When time matters most: Implementing GAAD with navify® Algorithm Suite for early detection of liver cancer

Success story

A diverse group of healthcare professionals collaborating around a laptop in a meeting room, symbolizing teamwork and technology integration in medical environments.

Medizinische Hochschule Hannover

  • University Hospital in Hannover, Germany

  • Serves nearly 60,000 inpatients annually

  • Certified Centrum for Liver Cancer

  • MHH physicians contribute to Liver Cancer guidelines for patient management

Digital solutions for early detection of hepatocellular carcinoma

Each year in Germany, approximately 500,000 people are diagnosed with cancer.1 For affected patients, early detection is essential to increase their chances for survival.2 Hepatocellular carcinoma (HCC) in particular is one of the leading causes of cancer-related death globally. However, if identified at an early state, surgical resection offers a favorable prognosis, with 5-year survival rates of more than 70%.3

Clinical algorithms are increasingly important in the race to identify high-risk patients — especially at the early and potentially curative stage of disease. Beginning in December 2022, Prof. Dr. R. Lichtinghagen, laboratory director at University Hospital in Hannover – Medizinische Hochschule Hannover – committed to utilizing the CE certified algorithm GAAD hosted by navify Algorithm Suite digital solution to capture the clinical benefits of the GAAD solution for hepatocellular carcinoma (HCC).

According to Prof. Dr. Lichtinghagen, results of the study bode well for enabling local digital transformation in HCC patient management on a larger scale, with a continually expanding certified algorithm library.

Challenge

Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide.4 Frequent testing in high-risk groups is demonstrated to improve survival by 37%.5 Diagnosis usually occurs at late stages due to asymptomatic courses, which drastically reduces patient survival. By using clinically validated algorithms, such as the GAAD algorithm, a risk score can be determined by combining two biomarkers with the patient’s sex and age, aiding in the diagnosis of HCC at an early stage.

Solution

Detect early

The CE-marked GAAD algorithm is connected to the hospital’s laboratory information system (LIS) or hospital information system (HIS) via the navify Algorithm Suite cloud-based platform. For patients with relevant pre-existing conditions, the algorithm can be requested as a standard parameter in laboratory testing.

To support early detection of HCC, four data points (Age, Sex, Elecsys® PIVKA-II and Elecsys® AFP results) for the patient are considered. The result is a clinically validated semi-quantitative risk factor score that may indicate increased risk for HCC, supporting a decision by the treating physician to recommend further diagnostic workup.

Adoption of navify Algorithm Suite carries a relatively low resource burden and integration into the workflow can be achieved with only light efforts from customer IT admin, typically numbering hours throughout the integration journey.

navify Algorithm Suite, a novel cloud-based platform introduced by Roche in 2022, aims at enabling and supporting the integration of clinical algorithms such as GAAD into the technical IT workflow of laboratories or hospitals.6

Prof. Dr. Lichtinghagen’s study project at Hannover Hospital focuses on evaluating the value and usability of an algorithm and a cloud-based platform in clinical practice, including efforts to integrate and implement these tools into the everyday workflow and practice in the clinic and laboratory.

The GAAD algorithm is like a digital parameter that runs in routine as a normal laboratory value – now we have no additional effort.

Prof. Dr. R. Lichtinghagen

navify Algorithm Suite: University Hospital Hannover challenges and opportunities

Learn how Prof. Dr. Lichtinghagen from the University Hospital Hannover in Germany reflects on the challenges and opportunities for the implementation of clinical algorithms.

Results

Simplified process, saved time, reduced costs

As reported by Prof. Dr. R. Lichtinghagen in a semi-structured interview, results of the study project include the following key data points:

90%manual actions reduction

navify Algorithm Suite reduces manual actions required by 90%, from 10 steps for risk score calculation before using Roche solutions (i.e., navify Algorithm Suite, GAAD) to just 1 step after implementation, thereby reducing potential for manual error. The user no longer needs to take aliquots from the sample, assign them to a rack, analyze them separately and enter the results.

~2hours daily time saving

In addition, Dr. Lichtinghagen reports that engaging navify Algorithm Suite, GAAD produced time saving of ~2 hours daily, accruing to ~8 hours per week.

~€12,000 cost saving per year

Time-saving leads to estimated cost savings of ~€12,000 per year (estimation based on the average salary at the public rate in Germany, i.e., €58,000 for a lab technician, as listed publicly).*

Conclusion

The early detection of cancer is just one example of the promising use of clinically validated algorithms. The cloud platform as a secure IT infrastructure and interface for connection to a customer’s existing LIS or HIS enables scaling of the available algorithms, such as for cardiology or chronic disease, to further indications.

To enable rapid adaptation and expansion of the range of clinically validated algorithms, the cloud platform can be expanded to include algorithms from various start-ups and partner companies.

References and notes
  1. World Cancer Research Fund International, Global Cancer Data by Country, available at: https://www.wcrf.org/cancer-trends/global-cancer-data-by-country/; accessed 5 June 2023
  2. Ferlay J. et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019. Apr 15;144(8): 1941-1953.
  3. W, Wang, C, Wei. Advances in the early diagnosis of hepatocellular carcinoma, Genes & Diseases, Volume 7, Issue 3, available at: https://www.sciencedirect.com/science/article/pii/S2352304220300222; accessed 5 June 2023
  4. Zhang BH et al. Randomized controlled trial of screening for hepatocellular carcinoma, J Cancer Res Clin Oncol 2004;130: 417-22
  5. Zhuo,Y,  Chen Q. Chatwal J. (2019). Hepatocellular Carcinoma: Translational Precision Medicine Approaches, Chapter 3 Changing Epidemiology of Hepatocellular Carcinoma and Role of Surveillance, Available at: https://www.ncbi.nlm.nih.gov/books/NBK553755/#:~:text=HCC%20is%20responsible%20for%2080,cause%20of%20cancer%20deaths%20worldwide; accessed 5 June 2023
  6. https://diagnostics.roche.com/global/en/news-listing/2023/roche-introduces-navify–algorithm-suite–a-digital-library-of-m.html
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