THE ICA INTEGRATED COGNITIVE ASSESSMENT TACKLING DEMENTIA WHEN IT COUNTS

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Piers George
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1 THE ICA INTEGRATED COGNITIVE ASSESSMENT AI TACKLING DEMENTIA WHEN IT COUNTS 1

2 CONTENTS INTRODUCTION WHO WE ARE CURRENT ISSUES THE ICA BENEFITS MILESTONES MEDIA PRESCENCE

DEMENTIA is the biggest healthcare challenge of the 21 st century (According to the World Health Organization) Costing the world ~US$1 Trillion annually 1 In the US & UK 1 in 2 people never receive a

3 DEMENTIA is the biggest healthcare challenge of the 21 st century (According to the World Health Organization) Costing the world ~US$1 Trillion annually 1 In the US & UK 1 in 2 people never receive a formal diagnosis, increasing to 9 out of 10 people in lower economic countries The early and proactive screening of dementia could save $7.9 trillion in the US alone, according to Alzheimer s Association 2 There is a massive market for a cost-effective, sensitive and scalable test to allow the earlier diagnosis of dementias and other neurodegenerative conditions 3

OUR MANAGEMENT TEAM Born out of Cambridge, we are proud that our team has grown to include DR. SINA HABIBI Co-founder, CEO DR. SEYED RAZAVI Co-founder, CSO DR.

MARK PHILLIPS Chief Compliance Officer PhD in Engineering, nano-biotechnology, University of Cambridge. Chair of Cambridge University Entrepreneurs.

Set up medical device and pharmaceutical distribution and sales companies. PhD in neuroscience, University of Cambridge.

Extensive experience in Artificial Intelligence (AI) and machine learning applications. MBA from the University of Cambridge, PhD from University of Glasgow.

4 OUR MANAGEMENT TEAM Born out of Cambridge, we are proud that our team has grown to include DR. SINA HABIBI Co-founder, CEO DR. SEYED RAZAVI Co-founder, CSO DR. THOMAS SAWYER Chief Operating Officer DR. CHRIS KALAFATIS Chief Medical Officer DR. MARK PHILLIPS Chief Compliance Officer PhD in Engineering, nano-biotechnology, University of Cambridge. Chair of Cambridge University Entrepreneurs. Executive management in digital health and gaming. Experienced in mathematical modelling and big data consultancy. Set up medical device and pharmaceutical distribution and sales companies. PhD in neuroscience, University of Cambridge. Post-doctoral researcher at MIT studying the human brain in health and disease using the combination of multimodal neuroimaging techniques and computational modeling. Extensive experience in Artificial Intelligence (AI) and machine learning applications. MBA from the University of Cambridge, PhD from University of Glasgow. 15 years of experience in setting up companies, executive consulting and private equity investment in sectors including biotechnology (Alzheimer s drug development), IT, logistics and natural resources across the globe. Guest lecturer in Finance at Cambridge, Exeter and UCL Consultant in Old Age Psychiatry at Maudsley Hospital in South London, lectures at Kings College London. Developed electronic clinics for older people and led strategic NHS partnership schemes in Dementia and has worked across different NHS trusts to modernise the practice and scope of Memory Services MSc in management, University of Cambridge. Former GSK Senior Executive with over 30 years experience in the pharmaceutical, diagnostics and life sciences industries. Has led global teams in research and development, and in manufacturing to create new businesses, products and transform performance. 4

5 THERE IS A PROBLEM WITH DETECTING DEMENTIA Existing assessment methods suffer from PRECISION LIMITATIONS REQUIRES EXPERT ADMINISTRATION LANGUAGE DEPENDENCE EDUCATION DEPENDENCE A LEARNING EFFECT Current assessment methods are bound by assessor bias, differences in interpretation, and a lack of sensitivity in recording patient response A Health Care Professional (HCP) has to administer existing tests, taking up valuable time Current assessment methods can be significantly affected by the subject's level of competence in the language the test is conducted in; leading to lack of confidence in the results Generally, the higher a subject s level of education, the better they will score in knowledge and memory based testing With existing methods, a patient can seem to be getting better, when in fact they are simply learning how to do the test So we developed a test FREE FROM THOSE DRAWBACKS, we developed the ICA 5

