In questa sezione potrete consultare i risultati del progetto DARE in open access: risorse software su GitHub, pubblicazioni su Zenodo, e dataset pubblici.
DATASET:
SOFTWARE:
LETTERATURA GRIGIA:
Deliverable: D1.1 List of process and outcome indicators
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: The DARE project aims to provide the Italian Ministry of Health and NHS with innovative technologies that are effective, efficient, and ready to be used, enabling the country to accelerate and revolutionize the health paradigm encompassing prevention through to treatment. Indicators are defined as specific, observable, and measurable changes showing progress toward achieving a specific output or outcome in a logic model or work plan. The purpose of this deliverable is to provide all DARE consortium partners with a list of possible indicators that will be used to assess the utility and implementability of innovative technologies during the development of a pilot.
The DARE project consortium involves many entities and promotes the implementation of a wide variety of studies that focus on prevention, and the maturity level of the proposed pilots could be very different. Two frameworks have been selected for the identification of indicators: the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) Evidence to Decision (EtD) framework, to be used by any partner that will implement a clinical study, and the Predictive Clinical Model framework, to be followed by any proponent that will focus on creating a predictive clinical model using artificial intelligence, machine learning, and deep learning.
The GRADE EtD framework is a tool used to inform and guide health system and public health decision-making. It presents a set of criteria and indicators that can be used to evaluate and assess the potential benefits, harms, feasibility, acceptability, and impact of an intervention or option. Each domain of the GRADE EtD is filled with a list of possible indicators that should be gathered in the course of the development of the pilots.
The list of indicators includes the seriousness of the problem, priority of the problem, clinical utility of the intervention, impact of the intervention, benefits and harms of the intervention, balance between the desirable and undesirable effects, equity and human rights, financial and economic considerations, values and preferences, acceptability, and feasibility.
Deliverable: D1.2 Stakeholder engagement
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: The successful implementation of the DARE project will heavily rely on stakeholder involvement, which calls for close cooperation across the different work packages (WPs) and the concerted efforts of all the consortium members.
Deliverable: D1.3 Communication and Dissemination plan
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: D2.1 Inventory of the Ethical and Legal Framework
WP Number: WP2
Dissemination Level: Restricted
Publishable Summary: This Deliverable "D2.1 – Inventory of the Ethical and Legal Framework" is part of the "WP2 – Legal and Ethical Framework" within Spoke 1 ("Enabling Factors and Technologies for Digital Prevention") of the DARE project. Its aim is to provide an overview of the currently applicable legislative provisions and proposals being developed in the European forum in order to offer a general framework of ethical and legal issues in relation to privacy, artificial intelligence and the most relevant points in relation to the issue of health prevention.
Deliverable: D3.1 Analysis of the technological framework and interoperability requirements
WP Number: WP3
Dissemination Level: Public, fully open
Publishable Summary: This document provides a comprehensive update on the technological framework, interoperability requirements, and integration strategies for digital health data management in Italy in the context of the DARE project. It discusses two primary technological pillars: the INFN DataCloud and the AlmaHealthDB, which are designed to ensure secure data management and compliance with legal and regulatory standards. This document provides a comprehensive update on the technological framework, interoperability requirements, and integration strategies for digital health data management in Italy in the context of the DARE project. It discusses two primary technological pillars: the INFN DataCloud and the AlmaHealthDB, which are designed to ensure secure data management and compliance with legal and regulatory standards.
The document defines cloud interoperability as the ability of systems to interact and exchange information, emphasizing the importance of avoiding vendor lock-in and ensuring data portability.
It proposes metrics to evaluate interoperability and portability, including transport interoperability, policy compliance, and data retrieval capabilities, which will aid in assessing the cost-effectiveness of porting applications to the DARE platform.
Moreover, the document proposes a National Integration Strategy to create a unified approach for clinical data processing across various projects, promoting the use and reuse of clinical data for research while adhering to legal constraints. The strategy starts from the definition of short-term objectives, including the secure deployment of the Salus Ratio application on certified cloud services and the establishment of a centralized authentication system using Keycloak. Then, a long-term vision is proposed as a second phase of the strategy, focusing on making Salus Ratio as a Service available on the ICSC cloud, allowing for the management of sensitive data in compliance with GDPR.
Deliverable: D4.1 Computing solutions deployment strategy
WP Number: WP4
Dissemination Level: Restricted
Publishable Summary: This deliverable presents the results of the research activity carried out by the project consortium on the state of the art and the best practices of computing solutions deployment strategies. The aim of this deliverable is to provide a comprehensive overview of the current situation, the challenges, and the opportunities of computing solutions deployment in the context of DARE project for all the pilots in spoke 2 and spoke 3. The deliverable also identifies the main gaps and needs that the project intends to address with its innovative computing solutions deployment strategies.
