health Research.

‘After the first meeting in the autumn of 2019, so this has gone fast. We could both see the potential. The apps that have been developed have really improved. They’re based on research, they’re tested and validated and they work really well. Considering that as many as one in three people develop cancer and about one in four people live with chronic pain, there’s definitively a need and a market for them. After the meeting, we agreed that we had to take it further,’ says Sandreid.

Sandreid knew from experience that it is difficult to find a profitable payment model for health apps, particularly apps that are targeted at patients, where hospitals are normally the purchaser.

Solberg Nes knows this too. It is not the first time she and the department have tried to launch their digital solutions.

‘We were in contact with Medinnova, the predecessor to Inven2, as far back as 2009, to discuss commercialisation of the app, SiSom. It was developed to improve communication between sick children and healthcare professionals. Even with a number of commercial partners, we were unsuccessful in trying to get this product onto the market. There’s still a lot of international interest in SiSom, so I’m hoping that we’ll succeed. I think we were ahead of our time, and that, now, the time is right,’ says Solberg Nes.

Sandreid agrees with Solberg Nes that the department was ahead of its time.

‘Few people had smart phones and tablets ten years ago, and they generally weren’t used in hospitals. Now the time is right. We know that the hospitals that are familiar with SiSom are very happy to start using the app,’ says Sandreid.

However, they will have to wait a while before the app becomes commercially available through dHealth.

‘SiSom need a software upgrade, which is quite expensive. The plan is to commercialise the other three apps first and then have the financial muscle to implement the upgrade,’ says Sandreid.

Seeking investors

Sandreid has spent a lot of time discussing payment models and business development of the apps with national and international parties.

‘There are different target groups for the apps; therefore, we’ve got to have different customers and payment models. We’re currently working out the details,’ says Sandreid.

One such discussion led to the setting up of dHealth as a company, with Thomas de Mora as CEO. He has over 30 years’ experience in business development, the last 15 of which were in IT.

‘When I heard about the apps from Inven2, I immediately thought that this was something with great potential, and I wanted to be involved. We’re just getting started, and, as with most start-ups, our focus is on having everything in place at the same time: Business plans, payment models, putting together a good team and implementing a marketing plan. Then, there’s the issue of securing capital in order to expedite internationalisation of the company,’ says de Mora.

He highlights the global trend for individuals to be more involved in their own healthcare. Together with healthcare professionals, the patients should be more active in making the best healthcare decisions for themselves. This is also referred to as ‘empowerment’ meaning self-efficacy, life skills or helping people to help themselves.

‘Our health apps are an important tool in providing assistance with life skills,’ says de Mora.

Inven2 has provided assistance with the Department of Digital Health Research’s licensing process and has also given dHealth a convertible loan. This loan can be converted into shares at a later date when other investors come on board.

Sandreid and de Mora are eagerly awaiting feedback from the Research Council of Norway’s Forny programme to find out if they will receive support for continued business development.

‘With or without Forny, the plan is to get investors on board early in 2021. Then we’ll have enough in place to be able to make a presentation,’ says Sandreid.

Thomas de Mora. Photo: dHealth. 

Scientifically based and patient involvement

The digital solutions that the Department of Digital Health Research has developed are unique in many ways.

‘There are a myriad of health apps on the market, but we’re different in that we’re research-based. We look at what the research finds to be effective and then combine this with feedback and close dialogue with the end users, patients and ideally healthcare professionals throughout the entire development process,’ says Solberg Nes.

She points out that the challenge for patients is not necessarily findings apps or digital tools for their situation.

‘Even if we know that a program or app works, it doesn’t help unless the end users actually use the solution. Therefore, we invest a lot of time in involving the end users so that we know what’s required for them to actually use the program or app,’ says Solberg Nes.

‘When the app has been developed, it will be clinically tested in pilot studies and randomised controlled trials. For StressProffen, this meant that half of the cancer patients in one trial were given access to the app, and the other half were not. The patients’ quality of life, mental health and experience of stress were evaluated before and after the trial.

Randomised controlled trials mean that we can measure the effect of the apps and adjust them to make them even better. We now have 12 months of usage data for StressProffen. The data show that patients who use the app are less stressed, less depressed and have a better quality of life. It’s very rewarding for us to see that StressProffen works. We definitely want users to get the best possible support from this,’ says Solberg Nes.

A global initiative

de Mora thinks that the fact that the health apps are developed by researchers and healthcare professionals together with the users and then clinically tested is what makes them unique and appealing.

‘The US is the biggest global market. There should be a big demand there for Epio and eChange, which are tools that assist with pain relief and weight stabilisation respectively. A major challenge for American society is that many people are overweight, and there has been an opioid crisis because many people became dependent on opiates for pain relief. They need new tools that work and are not harmful,’ says de Mora.

Sandreid says that Canada and Europe are potential markets too.

‘I think these apps may work even better when integrated with social media, where we can appeal to cooperation, affiliation and group thinking. Here, the app users can interact, help each other and give advice and support. Then, this will become a useful way for the company to develop market knowledge,’ says de Mora.

He thinks that the coronavirus pandemic has highlighted how important the remote follow-up of patients and users is and that it may have changed the mindsets of healthcare professionals as well as users.

Would you like more information about the company?

Then please contact Thomas de Mora by email.

Epio. Photo: Oslo University Hospital.

StressProffen. Photo: Oslo University Hospital.

eChange. Photo: Oslo University Hospital.

Facts:

dHealth

• A newly established company that will further develop and commercialise digital health apps that have been developed at the Department of Digital Health Research at Oslo University Hospital.
• Thomas de Mora is CEO.
• Four apps have been licensed that are being further developed to make them ready for sale over the next two years.
• Currently working on establishing the company and further developing the apps to make them ready for sale in different countries and to different buyers.
• Would like to get in touch with potential partners and investors.

See the dHealth homepage for more information.

The Department of Digital Health Research

• The Department is organised under the Division of Medicine at Oslo University Hospital, and based at Aker Hospital.
• Works on developing, testing and implementing digital solutions that can increase patients’ knowledge with regard to their own health and coping mechanisms. The solutions will also help to improve individual follow-up, communication and interaction between the patient and healthcare professionals.
• An interdisciplinary research department with expertise within nursing, psychology, physiotherapy, public health and health promotion, marketing, film and graphic design, digital design, technical architecture and system development.
• Lise Solberg Nes is head of the department. She is a researcher, clinical psychologist and adjunct professor at the Mayo Clinic in the US.
• The department has, or is in the process of developing, almost 20 digital tools. See a list of these on the homepage under Projects.
• StressProffen has attracted attention in the Norwegian cancer research environment. Versions of StressProffen are now being offered to Norwegian women with breast cancer in a major trial under the auspices of the Cancer Registry of Norway and other partners with the support of The Norwegian Cancer Society’s Pink Ribbon Campaign.
  Read more about the research project ‘Coping After Breast Cancer (CABC)’ (‘Stressmestring etter brystkreft [SEB]’ – In Norwegian only) here.

More information available on the Department of Digital Health Research’s homepage.

The post Digital assistance for life skills appeared first on Inven2 2020.