The idea of the Carlos III Health Institute to amalgamate a public hospital and a research institute is turning Spanish medicine upside down. Examples of this are IdiPAZ from La Paz (Madrid), VHIR from Vall d’Hebron (Barcelona) and IDIVAL, from the Marqués de Valdecilla Hospital (Santander).
At the head of IdiPAZ its scientific director, José Luis López-Sendón, opens fire with something that could be obvious: “the biggest revolution that this union has produced is the change of mentality in hospitals in the last 10 or 12 years.” He adds that “the investigation was seen by a large majority as a theft of time dedicated to assistance, as a whim of someone who overburdened the staff.” However, 10 years in the institutes is a second in the history of medicine.
IdiPAZ has 9 areas of knowledge. “The most powerful is that of neurosciences. Also the one of cardiovascular. Also, the program infant transplant at a European level together with the area of infectious diseases. And another great area is that of innovation in artificial intelligence technologies. He is going to turn medicine around, ”explains López-Sendón.
“In cardiology there is a program to identify people who have cardiotoxicity from chemotherapy treatments and in neuroscience aspects of neuronal function recovery are being investigated. What scientists do is put a grain of sand on another grain of sand and from time to time a Turing or a Fleming comes out. It’s a race to the bottom”, emphasizes López-Sendón.
Teams tend to be increasingly multidisciplinary. Medical teams that work in parallel with engineers, pharmacologists, biochemists… .
“Based on the fact that the research institutes have been a great idea of the Carlos III Health Institute, they have changed the mentality of the people at the hospital. In addition, it is essential that in the area of biomedical research, basic and clinical research go hand in hand. Another of the objectives is to identify the diseases that are going to be most relevant for the living population, because there is going to be a tremendous group of cardiovascular diseases and neurological diseases that until now were unusual (for example, suicide, dementia…), specifies Lopez-Sendon. And she concludes:the dialogue between society and science is at its dawn. It is necessary not only to spread the news but also to educate the population and that is a task that has to be done with a team of information professionals, from the university and with the researchers who are in the hospitals.”.
VHIR, organization in eCORE
Research in Vall d’Hebron dates back to the 1960s, although it was in 1994 when what is now the Vall d’Hebron Research Institute (VHIR) was officially established. It was created with the intention of supporting clinical research projects and conducting clinical trials (translational research).
“Since 2022, the organization of the VHIR is based on eCORE (collaborative research spaces) oriented to health challenges, such as global health; chronic and prevalent diseases and aging; women’s and children’s health and minority diseases; the brain, mind and behavior; and cancer. In addition, there are two transversal eCOREs: Personalized Medicine, Innovative Diagnosis, Molecular Imaging and Digital Health and Advanced Therapies and Interventions, Nanomedicine, Transplantation and Donation”, he details. Patricia Pozo Rosich, Vice President of the Internal Scientific Committee of the Vall d’Hebron Research Institute (VHIR).
“Now we have the Clinical Research Support Unit (USIC), essential to support clinical trials. Regarding technology, we also have the High Technology Unit (UAT) which provides researchers with state-of-the-art equipment and specialized technical advice”, explains the also head of the Section of the Vall d’Hebron Neurology Service.
Clinical studies have gone from 600 in 2017 to 849 in 2021. Most of them in the early stages of research (phases 1-2 and 3). And the number of patients has almost doubled in the last five years, to 1,067 in 2021. The same has happened with scientific publications, which have gone from just over 1,000 in 2017 to 1,641 in 2021. In addition, 59 percent have been in first quartile magazines.
From a scientific point of view, they plan to have the latest technology in gene therapy and also a new cyclotron that will allow the development of new diagnostic and treatment tools based on radioisotopes.
IDIVAL, a power in artificial intelligence
Research in Valdecilla is in the DNA of the hospital, founded in 1929 by the Marqués de Valdecilla. “We have 5 research areas with 30 research groups. They are the area of cancer, neuroscience, the area of systems pathology, technological development and diagnosis, and a cross-sectional area (where they fit from public health, epidemiology, primary care nursing…). We even have a health economics group, a health rights group and a photonics engineering group,” he says. Marcos López Hoyos, scientific director of the Valdecilla Research Institute (IDIVAL).
With close to 800 affiliated researchers, “our two star lines are: that of early phase clinical trials (which is part of the SCReN platform) and a project that we developed in the midst of the pandemic. Is about Cantabrian cohort. Launched in the middle of the pandemic. “We wanted to recruit the population of Cantabria to study health problems. With 2 requirements, that they were residents of the community and that they were between 40 and 69 years old. 21,000 volunteers have been recruited.
Nevertheless, is not the only one. There are other cohorts within the institute that also enjoy prestige beyond our borders. It is the case of the Valdecilla Cohort. “This is a study of neurodegenerative diseases and in which we are an important part of multiple international projects” and the Camargo cohort, “which was initially created to study bone-related problems in the postmenopausal population and which we are now referring to for other health problems. And we also have some cohorts in liver disease, specifically in hepatitis C and fatty liver (which is the most prevalent liver disease). In fact, our institute and the institute’s digestive group led the entire hepatitis C eradication plan in the country”, points out the head of the Valdecilla Hospital’s Immunology Service.
However, there is a field that has a foot between the present and the future, where Valdecilla already has a lot to say. It is that of artificial intelligence. “For us it is essential. We are powerful in photonic engineering, what you have to see is how to handle it in the diagnosis. We are clearly facing data science, biomedical research, which today is supported by technological and methodological bases. We handle a huge amount of data. In the environment of a hospital like Valdecilla, more data is handled than in many of the Ibex35 companies”, emphasizes López Hoyos. Exploiting all that information that provides enormous knowledge is the path of this hospital.
The head of IDIVAL tells GM that his star project “It is a personalized medicine project that is based on samples, but above all on data. From personalized medicine and research in Big Data, they trust to obtain information that results in the well-being of patients.
“It is something that will change the ways of acting in health in health programs. One of the great challenges of health research centers. In this sense, we are coordinated with different teams that allow us to integrate from basic to clinical. There’s a photonic engineering group collaborating with the neurology, rehabilitation, cardiology service… and we also want to get closer to the supercomputing group that we have within the University of Cantabria”, continues López Hoyos.
“Medicine today is not only for doctors, it is not only for biologists, it is for any science in which we can obtain information and conclusions from unifying all the data that we are collecting daily. The way of working is changing, we are in continuous recycling. Artificial intelligence and data companies continually affect what we do. That is already here, it is present”, assures the scientific director of IDIVAL.