Deliverable: D4.2 Best practices and tools for building ML-based systems
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: An ML-based system is a software artifact that incorporates machine learning (ML) components to enable various functions (Sculley et al., 2015). A core part of these systems is the ML model. Significant effort is generally required to integrate ML models into larger systems, which goes well beyond model training and testing. Other important tasks to consider include data collection and versioning, experiment tracking, model deployment, and model monitoring. Amershi et al. (2019) describe these activities as a pipeline to build ML models.
The complexity of this model-building pipeline has resulted in efforts to develop mature practices and tools for the deployment and maintenance of ML components, giving rise to a research and practice field known as MLOps (Machine Learning Operations). Rooted in software engineering and inspired by DevOps (Bass et al., 2015), MLOps emphasizes process automation to achieve continuous delivery of ML models within ML-enabled systems (Treveil et al., 2020). Among the several objectives of MLOps, there is the facilitation of several non-functional requirements of ML-enabled systems (e.g., reproducibility, explainability, fairness), among which system security is considered of growing importance, especially in safety- or mission-critical domains such as healthcare.
Task 4.2 aims to analyze the current state of the art and identify (i) recommended best practices and (ii) technical solutions for implementing machine learning pipelines that support the development of ML-based systems. To achieve the first goal, we conducted a systematic review of the literature on MLOps practices and tools specifically focused on the healthcare domain. To fulfill the second objective, we reviewed the most popular MLOps solutions, focusing on those available as Free and Open-Source Software (FOSS). A well-designed combination of the reviewed tools has the potential to improve the development and maintenance of a wide range of ML-based components, ensuring that they meet the stringent quality standards required in safety-critical domains such as healthcare.
Deliverable: D5.1 Definition of the reaseach design and database linkages for individual risk stratification
WP Number: WP5
Dissemination Level: Public, fully open
Publishable Summary: With the progressive aging of the Italian population and the consequent increase in chronic diseases, healthcare policymakers are recognizing the need to improve the management of chronic and multi-chronic patients through patient-centered care. This approach shifts the focus from individual pathologies to the overall care of the patient. The available administrative datasets of the Local Health Authorities (LHAs) involved in this project are to be linked both internally and with other data sources for risk-stratification and evaluation of interventions. The administrative databases explored for record linkage include hospital discharge data, emergency department access, mortality registry, drug purchases, general practitioners’ registry and payments, home assistance care, ambulatory visits, and intermediate care. Full integration of the data has been possible only for the LHA of ROMA1 due to privacy and procurement issues. Preliminary results have been obtained only for the ROMA1 LHA.
Deliverable: 5.2 Definition of the activities targeted to healthcare professionals for supporting proactive care approaches and training initiatives
WP Number: WP5
Dissemination Level: Public, fully open
Publishable Summary: Deliverable S1.D5.2, part of the DARE (Digital Lifelong Prevention) project, focuses on integrating innovative digital tools and data-driven approaches to enhance proactive healthcare strategies, equity, and efficiency. Supported by the PNC-I.1 funding initiative, the deliverable addresses challenges in chronic disease management and preventive care through predictive modeling, population stratification, and tailored interventions, aligning with the goals of the National Recovery and Resilience Plan (PNRR).
Deliverable: 6.1 Plan for enhanced educational programming
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: 6.2 Plan for Advanced Training Courses
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: 7.1 Sustainability Management Plan
WP Number: WP7
Dissemination Level: Restricted
Publishable Summary: This Deliverable Report is the sustainability plan related to the DARE initiative - Digital Lifelong Prevention, funded by the Ministry of University and Research as part of the National Complementary Plan PNC-I. The plan focuses on the sustainability of the National Health Service, prevention as a service, digital health technologies, and the financial framework of digital healthcare in Italy. Additionally, it presents the canvas methodology, an analysis of the stakeholders, and organization of the DARE Foundation, as well as the vision and missions of the initiative. The document also examines the path towards sustainability, including monitoring of the pilot studies involved in the overall initiative, financial sustainability, and overall sustainability.
Deliverable: 7.2 IPR management and exploitation services
WP Number: WP7
Dissemination Level: Restricted
Publishable Summary: Management of intellectual property rights plays an important role in all research projects.
