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D3.5 - Deployment of the first version of stakeholder-centric reports

Wee, Leonard; van Beusekom, Bart; Hogenboom, Joshi; Hanebaum, Simone; Stark, Dan; Lindner, Oana

Abstract

The STRONG AYA data ecosystem and federated learning infrastructure is a digital artefact for sharing insights from data. Technical and governance of the data ecosystem and federation technology is described elsewhere in other deliverables. In this report, we tackle the question of how we have made the technological integration between the stakeholder-centric data visualization dashboard core elements (as described in D3.4) with the technical architecture as described in D3.3.

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1 A new, in e disciplina y, mul i- s akeholde Eu opean ne wo k o imp o e heal hca e se ices, esea ch and ou comes o Adolescen s and Young Adul s wi h cance . STRONG-AYA – No. 101057482 – D3.4 2 Deli e able Repo WP3 – In as uc u e and in e ope abili y Deli e able D3.5 Deploymen o he i s e sion o s akeholde -cen ic epo s Due da e o deli e able: 30 Sep embe 2024 Ac ual submission da e: 03 Ma ch 2025 P ojec : STRONG-AYA Lead Con ibu o Leona d Wee, UNIMAAS Email [email p o ec ed]l O he Con ibu o s Ba an Beusekom, IKNL Joshi Hogenboom, UNIMAAS Simone Hanebaum, NKI Daniel S a k, Leeds Oana Lindne , Leeds Emails Due da e 30 09 2024 Deli e y da e 03 03 2025 Deli e able ype R Dissemina ion le el SEN Desc ip ion o Wo k Ve sion Da e V1.0 31/10/2024 STRONG-AYA – No. 101057482 – D3.4 3 Desc ip ion: This ini ial e sion o he s akeholde -cen ic epo s, ins an ia ing he modi iable empla e ha can be cus omized o e emainde o he p ojec o i wi h each s akeholde g oup and hei needs. Summa y The STRONG AYA da a ecosys em and ede a ed lea ning in as uc u e is a digi al a e ac o sha ing insigh s om da a. Technical and go e nance o he da a ecosys em and ede a ion echnology is desc ibed elsewhe e in o he deli e ables. In his epo , we ackle he ques ion o how we ha e made he echnological in eg a ion be ween he s akeholde -cen ic da a isualiza ion dashboa d co e elemen s (as desc ibed in D 3.4) wi h he echnical a chi ec u e as desc ibed in D 3.3. An in eg a ion has been made easible based on a amewo k o so wa e wo k low au oma ion, i.e. Gi Hub Ac ion Wo k lows, Gi Hub Sec e s o c eden ials managemen and Gi Hub Runne o secu e code execu ion wi hin he conso ium ede a ion Van age6 a chi ec u e. A pa ien - acing AYA-speci ic dashboa d isualiza ion, allowing explo a ion o opics o impo ance o pe sonal heal h ca e, and heal h ou comes, has been ins an ia ed. A “li e” e sion using syn he ic da a and a no-login public web esou ce has been p o ided, using he eely accessible Da aW appe as a da a dashboa d/ isualiza ion module. The e will be a numbe o imp o emen s ha a e sla ed o implemen a ion in he upcoming e sions, such as mul iple le els o use access and “deep di e” pe missions wi hin a gi en dashboa d, and ac i a ion o mul i- ac o au hen ica ion o hose dashboa ds ha migh allow deep di es in o he s a is ical agg ega es. The same echnological in eg a ion amewo k be ween dashboa ds and sys em a chi ec u e will be used o o he s akeholde -cen ic dashboa d izualiza ions, such as a da a quali y managemen sys em o PIs and sepa a e dashboa ds o pe o ming mo e complex ypes o s a is ical modelling. STRONG-AYA – No. 101057482 – D3.4 4 1 Table o Con en s SUMMARY (MAX ½ PAGE) .......................................................................................................................................... 3 1 TABLE OF CONTENTS .......................................................................................................................................... 