6 A SOLUTION WITH UNIQUE BENEFITS The ICA demonstrates critical benefits over existing methods LANGUAGE INDEPENDENT SELF ADMINISTERED EDUCATION INDEPENDENT WEB DEVELOPMENT NO LEARNING EFFECT SENSITIVITY THROUGH AI AN INTEGRATED COGNITIVE ASSESSMENT - THE ICA 6

7 ICA OUTLINE PROCESS Background science: predicting the reaction time of healthy human subjects in a rapid categorization task, using natural image statistics 2 + STIMULUS ISI MASK ANIMAL? 100 ms 20 ms 250 ms CTA Subjects are exposed to a succession of short exposure visual stimuli and asked to react to a simple question - whether or not they saw an animal. The images used vary in their properties, and the speed and accuracy of response to these vary according to the cognitive ability of the subject The test takes advantage of millions of years of human evolution the human brain s strong reaction to animal stimuli 7

The speed of Information transmission is slower in affected neurons.

8 ICA THEORY AT THE MICRO LEVEL Measuring reaction time is a good proxy for mental health for two reasons 1. The speed of Information transmission is slower in affected neurons. Neurotypical Non-affected Affected 2. Fewer neurons in the hierarchy means more processing time A B 8

ICA THEORY AT THE MACRO LEVEL Engaging large volumes of neuronal pathways and brain structures, thus giving greater sensitivity to mild impairment than memory-focused tests 3 Writing in the

9 ICA THEORY AT THE MACRO LEVEL Engaging large volumes of neuronal pathways and brain structures, thus giving greater sensitivity to mild impairment than memory-focused tests 3 Writing in the scientific journal Nature, Kosik contends that 9 REF: NATURE / Kenneth S. Kosik 06 November 2013 Detecting the first disruptions to brain circuitry, and tracking the anatomical and physiological damage underlying the steady cognitive decline that is symptomatic of Alzheimer's, will require tools that operate at the 'mesoscopic' scale: techniques that probe the activity of thousands or millions of networked neurons.

10 ICA UTILISING ARTIFICIAL INTELLIGENCE Detailed multidimensional data are used to provide meaningful outputs Reaction Accuracy ICA results Summary feature extraction AI Cloud Processing Prediction delivered to EHR Accuracy and reaction time to images are related to multiple image properties e.g. complexity, entropy, degree of surprise Users patterns of reactions can then be compared to known data and classified, giving a likelihood of belonging to a particular group 10

EVOLVING AI ENGINE The ICA is always learning, improving and can incorporate other

sensitivity over time as the system collects more data SENSITIVE Multinomial logistic

scores by comparison to learnt clusters WEB DEVELOPMENT ATTRIBUTE SPECIFIC Users

11 EVOLVING AI ENGINE The ICA is always learning, improving and can incorporate other data ADAPTABLE The AI engine can be continuously updated improving its accuracy and sensitivity over time as the system collects more data SENSITIVE Multinomial logistic regression is used to create accurate hyperplanes, enabling sensitivity to new users scores by comparison to learnt clusters WEB DEVELOPMENT ATTRIBUTE SPECIFIC Users attributes (sex, age or other inputs) can be combined to produce meaningful and accurate outputs 11

DEVELOPED FOR APPLE IOS Working with the NHS and EHR providers like EMIS, the ICA can be used independently, or integrate directly into a doctor s workflow UBIQUITOUS PLATFORM No need for

12 DEVELOPED FOR APPLE IOS Working with the NHS and EHR providers like EMIS, the ICA can be used independently, or integrate directly into a doctor s workflow UBIQUITOUS PLATFORM No need for specialist and expensive equipment SECURE & SAFE HIPPA compliant with fully encrypted databases to ensure patient data security CLOUD HOSTING Scalable, easily integrates EHR systems, wherever they are 12