Based on guidance by the European Commission as well as the applicable EU law framework, aim of this report is to map the intellectual property options and tools available to the DARE Initiative partners for protection of the IP created during the project execution.
To this end the analysis includes a presentation of protection and exploitation methods of IP Rights (such as trademarks, patents, copyright and transfer and licensing agreements).
This generic presentation is followed by a first approach of how DARE’s results could be protected and exploited in the future. Given the early stage of project development, this report’s main purpose is not to bring forward a final protection and exploitation plan but instead to provide project partners with timely and comprehensive guidance on efficient and competent protection of their project-related IP rights. This includes for instance advice on a dissemination policy, confidentiality and trade secret practices, as well as exploitation strategy. It is recommendable that these suggestions are finalized in the final Spoke Affiliates Agreement.
Deliverable: D2.2 Report on the implementation of the requirements
WP Number: WP2
Dissemination Level: Restricted
Publishable Summary: In the previous deliverable, SP1.D2.1 Inventory of the Ethical and Legal Framework, the WP2 group conducted an in-depth analysis of European regulations and legislative proposals relevant to the DARE project. Key normative references were identified in critical areas such as personal data protection, artificial intelligence regulation, civil liability, and cybersecurity. This document, delivered in December 2023, highlighted the importance of a comprehensive and harmonized regulatory framework to support and govern technological development.
Deliverable: D3.2 Multi-dimensional interoperability strategies and solutions deployed
WP Number: WP3
Dissemination Level: Public
Publishable Summary: This deliverable presents the strategies and solutions for multi-dimensional interoperability deployed within Spoke 1 of the DARE project, focusing on the activities of WP3. The document details the governance, technical, semantic, organizational, and legal interoperability frameworks established to enable seamless data exchange and integration across the DARE ecosystem, supporting pilots in Spoke 2 and Spoke 3. The deliverable builds upon the requirements and architecture defined in D3.1 and incorporates lessons learned from the deployment and early operation of interoperability solutions in real-world settings.
Deliverable: D4.3 Report on the development and integration of wearable/portable solutions
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: This Deliverable presents an overview of the studies carried out within the DARE project which leverage wearable and portable devices to support the development of innovative digital health solutions. This document reports the status of the activities conducted by the various partners involved in Spoke 1 and is structured according to application context. Within each context, individual contributions from the partners are presented, including the study objectives, adopted methodologies, developed strategies, and key findings.
While the activities conducted so far have primarily focused on individual study goals, they provided a solid foundation for understanding the capabilities and limitations of different wearable systems in various real-world and clinical contexts.
Future efforts will be mainly address at increase and promote cross-pollination and collaboration between different partners, with the aim of harmonizing protocols, unifying data processing and analysis workflows, and fostering interoperability across studies addressing similar objective.
Deliverable: D4.4 Report on developed computational models
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: This Deliverable reports on the status of Computational Models developed up to Month 36 of the DARE project. Several Computational Models have been designed to address challenges in the health domain (as per the DARE goals), facing a huge diversity of tasks. This deliverable presents 30 different models, addressing a range of heterogeneous health-related issues, from more specific ones, such as the interpretation of EEG signals, to software frameworks that support common tasks like data management, filtering, and retrieval. For each Computational Model, a brief description is provided and, when relevant, links to the related scientific products are given.
Deliverable: D6.3 Intermediate update on the educational and training plans
WP Number: WP6
Dissemination Level: Public
Publishable Summary: The deliverable 6.3 "Intermediate update on the educational and training plans" composed by Task 6.3 “Enhancing and supporting human resources” has been developed in the direction of delivering advanced training activities specifically addressed to newly hired and DARE workforce, through the following training activities: Summer School on Digital Prevention; Seminars on the technological and ethical aspects of digital prevention; Good clinical practice workshop; Re-train Me programme (ICS-C).
Deliverable: D7.3 Data-Driven approaches to Technology Transfer
WP Number: WP7
Dissemination Level: Restricted
Publishable Summary: This Deliverable is an all-encompassing data-informed technology transfer strategy for healthcare practice in the context of integration of artificial intelligence and high-level analytics in medical innovation. It explains in detail how new-generation AI technologies— machine learning, generative models, and edge computing—revolutionize clinical decision-making, diagnosis cycles, and overall operations efficiency. The report illustrates how essential it is to bridge theory-based innovation and practice implementation using evidence-based strategies supporting regulation adherence, ethical imperatives, and fiscal sustainability.
