Intermountain Health researchers are helping to lead a national consortium of healthcare systems and hospitals in a new federally-funded initiative that will use advanced technologies – including AI and machine learning – to improve treatment for patients with acute respiratory distress syndrome (ARDS), pneumonia, and sepsis – the most common and devastating conditions found in critically ill patients.

Hundreds of thousands of people infected with the COVID virus during the pandemic who were hospitalized and in critical condition ultimately died from these conditions. ARDS, pneumonia, and sepsis, together kills hundreds of thousands of people in the United States each year.

Through a major $51.6 million grant from the National Institutes of Health, researchers from 22 hospitals from across the country — collaborating through a clinical coordinating center at Vanderbilt University Medical Center — will identify what makes these patients different, which will allow researchers to find targeted treatments for them.

The consortium will start enrolling patients by early 2024 and hopes to enroll 5,000 patients overall in the next five years.

Intermountain Health is leading one of six groups of healthcare systems that make up the APS Phenotyping Consortium, which plans to bring together many of the nation’s experts in phenotyping critical care illnesses.

A major goal of this national consortium is to understand the different types of ARDS, pneumonia, and sepsis, and from that, to develop treatments targeting specific dysfunctional pathways.

Early work of this group will focus on “phenotyping” ARDS, pneumonia, and sepsis — identifying subtypes of each syndrome based on biological similarities and differences among different patients.

There are many different causes for and severities of ARDS, pneumonia, and sepsis. ARDS, pneumonia, and sepsis, together kills hundreds of thousands of people in the United States each year. ARDS and sepsis are most often caused by pneumonia, which is a syndrome itself, with poor results: up to 50% mortality rate, and for survivors there’s often a reduced quality of life and an ongoing risk for early death.

Despite this grim reality, other than antibiotics, there are currently few effective specific therapies for patients with ARDS, sepsis, and pneumonia.

Treatment has been hampered by an incomplete understanding of how each syndrome develops. Now, emerging evidence suggests that ARDS, pneumonia, and sepsis likely represent many distinct disorders with different underlying causes and disease mechanisms.

“For 20 years, the scientific community has been searching for effective treatments for ARDS and sepsis patients, without much success,” said Samuel Brown, MD, MS, principal investigator of the Intermountain-led InterACT Center within the Consortium and vice president for research and research professor at Intermountain Health.

“Part of the problem is that we’ve been imprecise, and assumed everyone is the same and will respond to the same therapies. But they clearly don’t. The disease syndromes often differ from patient to patient. We need to better understand the meaningful patient subgroups in order to identify effective treatments,” he added.

The six lead sites of the consortium, which is structured in a hub-and-spoke model, are Intermountain Health, University of California San Francisco, University of Colorado, University of Michigan, University of Pennsylvania, and Vanderbilt University Medical Center.

Researchers will study patient by collecting information on them through assessments like blood and genetic tests, and track patients’ progress and outcomes. Then, using advance technologies like advanced analytics, AI and machine learning, they will identify patient types, and actionable targets within each type that would then be suitable for further, more specific, clinical trials.

Dr. Brown said that this is a radically different way of approach patients with ARDS, sepsis, and pneumonia, and will lead to a new treatment paradigm.

“It’s as if we’ve been looking at apples and oranges and watermelons, and treating everyone as if they were apples,” he said. “We need to be more precise, and bring true precision medicine to these critically-ill patients.”

Disclaimer: The research described above is supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number HL168416 and the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number HL168416. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

About Intermountain Health

Headquartered in Utah with locations in seven states and additional operations across the western U.S., www.intermountainhealth.org is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information or updates, see https://intermountainhealthcare.org/news.