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The Radboudumc Academic Medical Network invests in regional collaboration in the areas of prostate cancer, side effects of proton pump inhibitors, vaccines for individuals with compromised immune systems, and treatment of advanced knee osteoarthritis. Joint research projects, involving researchers from Canisius Wilhelmina Hospital, Jeroen Bosch Hospital, Rijnstate Hospital, and Sint Maartenskliniek collaborating with researchers from Radboudumc, receive a total of over 1.1 million euros.
The Radboudumc Academic Medical Network is an initiative to strengthen the ties between Radboudumc and Canisius Wilhelmina Hospital, Jeroen Bosch Hospital, Rijnstate Hospital, and the Sint Maartenskliniek. The hospitals share a regional ambition in research: Innovation and personalized network care.
To achieve this ambition, the hospitals invest in research projects, where researchers from CWZ, JBZ, Rijnstate, and SMK collaborate with researchers from Radboudumc. Following the success of previous years, four Junior Researcher positions have been awarded again.
Celebratory
Researchers from Radboudumc and PhD holders from the collaborating hospitals were invited to submit a project proposal. A review committee consisting of representatives from CWZ, JBZ, Rijnstate, SMK, and Radboudumc evaluated the project proposals based on criteria such as their societal relevance, alignment with the shared strategy, and scientific quality.
During the celebratory event at the Radboudumc Experience Center on April 25th, one Junior Researcher position per collaborating partner was awarded, each amounting to €280,000,- for a period of four years. These are the four awarded projects:
Fusion of MRI and pathological images in prostate cancer
Radboudumc: Geert Litjens
CWZ: Jean-Paul van Basten
This project aims to enhance the personalization of treatment decisions for prostate cancer patients within the existing Prosper network of Radboudumc and partners. CWZ plays a central role in robot-assisted radical prostatectomy (RARP) and is the co-applicant in this initiative.
Prostate cancer care is essential for Radboudumc and CWZ, with each institution focusing on different aspects. Radboudumc specializes in diagnostics, particularly in areas such as mpMRI and the application of AI in radiology and pathology. Meanwhile, CWZ excels in RARP surgeries and the improvement of surgical outcomes. Collaboration between the two centers on the clinical front is already well-established, with shared urologists.
We can effectively leverage both centers' complementary knowledge and expertise by deepening the joint research efforts in prostate cancer. Radboudumc contributes its proficiency in AI for identifying predictive biomarkers, while CWZ brings its experience in tailoring surgical treatments for prostate cancer patients.
Reducing side effects of proton pump inhibitors
Radboudumc: Joost Hoenderop
JBZ: Ron Kusters
Proton pump inhibitors (PPIs) are utilized by approximately 2.8 million individuals in the Netherlands, and concerns about associated complications such as osteoporosis, chronic kidney failure, and impaired mineral/vitamin absorption have risen over the past decade (1,2).
The outcome of our research will bring direct benefits to both medical professionals and patients. Doctors prescribing PPIs will be better equipped to detect potentially serious side effects early on, allowing patients to undergo timely and appropriate interventions. From the perspective of patients and society, this translates to an enhanced health experience and improved everyday functionality. Our insights into these aspects will be gleaned through patient surveys focused on symptom recognition and severity.
The collaboration between the two research groups, leveraging their complementary expertise, promises a deeper understanding of complaints related to PPI usage and their correlation with side effects arising from abnormal electrolyte levels. The innovative machine learning algorithms and the already validated clinical decision support system deserve recognition within the regional network for their demonstrated value in patient care.
The consolidation of expertise, including the involvement of an internist and a hospital pharmacist, completes our multidisciplinary team, offering a pathway towards the practical application of the knowledge gained. By delving into the impact of one of the most commonly prescribed medications and developing tools for early intervention, our efforts hold significant promise for a positive impact on healthcare, with individual patients experiencing the benefits.
Vaccine efficacy in immunocompromised individuals
Radboudumc: Quirijn de Mast
Rijstate: Robert-Jan Hassing
The number of immunocompromised individuals has sharply risen because of the increasing use of immunomodulating drugs. Use of these drugs is associated with an increased infection risk, including respiratory infections and shingles. While guidelines recommend specific vaccinations for this group to curb infectious risks, vaccine efficacy is diminished by immune suppression, often necessitating adjustments in vaccine schedules and insufficient protection against infectious diseases. Our project addresses this challenge by proposing the strategic use of so-called 'trained immunity-inducing' vaccines to improve the vaccine efficacy of other vaccines.
The project is conducted at the vaccination policlinics of Rijnstate and Radboudumc. Immunomodulators are prescribed to thousands of individuals in both hospitals. Both vaccination policlinics aim to assume a leading role in centralizing vaccination care for immunocompromised individuals in 2024, aligning with updated quality improvement and vaccine reimbursement policies. The innovative vaccination strategy holds the potential to revolutionize vaccination paradigms for immunocompromised individuals, thereby reducing costs and alleviating the infectious burden in this susceptible population.
The proposed project aligns well with the scientific and patient care strategies of both partners. Rijnstate has extensive clinical expertise in infectious diseases and immunology, including 3 internists/infectious diseases specialists, 2 internists/clinical immunology/allergy specialists, and 2 medical immunologists. Currently, a center for infectious diseases and immunity, including a vaccination expert group, is being established. This aligns well with Radboudumc, which is globally recognized for its immunology and infectious diseases research. Both institutes have long existing and recognized vaccination policlinics. Combining forces in the present project will be the start of a unique regional initiative for vaccination studies.
Personalized treatments for optimized survival of revision TKA
Radboudumc: Dennis Janssen
SMK: Petra Heesterbeek
Total knee arthroplasty (TKA) is a successful intervention for treatment of advanced knee osteoarthritis. Due to the ageing population and increases in risk factors such as obesity, the number of TKA operations is expected to increase significantly over the upcoming decades. TKA currently does not provide a permanent solution for every patient, and particularly younger patients with a longer life expectancy often require one or more revision surgeries during their lifespan. As a result, the number of revision total knee arthroplasties (rTKA) has increased over the past years, with projections predicting a significant increase of up to 90% in the coming decades, which will place an immense burden on the health care system.
Revision surgery is associated with a higher risk of failure compared to the initial surgery, with 33% of the re-revisions TKA caused by aseptic loosening.
SMK is the largest orthopaedic clinic with 400 rTKA procedures performed annually. The Orthopedic Innovations group is an internationally esteemed research group specialized in clinical studies, with a main focus on functional evaluation and survival analysis of primary and revision arthroplasty.
Radboudumc’s Orthopaedic Research Lab (ORL) performs fundamental and applied research on the biomechanical aspects of musculoskeletal disorders, with optimization of survival of joint replacement as a main focus. The ORL has many past and present collaborations with clinical and industrial partners to evaluate joint reconstructions. The ORL features a physical testing facility with access to human cadaveric specimens and has a custom infrastructure for computational modelling to facilitate population-based mechanical modelling.
The current project will provide invaluable input to optimize orthopaedic care for patients requiring knee revision surgery, which will be shared with our regional clinical collaboration partners.