Deliverable: D7.4 Business oriented services
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: This deliverable reports the activities carried out in Task 7.4 of the DARE initiative, which focuses on the contribution of Spoke 1 to the project’s overall exploitation strategy. Unlike Spoke 2 and Spoke 3, which develop domain-specific pilots and user-facing digital prevention solutions, Spoke 1 produces enabling technologies, infrastructural components, and methodological frameworks that support the design logic, requirements definition, and long-term feasibility of downstream innovations, without implying direct operational use within the pilots during the project timeframe.
The work performed in Task 7.4 concentrates on documenting how these cross-cutting components—such as interoperability frameworks, AI and HPC infrastructures, data governance models, regulatory compliance tools, evidence-generation methods, and digital data-collection platforms— provide functional reference architectures and methodological guidance that inform how pilots could ensure data quality, interoperability and regulatory alignment in future deployments, while not being directly integrated into all ongoing pilot activities.
These assets are essential for ensuring data quality, interoperability, regulatory alignment, computational capability, and methodological consistency across the DARE ecosystem.
WP7 applies a unified methodology for awareness, capacity building, and evaluation of exploitation pathways. In this context, Spoke 1 contributes indirectly by supplying the enabling elements that allow Spoke 2 and Spoke 3 teams to progress through entrepreneurial training, feasibility assessment, and acceleration programmes when applicable. The absence of direct startup-oriented outputs in Spoke 1 reflects the infrastructural nature of its work, which is better aligned with exploitation routes such as institutional adoption, licensing, service provision, and standardisation.
The deliverable outlines how Spoke 1 supports the DARE translation framework by creating the technical, regulatory, and methodological conditions necessary for the sustainable exploitation of digital prevention innovations. This contribution strengthens the long-term scalability and sustainability of the project and ensures that the solutions emerging from Spoke 2 and Spoke 3 can be deployed, assessed, and adopted within real-world health and community settings.
Deliverable: 5.3 Results and fine-tuning of the initiatives
WP Number: WP5
Dissemination Level: Public, fully open
Publishable Summary: This deliverable reports the results of Work Package 5 – Task 5.3 of the DARE project, focused on policy evaluation, impact analysis, and upscaling of digital health initiatives for the management of chronic conditions. The work contributes to the objectives of Spoke 1 by assessing how digital technologies, organizational models, and data-driven tools can support more effective, sustainable, and integrated healthcare systems.
The document presents three main research lines developed by different partners.
First, the UNIBA–ASL Bari unit outlines the completion of the theoretical and preparatory phase for evaluating integrated care models for Cardio-Renal-Metabolic (CRM) syndrome. This includes the development of a Data Protection Impact Assessment and an organizational framework structured around seven pillars—patient-centered care, holistic approach, digital integration, efficiency, workforce well-being, sustainable governance, and data-driven decision-making—aligned with DARE’s expected societal, economic, and policy impacts.
Second, the UNIBO–AUSL Romagna unit reports substantial progress in the implementation and use of a population risk stratification tool (ACG®) to support healthcare planning and policy assessment. The tool has been fully deployed, staff trained, and first applications completed, particularly for chronic heart failure patients. In parallel, several empirical evaluations of telemonitoring initiatives are described, including programs for chronic patients in remote areas, patients with implantable cardioverter-defibrillators, congestive heart failure patients supported by primary care nursing programs, and individuals with type 1 diabetes using automated insulin delivery systems. These studies provide evidence of improved adherence, reduced acute care utilization, and important insights for scaling up digital health interventions.
Third, in the UNIROMA2 and ASL Roma 1 units examine governance, regulatory, and organizational dimensions of digital health implementation, with particular attention to telemedicine pathways, eligibility criteria, privacy safeguards, and coordination among healthcare professionals. This research design emphasizes the importance of aligning technological innovation with regulatory compliance, organizational processes, and stakeholder engagement.
Overall, the deliverable demonstrates that effective digital prevention and chronic care require the joint adoption of advanced technologies, organizational innovation, and robust governance frameworks. The findings provide actionable evidence for policymakers on how to scale up digital health solutions in a sustainable, equitable, and evidence-based manner.
Deliverable: D1.1 Process and outcome indicators in Spoke 2
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: The objective of the DARE project is to deliver innovative technologies that are effective, efficient, and readily deployable, thereby enabling the Italian Ministry of Health and the NHS to expedite the translational process in support of the prevention healthcare landscape.
Deliverable: D1.2 Stakeholders’ network and planned activities
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: D2.1 Concept of digital advanced functions and definition of protocols
WP Number: WP2
Dissemination Level: Public, fully open
Publishable Summary: The Spoke 2 (SP) in the D.A.R.E. Project advances primary prevention initiatives through pioneering digital innovations and meticulous protocol formulations. The efforts are directed towards pioneering an advanced interoperable surveillance system, an epitome of innovation integrating administrative, clinical, health, and environmental data sources.
