The white paper entitled “IN-Silico trials for treatment of acute Ischemic STroke" describing the main concepts of the INSIST project has recently been published in the journal “Frontiers in Neurology”
Stroke is the number one cause of disability in the Western world and the 3rd most common cause of death. Despite new treatment options with intra-arterial thrombectomy, still 2 out of 3 patients still have a poor outcome. The main goal of INSIST is to advance treatments of ischemic stroke and its introduction in clinical practice by realizing in silico clinical stroke trials in which stroke and treatment are modeled.
The publication of the project white paper in the 2nd most cited open access journal in Clinical Neurology is a huge step forward in the dissemination of in silico clinical trials applications for a clinical audience.
You can read the full paper here: https://www.insist-h2020.eu/images/Dissemination/In-Silico_Trials_for_Treatment_of_Acute_Ischemic_Stroke.pdf
Abstract:
"Despite improved treatment, a large portion of patients with acute ischemic stroke due to a large vessel occlusion have poor functional outcome. Further research exploring novel treatments and better patient selection has therefore been initiated. The feasibility of new treatments and optimized patient selection are commonly tested in extensive and expensive randomized clinical trials. in-silico trials, computer-based simulation of randomized clinical trials, have been proposed to aid clinical trials. In this white paper, we present our vision and approach to set up in-silico trials focusing on treatment and selection of patients with an acute ischemic stroke. The INSIST project (IN-Silico trials for treatment of acute Ischemic STroke, www.insist-h2020.eu) is a collaboration of multiple experts in computational science, cardiovascular biology, biophysics, biomedical engineering, epidemiology, radiology, and neurology. INSIST will generate virtual populations of acute ischemic stroke patients based on anonymized data from the recent stroke trials and registry, and build on the existing and emerging in-silico models for acute ischemic stroke, its treatment (thrombolysis and thrombectomy) and the resulting perfusion changes. These models will be used to design a platform for in-silico trials that will be validated with existing data and be used to provide a proof of concept of the potential efficacy of this emerging technology. The platform will be used for preliminary evaluation of the potential suitability and safety of medication, new thrombectomy device configurations and methods to select patient subpopulations for better treatment outcome. This could allow generating, exploring and refining relavant hypotheses on potential causal pathways (which may follow from the evidence obtained from clinical trials) and improving clinical trial design. Importantly, the findings of the in-silico trials will require validation under the controlled settings of randomized clinical trials."