4 2 DEFINITIONS....................................................................................................................................................... 5 3 ABBREVIATIONS ................................................................................................................................................. 6 4 PROJECT INTRODUCTION ................................................................................................................................... 7 PROJECT BACKGROUND ........................................................................................................................................................ 7 5 DELIVERABLE INTRODUCTION ............................................................................................................................ 9 5.1.1 Disclaime ................................................................................................................................................... 10 5.1.2 Complemen a y documen a ion ................................................................................................................. 10 6 FEDERATED DATA ECOSYSTEMS – LOCAL/CENTRE LEVEL................................ ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 1: DATA MANAGEMENT INSIDE PARTNER INSTITUTION .............................. ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 2: TRUSTED COMPUTING ENVIRONMENT FOR RESEARCH ........................... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 3: MOVING EXTRACTED DATA INTO RESEARCH ENVIRONMENT .................... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 4: UPDATING OF DATA OVER TIME ........................................................ ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 5: PATIENT REPORTED OUTCOMES DATA COLLECTION ............................... ERROR! BOOKMARK NOT DEFINED. 7 FAIR DATA PRINCIPLES ................................................................................... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 6: EXECUTING DOCKER CONTAINERIZED SOFTWARE .................................. ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 7: DEFINING METADATA FOR MAPPING TO THE COS ................................ ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 8: ADDING HARMONIZED COS SCHEMA AS METADATA ............................. ERROR! BOOKMARK NOT DEFINED. 8 FEDERATED ANALYTICS AND FEDERATED LEARNING ...................................... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 9: DATA VISUALIZATION DASHBOARDS ................................................... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 10: FEDERATED LEARNING OF STATISTICAL MODELS.................................. ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 11: PROTECTIONS AGAINST RUNNING UNAUTHORIZED CONTAINERS ............ ERROR! BOOKMARK NOT DEFINED. 9 SECURE WEB INFRASTRUCTURE – THE PAN-EUROPEAN ECOSYSTEM ............. ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 12: SOFTWARE INFRASTRUCTURE VANTAGE6 ......................................... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 13: USE OF THIRD PARTY SECURE AGGREGATION TO ENHANCE SAFETY ......... ERROR! BOOKMARK NOT DEFINED. TECHNICAL REQUIREMENT 14: SERVICES SUPPORTED BY SUBCONTRACTOR ....................................... ERROR! BOOKMARK NOT DEFINED. 10 APPENDIX A: SCHEMATIC ILLUSTRATIONS OF EXISTING DATA WORKFLOWS . ERROR! BOOKMARK NOT DEFINED. UNIVERSITY OF LEEDS (LEEDS, UK) ........................................................................................... ERROR! BOOKMARK NOT DEFINED. CENTRE LÉON BÉRARD (LYON, FR) ........................................................................................... ERROR! BOOKMARK NOT DEFINED. APPENDIX B : FAIR DATA ........................................................................................ ERROR! BOOKMARK NOT DEFINED. STRONG-AYA – No. 101057482 – D3.4 5 2 De ini ions STRONG AYA conso ium membe s a e e e ed o as ollowing wi hin his ex : 1. NKI-AVL – S ich ing he Nede lands Kanke Ins i uu – An oni an Leeuwenhoek Ziekenhuis (NL) 2. YCE – You h Cance Eu ope (RO) 3. INT – Fondazione IRCCS Ins i u o Nazionale dei Tumo i (IT) 4. FFUND – FFUND BV (NL) 5. CLB – Cen e de Lu e Con e le Cance Leon Be a d (FR) 6. ECO – Eu opean Cance O ganisa ion (BE) 7. UNIMAAS – Uni e si ei Maas ich (NL) 8. IKNL – S ich ing In eg aal Kanke cen um Nede land (NL) 9. EORTC – Eu opean O ganisa ion o Resea ch and T ea men o Cance AISBL (BE) 10. IGR – Ins i u Gus a e Roussy (FR) 11. MSCNRIO – Na odowy Ins y u Onkologii im. Ma ii Sklodowskiej-Cu ie – Pans wowy Ins y u Badawczy (Ma ie Sklodowska-Cu ie Na ional Resea ch Ins i u e o Oncology) (PL) 12. UOM – Uni e si y o Manches e (UK) 13. UOL – Uni e si y o Leeds (UK) 14. LTHT – Leeds Teaching Hospi als Na ional Heal h Se ice T us (UL) 15. SOUTHAMPTON – Uni e si y o Sou hamp on (UK) • G an Ag eemen (including i s annexes and amendmen s): he ag eemen signed be ween he bene icia ies o he HORIZON Resea ch and Inno a ions Ac ions (he ea e e e ed o as Ho izon) and he Eu opean Heal h and Digi al Execu i e Agency (he ea e e e ed o as HADEA) o he unde aking o he STRONG AYA p ojec (G an Ag eemen no. 101057482). • Bene icia y: Signa o ies o he G an Ag eemen • Associa ed Pa ne : En i ies which pa icipa e in he ac ion bu wi hou he igh o cha ge cos s o claim con ibu ions. • P ojec : he sum o all ac i i ies ca ied ou in he amewo k o he G an Ag eemen . • Conso ium: he STRONG AYA conso ium, including all he a o emen ioned pa ne s. • Conso ium Ag eemen : The ag eemen made be ween STRONG AYA membe s o he implemen a ion and execu ion o he ac ion ou lined in he G an Ag eemen . The ag eemen shall no a ec he pa ies’ obliga ions o HADEA on behal o he Eu opean Union, and/o o one ano he a ising om he G an Ag eemen . STRONG-AYA – No. 101057482 – D3.4 6 3 Abb e ia ions Ac onym/Abb e ia ion Meaning HCP Heal h Ca e P o ide PRO Pa ien Repo ed Ou come PROM Pa ien Repo ed Ou come Measu e COS Co e Ou come Se WP Wo k Package WPL Wo k Package Lead(s) WP1 Wo k Package 1 (De elopmen Co e Ou come Se AYA wi h cance & da a collec ion) WP2 Wo k Package 2 (Go e nance, Da a Secu i y and E hics) WP3 Wo k Package 3 (In as uc u e and In e ope abili y) WP4 Wo k Package 4 (Ope a ion o STRONG AYA ecosys ems, s akeholde and pa ien in ol emen , dissemina ion, exploi a ion, communica ion) WP5 Wo k Package 5 (Scien i ic coo dina ion and p ojec managemen ) KPI Key Pe o mance Indica o OA Open Access PAB Pa ien Ad iso y Boa d EC Eu opean Commission HADEA Eu opean Heal h and Digi al Execu i e Agency SC S ee ing Commi ee MT Managemen Team DMP Da a Managemen Plan STRONG-AYA – No. 101057482 – D3.4 7 4 P ojec In oduc ion P ojec backg ound To assis he eade wi h he backg ound o his p ojec , he ollowing ex s ha e been de i ed om s anda d documen a ion pe aining o he en i e y o he STRONG AYA p ojec : Cance a adolescen and young adul (AYA) age is a e, al hough 4-6 imes mo e equen han pedia ic cance (i.e. p epubescen pe iod). Howe e , his a i y does no e lec he signi ican pe sonal and socie al cos s o cance in his popula ion, as e lec ed in he po en ial yea s o li e los o sa ed, he dec eased p oduc i i y and quali y-o -li e due o he impac o he disease du ing o ma i e yea s, and he long- e m complica ions o disabili ies1. AYAs wi h cance o m a unique g oup; hey ace age-speci ic issues (e.g. In e ili y, unemploymen , inancial p oblems) and dec eased quali y o li e due o