Deliverable: D3.1 Concept of models and definition of protocols
WP Number: WP2
Dissemination Level: Public, fully open
Publishable Summary: The present document provides a detailed description of the structure of the deliverable S2.D3.1 - Concept of models and definition of protocols, released by the team of experts involved in WP3.
Deliverable: D4.1 Concept of models and design of experimental protocols
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: The DARE project is a pioneering initiative in research, focusing on innovation and technological advancements, especially in the healthcare system. SPOKE 2 (SP2), a key component, is dedicated to instigating change and innovation in primary prevention
through the integration of new technologies or repurposing existing ones with novel functionalities. Within SP2, Work Package 4 (WP4), titled "Digital tools for Primary Prevention," encompasses the design of eight pilot projects. These projects aim to promote primary prevention activities through technological innovation, grounded in scientific evidence, with the objective of developing strategies applicable to broader contexts.
Deliverable: D5.1 Concept of models and paths and mapping of eligible data sources
WP Number: WP5
Dissemination Level: Public
Publishable Summary: Staying ahead of the new health challenges, including population age group changes, requires developing effective prevention strategies based on combined real-world data and research-driven insights. In Working Package 5 (WP5) - Lifelong prevention approaches across the lifespan - of Spoke 2 (SP2) - Community-based Digital Primary Prevention - of the DigitAl lifelong pREvention (DARE) project, the goal is to identify risk factors over the lifespan, from birth and early childhood onwards, including healthy elderly individuals, to inform such strategies. To achieve this goal, WP5 will carry out a series of pilot studies to produce scalable and adaptable models. The mapping and detailed description of data sources suitable to WP5 purposes is instrumental to eventually allow an integrated multidimensional assessment of risk factors of disease development across the lifespan.
Suitable data sources encompass physical and psychological health, social, and environmental data.
Deliverable 5.1 aims at describing the models and paths underpinning digital innovation across WP5 pilot studies and providing detailed information on the architecture and codebook of eligible data sources to be used for WP5 pilot studies.
Deliverable: D5.2 Risk analyses and modeling
WP Number: WP5
Dissemination Level: Public, fully open
Publishable Summary: The objective of SPOKE 2 – Work Package 5 is to establish an epidemiological framework that will allow for the optimal exploitation of real-world and research-based biological, clinical, psychological, social, and environmental data. This exploitation will enable personalised, multidimensional disease risk prediction, as well as the implementation of more effective lifelong preventive strategies. Five pilots have been designed to fulfil the research aim of WP5. Each pilot presents its distinct structure, characterised by the data sets used and the analytical methods identified. Four pilot studies will collect data prospectively eventually providing research datasets for future integration with existing real-world or administrative data sources. These pilots have the main objective of identifying optimal digital screening instruments and early markers of disease. One pilot study focuses, instead, on the integrated use of different existing data sets including routine primary care data, environmental, socio economic and administrative data to identify disease risk factors. Depending on the research question, design, and type of variables collected varied, approaches to analysis plans have been developed including both traditional and artificial intelligence driven analysis approaches.
This second deliverable entitled “Risk Analyses and Modeling” aims at defining the plan and analyses
models for the study of risk factors of disease development and early markers of diseases across the
pilot projects.
Deliverable: D6.1 Plan for enhanced educational programming
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: The document outlines the initiatives undertaken within the DARE (Digital Lifelong Prevention) project, specifically focusing on SP2 (Community-Based Digital Primary Prevention) within the Working Package 6 (WP6) entitled "Education, training, and career paths. The primary aim of WP6 is to bridge the gap in digital knowledge and skills essential for primary prevention in healthcare, targeting graduates, postgraduates, and professionals working with real-world data in research settings.
These initiatives encompass various educational programs, including PhD courses, Master of Science (M.Sc.) degrees, and advanced learning courses. It has been emphasized the enhancing of digital and computational skills in healthcare, aligning with One Health and Planetary Health approaches.
To promote digital health culture, the program offers advanced learning opportunities to the public, focusing on health data science, medical statistics, community health research methodology, and more. Special training pathways are designed for the current DARE workforce and newly hired personnel, such as a Summer School on Digital Prevention and courses on evolutionary algorithms for machine learning.
