Pneumonia is a leading cause of death in children worldwide, despite the availability of a vaccine. To be properly vaccinated against the disease, children must receive a series of three shots over a period of several months. Researchers are now exploring ways to make the vaccine more effective by changing the timing of the shots.

Nearly a million children die from pneumonia each year, making it a leading cause of death in children and the single most important public health problem for children under the age of five. Most babies with access to preventive care receive three doses of the vaccine at 6, 10, and 14 weeks of age. The schedule is not ideal, as children are highly vulnerable until five years of age—and the vaccination schedule is designed to provide protection for the earlier years.

The children’s doctors there said, ‘We don’t know why the children are dying in the hospital. Come and help.’ So that’s why we started working there. What we found was that the most important cause of serious illness in the hospital was pneumonia. Andrew Pollard Director, Oxford Vaccine Group

The Oxford Vaccine Group is conducting a program called HimalayaHelp to determine if altering the vaccination schedule can extend childhood immunity throughout those critical first five years. For the trial, the team is scheduling the first two doses for infants who are 6 and 14 weeks old. The third dose is then administered when the infants are eight months old. The team is hopeful that this delay in administering the final vaccination will protect children until a much later age, thus reducing mortality from this serious disease.

“I’m passionate about Nepal because it is one of the poorest countries in the world, where there’s a huge need,” says Andrew  Pollard, Director of the Oxford Vaccine Group and Professor of Paediatric Infection and Immunity at the University of Oxford. “I believe that with this project, there are things we can do, which will make a difference to the lives of children there.”

Building Solutions with Everyday Technology
One of the biggest problems in medical informatics is keeping track of data and all of the associated details. Researchers must meticulously log who collected the data, how it was collected, and any associated information. Manually inputting this level of detail takes time away from actual research, while incomplete entries may cause problems for other researchers attempting to follow up.

“Edison said that genius is 1 percent inspiration and 99 percent perspiration,” says Jim Davies, Professor of Software Engineering at the University of Oxford. “If you can sort out some of the paperwork for [researchers] by building large-scale scientific office solutions that work, then you have more time for them to display their genius and solve the health—or social, or government, or scientific—problems that they’re there to do.”

At the University of Oxford, a team of six people seek to do just that. The team (from Oxford’s Department of Computer Science) works on software support for medical informatics. “Since 2005, we’ve been developing what you might call semantics-based solutions,” Davies says. “That is the meaning of the data. It is associated with the data at the point of capture, and that association is maintained throughout the whole life cycle of the data, so that whenever that data is processed and used as evidence, you know where it came from.”

The University of Oxford team, with support from Microsoft Research, developed software to address these issues in support of clinical trials and clinical studies in cancer. Based on Microsoft SharePoint technologies and Microsoft InfoPath information gathering program, the system—called CancerGrid—can be used to create and deploy clinical trial support infrastructure in a fraction of the time and at a fraction of the cost of conventional methods. The system can collect semantically well-defined and standardized data from multiple sources; however, the greater benefit is its ability to combine data simply and efficiently.

So what we were able to do was give them full document management support for their clinical studies—both in this country and in Nepal—using a combination of Microsoft tools. Jim Davies Professor of Software Engineering, University of Oxford

The University of Oxford Department of Computer Science team recognized that their colleagues in the Oxford Vaccine Group needed support for their clinical trial operations and believed that the CancerGrid technology could be of use.

Evolving Technology
By applying the technologies that they developed for cancer research, the University of Oxford team created new software to support clinical studies of vaccines. The new software, called Vaccine Data Management (VDM), used a combination of InfoPath, SharePoint, Microsoft Excel, and Windows Azure services to provide full document management support for the Oxford Vaccine Group’s clinical cancer vaccine studies in both England and Nepal.

“We’re using Microsoft InfoPath, which was exactly what they needed so that the researchers, the domain experts, could use this on their own desktops to create the forms they needed to acquire data,” Davies says. “These forms could then be fed into SharePoint Server and accessed from within rather than a broad collaboration.” The InfoPath and SharePoint technologies enable the team to distribute and manage forms securely, a critical requirement for ensuring patient privacy during clinical trials.

The researchers in Nepal now transmit data back to the University of Oxford in real time through a secure Internet connection. The level of data input that is required has been reduced, allowing them to spend more time performing actual research. The CancerGrid tool, and now VDM, were both developed with financial and technical support from Microsoft Research. It has been a very satisfying collaboration for both teams.

“What’s exciting about working with Microsoft Research is that they have the expertise, not only in computer science, but also in life sciences,” Davies says. “You have somebody who understands the requirements, the needs, the processes of scientists, but who also understands the technologies: what can and can’t be done, how you can best apply tools and technologies to solve real scientific problems.”

Websites:
research.microsoft.com/healthwellbeing
www.cs.ox.ac.uk/
cancergrid.org

Video:
Adjusting Childhood Pneumonia Vaccination Periods May Save Lives in Nepal