cance and i s ea men . Unlike dedica ed heal hca e and ials o pedia ic cance pa ien s, AYA-speci ic heal hca e se ices a e sca ce and a y ac oss Eu ope. AYAs who a e a he co e o socie y and economy need access o age- app op ia e and high-quali y heal hca e. De ining AYAs wi h cance as 15 o 39 yea s a ini ial cance diagnosis2, hei annual cance incidence is 42.2/100.000, wi h 156.431 cases in Eu ope and 1.231.007 cases wo ldwide epo ed in 2018 ( oge he 6.8% o all cance s)3. Popula ion-based da a om 27 Eu opean coun ies suppo s ha AYAs ha e lowe su i al han child en bu highe han adul s a ec ed by cance . Ad ances in cance ea men ha e led o inc eased su i al a es o AYAs wi h cance , imp o ing by 82% o all cance s be ween 1990 and 20074. Howe e , su i al imp o emen in AYA is mo e challenging han o child en and olde cance su i o s, which migh be due o he ac ha AYA ha e he highes absolu e excess isk o second p ima y malignan neoplasms5. AYA ace some dis inc challenges gi en ha hey do no belong o nei he pedia ic no adul oncology g oups. Cha ac e is ic ea u es o his popula ion g oup include unique spec um o cance ypes, di e en umo biology, unique complex psychological needs, dis inc la e sequelae, including impai ed e ili y, and pallia i e ca e. These ai s imply ha clinical managemen , ea men , diagnosis, psychological suppo will need o be designed and de eloped o AYA’s speci ic needs. Fo example, AYAs diagnosed wi h b eas and p os a e ca cinomas ha e wo se su i al han olde pa ien s because o he biological di e ences be ween hem, highligh ing he need o a ge sc eening me hodologies, ea men and policies o hei needs6. AYAs wi h cance also ace signi ican psychological challenges, including subs ance abuse, men al heal h issues, suicidal idea ions and inc eased emo ional bu den om cance and cance - ela ed mo bidi y. Finally, ailo ing cance ca e o AYA’s needs is di icul and due o many di e en complex ac o s including he low a e o pa icipa ion by AYAs in clinical ials and cance esea ch7. Despi e he inc easing awa eness and a g owing body o he scien i ic li e a u e, hese unique issues emain o be ully ecognized and add essed by he Eu opean heal h sys ems and AYAs wi h cance a e equen ly 1 S oneham SJ. AYA su i o ship: The nex challenge. Cance 2020; 126: 2116-2119. 2 Adolescen and Young Adul Oncology Re iew G oup. Closing he gap: Resea ch and Ca e Impe a i es o Adolescen s and Young Adul s wi h Cance . Na ional Ins i u e o Heal h, Na ional Cance Ins i u e, and Li es ong Young Aul Alliance: Be hesda, MD, USA, 2006. 3 T ama A, Bo a L, S elia o a-Fouche E. Cance Bu den in Adolescen s and Young Adul s: A Re iew o Epidemiological E idence. Cance J 2018; 24: 256-266 4 T ama A, Bo a L, Foschi R e al. Su i al o Eu opean adolescen s and young adul s diagnosed wi h cance in 2000-07: popula ion-based da a om EUROCARE- 5. Lance Oncol 2016; 17: 896-906. 5 Keegan THM, Bleye A, Rosenbe g AS e al. Second P ima y Malignan Neoplasms and Su i al in Adolescen and Young Adul Cance Su i o s. JAMA Oncol 2017; 3: 1554-1557. 6 S a k D, Bielack S, B ugie es L e al. Teenage s and young adul s wi h cance in Eu ope: om na ional p og ammes o a Eu opean in eg a ed coo dina ed p ojec . Eu opean Jou nal o Cance Ca e, 25(3), 419–427. 