New smart data concept to help patients with internal diseases get more active and live better lives

Establishing a digital assistance system based on artificial intelligence to support patients / Sports Medicine research group of Mainz University involved in two projects coordinated by the Mainz University Medical Center.

Regular and moderate physical activity can significantly improve the quality of life of people with internal diseases such as cancer and depression. Unfortunately, many people with internal disorders cannot sufficiently participate in exercise training for several reasons. For example, they often do not have access to appropriate exercise training programs, have a high therapeutic burden, fatigue, or simply no time to engage in physical activity.

Accordingly, the Sports Medicine research group led by Professor Perikles Simon at Johannes Gutenberg University Mainz (JGU) investigates how physical activity can be promoted and integrated into patients' daily lives by applying digital tools such as wearables and mobile apps in combination with secure data transfer and state-of-the-art data analysis. Overall, the primary aim of the research approach is to improve patients' quality of life.

With this smart data concept, we want to employ a digital infrastructure to support people with internal diseases as well as the exercise therapists who guide the patients' exercise therapy."

Barlo Hillen, research associate of JGU's Department of Sports Medicine, Disease Prevention, and Rehabilitation

The JGU Sports Medicine is involved in two related research projects coordinated by the Mainz University Medical Center: DECIDE, sponsored by the German Federal Ministry of Education and Research, and the EU project RELEVIUM.

DECIDE: Algorithms and smartwatches to be used for the benefit of patients

The JGU Sports Medicine research group strives to ensure advanced exercise load management for patients. The group wants to support patients in better coping with their individual disorders, improve their personal well-being, and increase their capability to deal with daily tasks or at least maintain this ability even as the disease progresses. The new project "Decentralized Digital Environment for Consultation, Data Integration, Decision Making, and Patient Empowerment" (DECIDE) is coordinated by Dr. Torsten Panholzer, head of Medical Informatics at the Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI) at the Mainz University Medical Center. One of the main objectives of DECIDE is to improve the level of support services available to patients with colon cancer, lung cancer, or depression living in the rural regions of Rhineland-Palatinate. The networking of regional hospitals, physicians, self-help groups, and researchers is coordinated by the University Medical Center of Johannes Gutenberg University Mainz. The research results are intended to directly support patients.

Collaborating with the Fraunhofer Institute for Industrial Mathematics (ITWM), the JGU research group plans to apply intelligent digital support systems that will enable individualized control of patients' daily physical activity. A smartwatch will register the patients' vital data as well as their perceived exertion and pain. The data is transmitted to an app on the patients' smartphone and from there to their therapists. A feedback loop and an automated data analysis system will ensure the appropriate modification of training recommendations for each individual on a regular basis. "In previous projects, it was necessary to analyze exercise protocols and draw up training plans manually. That was very time-consuming. Our digital tools will be able to process most of this work automatically, enhancing the efficiency of the process," added Hillen. Depending on the individual patient, recommendations may include moderate strength exercise, endurance exercise, i.e., brisk walking or jogging in intervals, and mobility training. The advocated forms of exercise will fit in the patient's daily routine. The aim is to minimize any potential logistical or financial barriers that might discourage patients from exercise participation.

Partners of the Mainz University Medical Center and the JGU Sports Medicine research group in the DECIDE project are the Fraunhofer Institute for Industrial Mathematics and the MCS Data Labs GmbH in Berlin. DECIDE is currently in the pilot phase studying healthy subjects. The German Federal Ministry of Education and Research (BMBF) is funding the project with EUR 5.5 million as part of its Digital Strategy program.

RELEVIUM: Improving the quality of life of pancreatic cancer patients

The EU project RELEVIUM aims to support patients with advanced pancreatic cancer. Their pain and uncontrolled weight loss should be alleviated based on highly personalized approaches including nutrition, physical activity, and pain management – along with chemotherapy. Digital systems with automated evaluation algorithms will in particular facilitate the monitoring of the patients' sarcopenia, nutritional intake, physical activity, and pain perception. The JGU Sports Medicine research group will give advice on suitable physical exercise and support the project consortium by planning and implementing randomized clinical trials in five medical centers in Europe, subsequently analyzing the extensive collected data.

"We will determine the effect of the smart data concept and investigate if patients do actually benefit from the use of digital tools and experience a better quality of life," said Barlo Hillen. With regard to physical activity, training programs will be organized similar to DECIDE, but these will be specifically adapted to the needs and abilities of people with pancreatic cancer. Pancreatic cancer has one of the lowest survival rates among cancers and is responsible for 95,000 cases of deaths per year in the EU alone.

The RELEVIUM consortium consists of 18 partners in ten countries. Major European medical and cancer centers in Belgium, Estonia, France, and Israel are included in RELEVIUM. The European research network is being coordinated by Professor Markus Moehler of Medical Clinic I at the Mainz University Medical Center. The project was launched on 1 September 2022 with a feasibility study involving both diseased and healthy participants and is planned to run until 2026. The European Union provides funding of about EUR 6 million for the project.