Utilizing a dedicated learning environment called "LearningFlix" and supported by IT infrastructure, the programs offer certifications via the ECTS system, micro-credentials, and open badges for shorter courses. SP2 through WP6 represents a crucial effort to combat the global shortage of healthcare professionals with digital skills. Collaboration among esteemed institutions underscores the collective push to improve digital competencies in epidemiological surveillance, health promotion, and primary prevention.
Deliverable: D6.2 Plan for Advanced Training Courses
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: The document details the initiatives within the DARE (Digital Lifelong Prevention) project, specifically focusing on SPOKE 2 (SP2) "Community-Based Digital Primary Prevention" within Working Package 6 (WP6) titled "Education, training, and career paths."
WP6 aims to address the shortage of skilled personnel and elevate digital knowledge and skills, emphasizing primary prevention, health promotion, and epidemiological surveillance in healthcare. It follows the One Health and the Planetary Health approaches.
The plan involves advanced post-graduate courses targeting professionals in emerging digital roles and organizations to bridge the digital divide in healthcare. The global shortage of digital experts in healthcare is highlighted, stressing the need for specialized professionals and re-training programs.
The consortium's institutions bring diverse training programs, from advanced biomedical and bioinformatics training at UNIPA to UCSC's focus on Epidemiology, Genetic Epidemiology, and Health Policy research.
SP2's aim is to equip professionals with essential digital skills through seminars, courses on ethics committees, narrative medicine, good clinical practice, and specialized workshops. The plan includes an online school on Digital Prevention and asynchronous access to master's degree modules.
The training leverages robust IT infrastructure and learning environments like "LearningFlix" to offer certifications through the ECTS system, micro-credentials, and open badges for shorter courses.
WP6 outlines a comprehensive strategy, led by UNIPA and esteemed partners, to address the shortage of skilled professionals in digital healthcare. The dynamic training plan, aligned with DARE's broader goals, ensures adaptability and responsiveness. The inclusion of specialized courses and seminars signifies a commitment to providing a holistic and contemporary education in healthcare.
Deliverable: D7.1 Sustainability Management Plan for Spoke 2
WP Number: WP7
Dissemination Level: Restricted
Publishable Summary: Not available
Deliverable: D7.2 IPR management and exploitation services
WP Number: WP7
Dissemination Level: Restricted
Publishable Summary: Not available
Deliverable: D1.3 Report on the design of the IT infrastructure and services
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: The DARE project is an innovative initiative aimed at enhancing prevention in healthcare through the integration of technological advancements and evidence-based practices. Deliverable 1.3 offers a comprehensive overview of the initial activities carried out within Work Package 1 (WP1), titled "Building Ecosystem and Infrastructures," as part of Spoke2 of the DARE project. This deliverable presents the design and deployment of a digital ecosystem intended to support innovative models for community-based surveillance and lifelong prevention strategies. The main goal of WP1 is to create a secure, scalable, and high-performance technological infrastructure capable of integrating and managing heterogeneous data sources—including health, environmental, occupational, and climate-related information—collected through wearable technologies, IoT/IoMT systems, and mobile applications.
To reach this goal, WP1 adopts a structured and phased methodology, ensuring each technological component is tailored to the requirements of real-world pilot initiatives. A key element is the implementation of a solid IT infrastructure (Task 1.2), specifically designed to support complex data flows while satisfying critical performance, interoperability, and cybersecurity requirements. This infrastructure serves as the foundation for the development of digital services under Task 1.3, aimed
at enabling and validating innovative prevention models and intervention strategies.
In addition, Task 1.4 addresses the real-world deployment of these services across pilot sites, organizing and coordinating the delivery of digital primary prevention solutions within local communities. By framing the ecosystem through an integrated model that links infrastructure, services, and implementation in the field, WP1 not only defines the technological and organizational processes involved but also highlights opportunities for refinement. This iterative approach allows stakeholders to continuously improve digital solutions, ensuring they are effective, sustainable, and responsive to the needs of both citizens and healthcare professionals.