7 Hayashi RJ. Adolescen and young adul cance su i o ship: The new on ie o in es iga ion. Cance 2019; 125: 1976-1978. STRONG-AYA – No. 101057482 – D3.4 8 unde se ed. In pa , his may ha e esul ed om he adi ional dicho omy be ween he in eg a ed pedia ic (“pa ien / amily-cen e ed”) ca e se ices e sus dispe sed (“disease- cen e ed”) adul oncology se ices8,9,10. Up o hal o AYAs wi h cance epo unme in o ma ional and se ice needs, impac ing hei di ec (su i al a es) and indi ec (long e m e ec s and men al heal h) eco e y o pa icipa e in socie y11. Fu he mo e, aligned wi h his ba ie is he low a e o heal h ca e u iliza ion by AYAs, especially p ima y ca e, gi en hei challenges o sus ain heal h insu ance co e age12. Acco ding o a su ey conduc ed h ough he ne wo ks o he AYA Wo king G oup o he Eu opean Socie y o Medical Oncology (ESMO) and he Eu opean Socie y o Paedia ic Oncology (SIOP Eu ope), 67% o p ac i ione s do no ha e access o specialized cen e s o AYA wi h cance , 67% had no access o a specialis cance se ice o la e e ec s managemen and 38% had no access o e ili y specialis s. Unde -p o ision and inequali y o AYA cance ca e is common ac oss Eu ope and especially in he Eas e n and Sou he n-Eas . Fu he mo e, he Wo king G oup also epo ed an absence o ou come measu es o moni o ing and e alua ing AYA cance ca e p og ams and con ol13. Among he ecommended u u e s eps, i has been iden i ied ha one o he mos impo an con ibu ions o AYA esea ch would be o pool da a (e.g. pa ien - epo ed ou comes, clinical and ea men da a) ac oss ins i u ions and coun ies and c ea e la ge coho s o esea che s o add ess he bu den o cance in AYA14. The e is a p esen a lack o da a s anda diza ion, da a in e ope abili y and (p ospec i e) collec ion o ou comes o ele ance o AYAs wi h cance ac oss cance ca e ins i u ions ac oss Eu ope. The STRONG-AYA p ojec aims o ackle he unde ep esen a ion o AYA’s expe iences and ou comes when na iga ing he heal hca e sys em and in clinical ca e by de eloping na ional in as uc u es o ou come da a managemen and clinical decision-making wi hin a pan-Eu opean ecosys em and es ablishing communica ion eedback o AYAs wi h cance and he heal hca e sys ems. This will be key o imp o ing heal hca e se ices, esea ch, ou comes and policies o AYAs and o ul ima ely be e cance ca e o his pa ien g oup. To his aim, STRONG-AYA b ings oge he an in e na ional mul i-disciplina y conso ium ac oss se en Eu opean coun ies, led by he Ne he lands Cance Ins i u e (NKI) and composed o academic esea ch o ganisa ions (Eu opean O ganisa ion o Resea ch and T ea men o Cance (EORTC), Uni e si y o Sou hamp on, Uni e si y o Leeds, Uni e si y o Manches e , Maas ich Uni e si y, Ne he lands Comp ehensi e Cance O ganisa ion (IKNL)), clinical pa ne s (I alian Na ional Tumou Ins i u e, Léon Bé a d Cen e, Gus a e Roussy Ins i u e, Ma ia Sklodowska-Cu ie Na ional Resea ch Ins i u e o Oncology, he Leeds Teaching Hospi als Na ional Heal h Se ice T us ), s akeholde and pa ien o ganisa ions (You h Cance Eu ope, Eu opean Cance O ganisa ion) and a consul ing company (FFUND). Building on p e ious ini ia i es, a STRONG-AYA da a ecosys em will be se up o alue-based ca e, esea ch and policy o AYA wi h cance by: 8 Fe a i A, S a k D, Pecca o i FA e al. Adolescen s and young adul s (AYA) wi h cance : a posi ion pape om he AYA Wo king G oup o he Eu opean Socie y o Medical Oncology (ESMO) and he Eu opean Socie y o Paedia ic Oncology (SIOPE). ESMO Open 2021; 6: 100096. 9 Osbo n M, Johnson R, Thompson K e al. Models o ca e o adolescen and young adul cance p og ams. Pedia Blood Cance 2019; 66: e27991. 10 Fa dell JE, Pa e son P, Wake ield CE e al. A Na a i e Re iew o Models o Ca e o Adolescen s and Young Adul s wi h Cance : Ba ie s and Recommenda ions. J Adolesc Young Adul Oncol 2018; 7: 148-152. 11 Keegan TH, Lich ensz ajn DY, Ka o I e al. Unme adolescen and young adul cance su i o s in o ma ion and se ice needs: a popula ion-based cance egis y s udy. J Cance Su i 2012; 6: 239-250. 12 Hayashi RJ. Adolescen and young adul cance su i o ship: The new on ie o in es iga ion. Cance 2019; 125: 1976-1978. 13 Salous os E, S a k D, Michailidou K e al. Repo on ESMO/SIOPE Eu opean Landscape p ojec key esul s: Mapping he s a us and needs in AYA cance ca e. La e-b eaking and de e ed publica ion abs ac s public heal h 2017; 28, 5: V643. 