'Cloud computing' and clinical trials: report from an ECRIN workshop.

Growing use of cloud computing in clinical trials prompted the European Clinical Research Infrastructures Network, a European non-profit organisation established to support multinational clinical research, to organise a one-day workshop on the topic to clarify potential benefits and risks. The issues that arose in that workshop are summarised and include the following: the nature of cloud computing and the cloud computing industry; the risks in using cloud computing services now; the lack of explicit guidance on this subject, both generally and with reference to clinical trials; and some possible ways of reducing risks. There was particular interest in developing and using a European 'community cloud' specifically for academic clinical trial data. It was recognised that the day-long workshop was only the start of an ongoing process. Future discussion needs to include clarification of trial-specific regulatory requirements for cloud computing and involve representatives from the relevant regulatory bodies.

Sentinel e-health network on grid: developments and challenges.

Grid technologies have proven their capabilities to settle challenging problems of medical data access. The grid ability to access distributed databases in a secure and reliable way while preserving data ownership opened new perspectives in medical data sharing and disease surveillance. This paper focuses on the implementation challenges of grid-powered sentinel networks within the e-sentinelle project. This initiative aims to create a lightweight grid dedicated to cancer data exchange and enable automatic disease surveillance according to definition of epidemiological alarms. Particularly, issues related to security, patient identification, databases integration, data representation and medical record linkage are discussed.

Grid-based International Network for Flu observation (g-INFO).

The 2009 H1N1 outbreak has demonstrated that continuing vigilance, planning, and strong public health research capability are essential defenses against emerging health threats. Molecular epidemiology of influenza virus strains provides scientists with clues about the temporal and geographic evolution of the virus. In the present paper, researchers from France and Vietnam are proposing a global surveillance network based on grid technology: the goal is to federate influenza data servers and deploy automatically molecular epidemiology studies. A first prototype based on AMGA and the WISDOM Production Environment extracts daily from NCBI influenza H1N1 sequence data which are processed through a phylogenetic analysis pipeline deployed on EGEE and AuverGrid e-infrastructures. The analysis results are displayed on a web portal (http://g-info.healthgrid.org) for epidemiologists to monitor H1N1 pandemics.

Grid-enabled sentinel network for cancer surveillance.

Recent developments of grid services for secured distributed data management open new perspectives for disease surveillance. In this paper, we report on our initiative to develop a surveillance network for breast cancer in the Auvergne region. The network gathers cytopathology laboratories, structures in charge of cancer screening and institutes in charge of cancer epidemiology. Data stored in cytopathology laboratories are queried through the grid for the purpose of second diagnosis and to produce statistical indicators. The paper describes the network goal and design and discusses specific issues related to patient identification and security.

SHARE road map for HealthGrids: methodology.

The SHARE(1) project (http://www.eu-share.org) was asked to identify the key developments needed to achieve wide adoption and deployment of HealthGrids throughout Europe. The project was asked to organise these as milestones on a road map, so that all technical advances, social actions, economic investments and ethical or legal initiatives necessary for HealthGrids would be seen together in a single coherent document. The full road map includes an extensive analysis of several case studies exploring their technical requirements, full discussion of the ethical, legal, social and economic issues which may impede early deployment, and concludes with an attempt to reconcile the tensions between technological developments and regulatory frameworks. This paper has been restricted to the technical aspects of the project. SHARE built on the work of the 'HealthGrid' initiative so we begin by, reviewing work carried out in various European HealthGrid projects and report on joint work with numerous European collaborators. Following many successful HealthGrid projects, HealthGrid published a 'White Paper' which establishes the foundations, potential scope and prospects of an approach to health informatics based on a grid infrastructure. The White Paper demonstrates the ways in which the HealthGrid approach supports many modern trends in medicine and healthcare, such as evidence-based practice, integration across levels, from molecules and cells, through tissues and organs to the whole person and community, and the promise of individualised healthcare. SHARE was funded by the European Commission to define a research roadmap for a 'HealthGrid for Europe', to be seen as the preferred infrastructure for biomedical and healthcare projects in the European Research Area.

SHARE, from vision to road map: technical steps.

We present the 'HealthGrid' initiative and briefly review work carried out in various European healthgrid projects. We report on joint work with numerous European collaborators. Since the European Commission's Information Society Technologies programme funded the first gridbased health and medical projects, the HealthGrid movement has flourished in Europe. Many projects have now been completed and 'HealthGrid' consulted a number of experts to compile and publish a 'White Paper' which establishes the foundations, potential scope and prospects of an approach to health informatics based on a grid infrastructure. With a second generation of projects now funded, the EC has commissioned the SHARE Project, a study to define a research roadmap for a 'healthgrid for Europe' as the preferred infrastructure for medical and health care projects in the European Research Area. The project explores the ways in which the healthgrid approach supports modern trends both in research in biomedicine and in healthcare, such as evidence-based practice and information integration.

Roadmap for a European healthgrid.

This paper proposes a 10-year roadmap to achieve the goal to offer to healthcare professionals an environment created through the sharing of resources, in which heterogeneous and dispersed health data as well as applications can be accessed by all users as a tailored information providing system according to their authorisation and without loss of information. The paper identifies milestones and presents short term objectives on the road to this healthgrid.

SHARE roadmap 1: towards a debate.

We present the 'HealthGrid' initiative and review work carried out in various European projects. Since the European Commission's Information Society Technologies programme funded the first grid-based health and medical projects, the HealthGrid movement has flourished in Europe. Many projects have now been completed and 'Healthgrid' consulted a number of experts to compile and publish a 'White Paper' which establishes the foundations, potential scope and prospects of an approach to health informatics based on a grid infrastructure. The White Paper demonstrates the ways in which the healthgrid approach supports many modern trends in medicine and healthcare, such as evidence-based practice, integration across levels, from molecules and cells, through tissues and organs to the whole person and community, and the promise of individualized health care. A second generation of projects have now been funded, and the EC has commissioned a study to define a research roadmap for a 'healthgrid for Europe', seen as the preferred infrastructure for medical and health care projects in the European Research Area.

Demonstration of in silico docking at a large scale on grid infrastructure.

WISDOM stands for World-wide In Silico Docking On Malaria. First step toward enabling the in silico drug discovery pipeline on a grid infrastructure, this CPU consuming application generating large data flows was deployed successfully on EGEE, the largest grid infrastructure in the world, during the summer 2005. 46 million docking scores were computed in 6 weeks. The proposed demonstration presents the submission of in silico docking jobs at a large scale on the grid. The demonstration will use the new middleware stack gLite developed within the EGEE project.

Proposing a roadmap for HealthGrids.

With the regular progress of technology and infrastructures, a growing number of grid applications are developed and deployed for life science and medical research. At the last HealthGrid conference in April 2005 in Oxford, many groups described successful usage of grids for compute intensive calculations. Very large scale deployment of a biomedical application in the area of drug discovery has been achieved on EGEE during 2005. On the other hand, beside a few pioneers, very few data grids have been deployed so far and knowledge grids are still at a conceptual level. This situation is expected to evolve quickly as many projects are focussed on developing data management services and knowledge management tools relevant to biomedical sciences. At this stage, it is important to identify the potential bottlenecks and to define a roadmap for the wide adoption of grids for healthcare. This article presents an analysis of the present adoption of grids for biomedical sciences and healthcare in Europe: it identifies bottlenecks and proposes actions that will be further assessed within the framework of the SHARE European project dedicated to the definition of a roadmap for HealthGrids.