Interview with WP3 leader: Luis Rodriguez-Rodriguez  

“Seeing different perspectives by connecting with other clinical research groups and those with different mindsets is very enriching"

Dr. Luis Rodriguez-Rodriguez, senior researcher at Instituto de Investigaciones Sanitarias San Carlos (IdISSC) in Madrid and leader of work package 3, focused on modular diagnostics, has a diverse background. “I am a rheumatologist and have been engaged in research for the past 15 years. My research has included basic laboratory work focused on genetics, as well as clinical research primarily aimed at improving the quality of life and addressing the disability associated with musculoskeletal diseases.” He mentions that he and his team have recently begun exploring the application of artificial intelligence and machine learning in rheumatology and musculoskeletal conditions, with the aim of developing useful models that will benefit both patients and physicians.

New tools for early diagnosis and referral

Rodriguez explains that work package 3 has two primary objectives, of which the first is the improvement of ‘Rheumatic’, an online symptom checker for people with musculoskeletal symptoms. The tool aims to provide guidance on whether users should seek further medical care and targets both individuals who have not yet received primary healthcare and those who are already receiving primary care. It benefits patients by advising seeking care at primary care and/or referrals to rheumatologists, thus enhancing the efficiency of the healthcare system.
The second objective is ‘Modular SPIDeRR’, a tool to improve patient referrals from primary to specialized care using real-world data. “This tool helps identifying patients who need to see a rheumatologist early, especially those at risk of having an inflammatory disease. The tool uses different types of data (administrative, clinical, laboratory) and adapts to various countries' healthcare systems. Each site can use multiple models to decide on referrals, with continuous validation to ensure accuracy”, says Rodriguez.  

Milestones and challenges

Major milestones for work package 3 include submitting the protocol for Modular SPIDeRR this month or next, completing patient recruitment for validating the Rheumatic questionnaire next year, and validating Modular SPIDeRR model in the third or fourth year. Rodriguez: “The main challenges involve working with heterogeneous real-world data from different sites and healthcare systems, as this data was not specifically collected for this study, making it less clean and consistent. Additionally, accessing this data is difficult, although this falls under the responsibility of work package 2”. The Rheumatic study, which involves straightforward patient recruitment and consent, presents fewer challenges. “It is like a very straightforward study.”

Tailored approach

Work package 3 relies heavily on work package 2 for data provision, and work package 6 for qualitative research on the acceptability of the tools being developed and understanding different healthcare systems. “Since healthcare systems vary between countries like the Netherlands, Germany, and Sweden, the tools must be tailored to fit these differences rather than adopting a one-size-fits-all approach.” Additionally, work package 3 collaborates with work package 7, which is responsible for the legal and ethical aspects of data use, and with work package 5, which is significant due to its focus on using genetics to improve diagnosis. Rodriguez: “For the development of the Modular SPIDeRR tool, retrospective data will be utilized, but for validating the Rheumatic online symptom checker, prospective data collection will occur from the general population, primary care, and rheumatology clinics”. This is interesting, he adds, as it may involve gathering genetic data and other information to assess whether genetic research scores enhance diagnostic accuracy or disease differentiation.

Dr. Luis Rodriguez-Rodriguez, senior researcher at Instituto de Investigaciones Sanitarias San Carlos (IdISSC) in Madrid

Valuable outputs

The work done in work package 3 paves the way for future studies, particularly in Spain with the new European Health Data Space legislation. When elaborating on the value of the work package’s outputs, Rodriguez highlights the Modular SPIDeRR tool. “The idea of developing a tool that helps physicians prioritize patients who would benefit from seeing a specialist is going to be good for patients because they will access the care they need sooner.” Rodriguez explains that the project also aims to bridge the gap between primary and specialist care, which are, so far, often significantly separated. Furthermore, the project encourages collaboration with other clinical and research groups. “It is very beneficial that this project connects us with other clinical research groups and those with different mindsets. Seeing different perspectives on the same subject is very enriching.”