14 Smi h AW, Seibel NL, Lewis DR e al. Nex s eps o adolescen and young adul oncology wo kshop: An upda e on p og ess and ecommenda ions o he u u e. Cance 2016; 122: 988-999. STRONG-AYA – No. 101057482 – D3.4 9 1. De eloping a Co e Ou come Se (COS) speci ically o AYAs wi h cance , ia a pa icipa i e consensus p ocess de ining mos impo an aspec s o hose di ec ly a ec ed by AYA cance , including pa ien s and heal hca e p o essionals. 2. Implemen ing he COS ac oss se e al na ional Eu opean heal hca e sys ems. Da a will be collec ed a local le el and will hen be included in a da a in eg a ion pla o m. An o e all ecosys em amewo k o da a analy ics and ou pu will be c ea ed suppo ing ede a ed analyses and he c ea ion o epo s ac oss clinical and pa ien - epo ed da a and making na ional eposi o ies o (pa ien - epo ed) heal h da a, a ailable o indi idual pa ien s, pa ien o ganisa ions, egula o y au ho i ies, as well as he pa ien s’ heal h ca e p o ide s o in o m clinical decision-making. The i e esul ing na ional ecosys ems will be connec ed o each o he in o he pan-Eu opean ecosys em using a ede a ed app oach also u ilizing he o e all ecosys em amewo k. 3. Dissemina ing he COS o a wide ange o local as well as pan-Eu opean s akeholde s, in pa icula by de eloping analy ical ools o p ocess and p esen pa ien ou come da a and es ablish eedback loops ha in o m pa ien s and clinicians. Implemen ing hese p ojec objec i es a e i e wo k packages wi hin he STRONG-AYA p ojec : • WP1: De elopmen Co e Ou come Se AYA wi h cance and Da a Collec ion (Lead: SOUTHAMPTON) • WP2: Go e nance, Da a Secu i y and E hics (Lead: EORTC) • WP3: In as uc u e and In e ope abili y (Lead: UNIMAAS) • WP4: Ope a ion o STRONG-AYA ecosys ems, S akeholde and Pa ien in ol emen , Dissemina ion, Exploi a ion, Communica ion (Lead: E.C.O.) • WP5: Scien i ic Coo dina ion and P ojec Managemen (Lead: NKI) STRONG-AYA will he e o e enable AYA ca e and esea ch o bene i om collec ion and pooling o pa ien - cen e ed da a and collabo a ion among all s akeholde s: pa ien s, heal hca e p o essionals, scien is s, and policymake s. Mo e widely, he p ojec will le e age he ne wo k o in e es ed o ganiza ions and ne wo ks es ablished unde STRONG-AYA o long- e m s eng hened p omo ion o he necessa y implemen a ion o specialis AYA cance se ices ac oss Eu ope. This will ul ima ely b ing no el insigh s in o AYA cance ca e, esea ch and policy, con ibu ing o he long- e m imp o emen o ou comes o people wi h AYA cance . 5 Deli e able in oduc ion The STRONG-AYA conso ium belie es ha inno a i e and pa adigm-b eaking ways o accessing p i acy- sensi i e mul i-ins i u ional da a, and acili a ing sha ing o knowledge ac oss ins i u ional da a siloes is u gen ly needed o imp o e heal hca e o his unique g oup o people. The key pilla s o STRONG AYA a e : (1) consensus (Delphi) de elopmen o a Co e Ou comes Se i.e. COS; (2) ede a ed lea ning in as uc u e o collec ing, managing and en iching AYA da a among pa icipa ing coun ies; (3) dissemina ing da a-d i en insigh s and da a analysis ools a pan-Eu opean le el o help imp o e pa e ns o ca e o AYAs e e ywhe e. A ede a ed da a ecosys em pa adigm o da a managemen and da a analysis was chosen as a me hod o add ess agmen a ion o da a, o add ess adop ion ba ie s associa ed wi h cen alized pa ien da a eposi o ies, and o be mo e easily able o suppo scale-up wi h a la ge numbe o expec ed u u e pa ne s/ins i u ions. The echnological co ne s one o he p ojec is ede a ed analy ics, i.e. pe o ming s a is ical da a analyses and gene a ing summa y isualiza ions o da a-analy ic esul s bu wi hou ansmi ing any indi idual pa ien -le el da a ou side o he da a-owning ins i u ion. STRONG-AYA