Deliverable: D3.3 Prototypal community trial platform
WP Number: WP3
Dissemination Level: Restricted
Publishable Summary: This deliverable, as part of Working Package 3 – Disease-independent determinants and lifestyles in daily-life and occupational environments – of Spoke 2 (SP2) – Community-based Digital Primary Prevention – within the Digital Lifelong Prevention (DARE), presents a comprehensive technical overview of the prototype designed for the CTP – Community Trial Platform. The prototype represents a key step in creating a robust digital infrastructure to support large-scale community-based healthcare interventions. It has been carefully defined based on a structured requirements design process, incorporating both functional and non-functional requirements explicitly formulated by key stakeholders at UniPA (University of Palermo). These requirements reflect a deep understanding of the operational, clinical and technological needs associated with the intended use of the platform in primary prevention settings. From a technical perspective, the prototype is designed to be scalable, modular, and interoperable, ensuring its adaptability to various deployment scenarios and integration with other digital health systems. The architecture prioritizes data security, user privacy, and compliance with GDPR regulations, incorporating features such as anonymization, encryption, access control, and activity
logging. The solution also supports flexible configuration of user roles (e.g., administrators, researchers, basic
users), management of health determinants and questionnaires, and real-time data collection,
reporting, and monitoring functionalities.
Deliverable: D4.3 Predictive algorithms
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: The DARE project is an innovative initiative aimed at enhancing disease prevention through
the use of digital technologies and data-driven approaches. Deliverable 4.3 presents the pilot activities developed within Work Package 4 (WP4), "Digital Tools for Primary Prevention," with a specific focus on the predictive algorithms adopted to support personalized and proactive healthcare interventions. Each pilot addresses a distinct public health challenge and leverages predictive modeling to identify at-risk populations, anticipate health events, and guide timely and targeted preventive measures:
Task 4.1 implements predictive models for automatic disease surveillance, using big data analytics to detect trends in hospitalizations and environmental exposures linked to climate change.
Task 4.2 supports vaccination strategies by applying data mining techniques to immunization records and developing predictive algorithms to identify individuals most likely to miss scheduled vaccinations.
Task 4.3 applies predictive algorithms to data from wearable sensors to improve the prediction of fall risk in older adults, enhancing current assessment tools.
Task 4.4 employs polygenic risk scores and behavioral indicators to guide personalized prevention strategies: lifestyle-based interventions for cardiovascular disease, and genetics-informed preventive approaches for cancer, which may include clinical surveillance or risk-reducing procedures such as prophylactic surgery.
The deliverable details the methodological approaches used to build and validate these predictive algorithms, the types of data sources integrated, and the expected impact on preventive healthcare. The insights gained from these pilot projects contribute to a broader understanding of how predictive analytics can be embedded into routine care pathways to support more efficient, equitable, and personalized prevention strategies.
Deliverable: D6.3 Intermediate update on the educational and training plans
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: The WP6 “Education, Training and Career Pathways” in Spoke 2 (SP2) coordinates all educational, training, and retraining initiatives, profiled on the SP2 research activities, following a coordinated effort with the WP6 of Spokes 1 and 3. The main aim is to address the lack of researchers and healthcare personnel qualified to use digital skills in the context of health prevention (from the primary across the other levels) and public health.
This intermediate report (Deliverable 6.3) presents an update on the implementation status of the educational and training plans under SP2-WP6, built up on the framework described in Deliverables 6.1 (mainly focusing on higher education programs) and 6.2 (focused on advanced training and professional retraining). The integrated strategy developed in these documents reflects the need for a comprehensive and sustainable model to strengthen digital competences in the healthcare sector, from university higher education to professional lifelong learning pathways.
Deliverable: D7.3 Business-oriented services
WP Number: WP7
Dissemination Level: Public
Publishable Summary: This deliverable describes the activities carried out in Task 7.3 for Spoke 2, which focuses on primary prevention and community-level digital health innovations. Unlike Spoke 1, which provides enabling technologies and methodological frameworks, Spoke 2 develops domain-facing solutions such as wearable-based monitoring tools, behavioural-risk prediction models, personalised prevention pathways, vaccination-support systems and population-level epidemiological analytics.
Through the ReActorPro training programme, several Spoke 2 teams translated scientific concepts into structured exploitation hypotheses. Projects such as FALLSPREDICT, Lifestyle Team, SMS-ME, Personalized Epidemiological AI and genomic-risk pilots, demonstrated clear potential for startup formation or hybrid public–private exploitation models. Other innovations, especially those related to vaccination processes (CAREVAX, DigiVax), aligned more naturally with institutional adoption by clinical or public-health organisations.
Task 7.3 also shows that while some Spoke 2 pilots may benefit from selected enabling components developed in Spoke 1 (such as interoperability frameworks, wearable-data processing pipelines, MLOps (Machine Learning Operations framework, MLOps) infrastructures, regulatory governance tools and the DARE App), several others are technologically autonomous and follow independent implementation pathways. This confirms the added value of the Twin Pilot model, which pairs some Spoke 2 pilots with Spoke 1 technical counterparts, when appropriate.
