The beginning ...

12 years ago the Technical University of Munich (TUM) spin-o

company ”Trium Analysis Online” followed the vision to improve human
health by developing web-based online tools to collect, manage, analyse and
disseminate clinical and biomedical data. Two main areas developed: the
”clinical trials engine”, a platform for the electronic data management of
clinical trials and ”CTG Online”, a platform for evidence based online decision
support in obstetrics with patented algorithms to detect drifts, shifts and
outliers in biosignals.
In 2000 Trium joined forces with the Institute for Medical Statistics and
Epidemiology of the Technical University of Munich (at that time headed by
Prof. Neiß) to respond to a request to form an ”International MS Trials,
Research and Resource Centre - IMSTRaRC”. The proposal from Munich was
successful and a 5-years contract with a total volume of 5m € was awarded from
the Multiple Sclerosis International Federation (MSIF) to Trium and the TUM.
The original aim was twofold: a) improving the prediction of the disease by
advanced mathematical modelling - maybe leading to virtual control groups, and
b) evaluating the use of MRI measures as potential surrogates for the disease


Sylvia Lawry Centre
for Multiple Sclerosis Research

The Sylvia Lawry Centre for MS research (SLC) was founded by
representatives of MSIF, TUM and Trium in 2001 as an independent legal entity
with long-term prospects for research and development. Since then, the SLC has
built the world’s largest collection of MS data sets coming from placebo arms
of clinical trials and natural history studies. All major pharmaceutical
companies and academic centres have contributed data free of charge to the
Centre, in total (as of July 2008) data from roughly 26100 patients summing up
to almost 100600 patient years.
Also in 2000 Trium Analysis Online and TUM were successful to obtain a 3-year
grant from the German Federal Ministry for Science and Education to develop a
universal platform for ”Mobile Medical Monitoring” with a multi-purpose
biomedical measurement tool called ”medshirt”. The medshirt and the
corresponding platform were developed and a wearable prototype was shown to be
able to record, transmit and analyse high resolution ECG data as well as other
biosignals together with GPS information. In the following years multiple e

orts were made to exploit potential synergies between these two

elds of MS
and mobile medical monitoring.

Development of the actibelt®

It became increasingly evident that the de

ciencies in the widely used
outcome measures that arose during the analysis of the SLC database cannot be
reasonably dealt with by more advanced statistical modelling. At that point a
more radical change seemed to be necessary and the idea emerged to use the
essence of the medshirt technology to develop a universal platform for the
mobile monitoring of disability: the ”actibelt®”, essentially a medshirt
compressed into a belt buckle, all sensors but the most essential one removed:
the 3D acceleration sensors, that would give meaningful information about the
motion of the body’s centre, certainly the most basic starting point when one
attempts to quantify human motion, at least from a physicist’s point of view.
Trium Analysis Online and subsequently the SLC became partners of one of the
major post human genome projects: ”


” and ”


”, both multi-million euro integrated projects with the focus on
genome-wide cardiovascular diseases funded by the European Union. Trium’s
responsibility was the development of an IT platform to pool the clinical data
and link this Patient Information Management System ”PIMS” to the ”LIMS”, the
Laboratory Information Management System that is hosted at the Wellcome Trust
Sanger Institute in Cambridge, UK.

Sylvia Lawry Centre and the
Tetrahedron Model

The SLC had been stimulated to broaden its basis by trying to apply the
concepts which had proven to be the tetrahedron modeluseful in MS research to
other areas. As a next field of interest cardiovascular disease was chosen. The
overarching ”tetrahedron concept” was developed.

Advances in imaging technology, genetic / genomics and biosignal analysis
carry all the potential to improve clinical decision making. Our concept is to
evaluate the additional value of these areas to multivariate statistical models
based on classical clinical variables that describe the phenotype of a speci

c disease -
Typically it is difficult to validate an improvement of classical prediction
models. The most promising candidates with a broader spectrum of possible
applications seem to be those biosignals that are related to human motion (3D
accelerometry). In contrast to the Human Genome Project and its successors,
where even basic concepts such as ”genes” are becoming more and more vague and
are still far away from the original stretch goal to develop individualised therapies,
the Human Motion Projects deals with entities that are inherently meaningful
for human health: human motion always matters, whereas speci

c genes and
MRI images don’t necessarily. In many diseases physical activity plays a dual
role as a meaningful outcome measure and treatment option. The tetrahedron
concept can be transferred to a number of diseases.

The Human Motion Institute -
one step further towards the

Human Motion Project

The research team is rapidly broadening their capability to pursue their
new mission in MS and an increasing number of other diseases: ”evidence-based
decision support tools for better clinical choices”.

The SLC has an excellent track record of successful implementations of
public private partnerships, to serve as a productive host for international
collaborative research, to develop evidence-based decision support tools and to
deal with the complexities of maintaining scientific independence while
encouraging their entrepreneurial development.
The human motion project is a natural development and extension based on the
results of systematic patient-based meta-analyses in the field of MS.

Recent and future activities towards the Human
Motion Project

(as of August 2008)



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