WITH BENEFITS TO BOTH HEALTH CARE PROVIDERS TIME AND COST EFFECTIVE Test duration of 5 mins, unsupervised IMPROVED SENSITIVITY AND ACCURACY Potential to detect cognitive impairment significantly

13 WITH BENEFITS TO BOTH HEALTH CARE PROVIDERS TIME AND COST EFFECTIVE Test duration of 5 mins, unsupervised IMPROVED SENSITIVITY AND ACCURACY Potential to detect cognitive impairment significantly earlier than current methods GREY AREA DISEASE DIAGNOSIS & MONITORING Allows detection and monitoring of grey area diseases such as MCI HOME MONITOR Can be used to monitor patients at home DIRECT REMOTE FEEDBACK Provides instant information to clinicians allowing timely decision making 13

AND DRUG DEVELOPMENT ACCURATE Language, education and culturally independent measurement INCREASING STUDY COHORT SIZES Effective recruitment tool for large scale drug trials REMOVE THE LEARNING

14 AND DRUG DEVELOPMENT ACCURATE Language, education and culturally independent measurement INCREASING STUDY COHORT SIZES Effective recruitment tool for large scale drug trials REMOVE THE LEARNING EFFECT Test can be repeatedly administered without affecting results EARLY DISEASE STAGE PATIENT RECRUITMENT The ICA s design allows earlier and cheaper recruitment AUTOMATED & REMOTE RESULT MANAGEMENT Automatic aggregation and correlation of data 14

15 COMPARING DIFFERENT DIAGNOSTIC METHODOLOGIES Across cost, sensitivity, specificity, invasiveness Method Low cost Sensitive Non- Invasive Early stage Specific * Cognetivity computerized test targeting brain functionalities other than memory Cognitive-computerized tests based on memory Cognitive tests, not computerized (e.g. questionnaires or conversation), done in a clinic Biomarkers reflecting molecular neuropathology (e.g. PET Scanning, CSF test) Diagnosis based on brain MRI done by a clinician s diagnosis or software-based (IXICO) *Specific to different types of dementia 15

16 ACHIEVED & ANTICIPATED MILESTONES We ve been busy, with a lot more to come ü IP covered (patents, trademarks and copy rights granted) ü Extended market research ü Product development ü Development trials ü ios (iphone / ipad ) versions developed ü User needs study completed ü Quality Management System (QMS) deployed ü Pre-submission to FDA ü Pilot studies on other conditions (i.e. Multiple Sclerosis) launched Development and validation trials completion QMS ISO accreditation Personal health monitoring partnership deal developed Peer reviewed publications FDA filing & approval CE filing & approval UK & US revenue Partnership with health providers and insurers Marketing, sales, distribution Strategic alliances Further publications Integration with EHR systems (initially EMIS) New markets (sports / concussion, performance) 16

FUTURE DEVELOPMENT STRATEGIES ICA patented Visual

expansion routes OTHER COGNITIVE DISEASES MS TBI ADHD

Performance monitoring Health monitoring Pharmaceutical

17 FUTURE DEVELOPMENT STRATEGIES ICA patented Visual Cognition and AI powered platform enables multiple expansion routes OTHER COGNITIVE DISEASES MS TBI ADHD Parkinson s Concussion NON-DISEASE APPLICATIONS Performance monitoring Health monitoring Pharmaceutical trials FURTHER TECHNOLOGIES VR Wearables Personalized medicine Deep learning 17

18 GLOBAL MEDIA TAKING NOTICE Its easy to see why we are being talked about in 18

Government backs new high tech early dementia assessment service to reduce time to diagnosis from 18 months to 3 months

Page 1. Government backs new high tech early dementia assessment service to reduce time to diagnosis from 18 months to 3 months Novel digital healthcare system to be trialled from early 2013 combines world-class