Regulatory and ethical considerations (GDPR, MDR, AI Act) emerged as key determinants of feasible exploitation pathways. The WP7 methodology supported teams in identifying realistic strategies, balancing scientific innovation with operational and compliance constraints.
Overall, Spoke 2 provides a substantial pipeline of prevention-oriented digital innovations with concrete exploitation potential, contributing significantly to DARE’s long-term sustainability objectives.
No Deliverables submitted under this objective yet.
Deliverable: D1.1 Process and outcome indicators
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: The overarching goal of the DARE project is to equip the Italian Ministry of Health and the National Health Service (NHS) with efficient, effective, and innovative technologies. This transition is geared towards revolutionizing the healthcare landscape to better serve our communities' needs. As a part of this endeavor, Spoke 3 WP1 assumes a critical role in evaluating the quality and appropriateness of proposed pilots. This task involves a rigorous assessment of several key elements, including study design, sample size justification, statistical analysis plan, and outcomes evaluation. Our role aligns with the DARE project’s objective of implementing innovative technologies and advancing prevention strategies, with the ultimate aim of improving health outcomes.
Deliverable: D1.3 Communication and Dissemination plan for Spoke 3
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: In Spoke 3 of the DARE project, titled 'Digitally-enabled secondary and tertiary prevention', WP1 is dedicated to devising and implementing an effective communication and dissemination plan. A critical challenge is integrating digital communication tools into clinical settings to maximize their impact. This is precisely what Spoke 3's initiatives strive to achieve. WP1's encourages and help developing tailored communication protocols that leverage digital tools to enhance secondary and tertiary prevention efforts. The presented initiatives, coming from the strategies of 38 pilots, encompass a diverse array of digital platforms, from social media channels to more specialized communication tools, catering to various demographic groups like infants, older adults, and patients with chronic conditions such as diabetes, inflammatory bowel disease (IBD), and kidney disease. These efforts are aimed at not just improving patient outcomes but also enhancing the efficiency of healthcare services. The first year has seen significant progress in defining these communication strategies and identifying key performance indicators to assess their effectiveness. Ensuring these communication methods are robust and well-integrated into clinical practice remains a priority for the success of the project.
Deliverable: D2.1 Concept and relevant design of the models
WP Number: WP2
Dissemination Level: Public, fully open
Publishable Summary: Work Package 2 (WP2) of the DARE project is a part of Spoke 3, titled 'Digitally-enabled secondary and tertiary prevention'. The overall scope is to make considerable progresses in current and novel “Personalization and Risk Stratification Tools”. WP2 comprises now seven tasks, each with a single pilot study, all focusing in fact on secondary and tertiary
prevention interventions supported by ICT infrastructures.
Deliverable: D3.1 Data acquisition and standardization
WP Number: WP3
Dissemination Level: Public, fully open
Publishable Summary: The Work Package 3 of the DARE project, titled “Digitally-enabled Biomarker Discovery”, is part of the Spoke 3 “DIGITALLY-ENABLED SECONDARY AND TERTIARY PREVENTION” and gathers 14 Pilot Studies focused on the identification and validation of specific biomarkers and radiomics approaches useful for secondary and tertiary prevention clinical intervention and supported by ICT infrastructures. In particular, WP3 will aim to test the efficacy of AI to predict the risk of complications and treatment efficacy in various non-communicable and communicable diseases in different ages (from children
to aged subjects), focusing on frailty, selection, and curation of cancer datasets.
The pilots will employ different methodologies including cross-validation of the normative models, using open-access harmonized data and curated datasets provided by the partners, will be performed, and techniques will be used which are capable of: i) identifying pathological factors alterations (e.g., generation of a "brain age connectivity score" and intellectual disability in genetic syndromes and subclinical psychiatric disorders; ii) predicting adverse events in chronic metabolic disorders; iii) predicting the risk of infections and acute adverse events in "elderly frail frequent users" of the Emergency Department (ED); iv) improving vaccination strategies; v) predicting clinical cancer phenotypes by integrating various data types such as somatic alterations, transcriptomic measurements, protein interaction networks into interpretable models. Throughout the initial 15 months of the project, from December 2002 to March 2024, the submissions of pilots were completed in collaboration with Spoke 1 experts.
Deliverable: D4.1 Concept and relevant design of the models
WP Number: WP4
Dissemination Level: Public, fully open
Publishable Summary: Work Package 4 of the DARE project titled “Digitally-enabled Biomarker Discovery” is a part of Spoke 3 “Digitally-enabled secondary and tertiary prevention”. It comprises seven Pilot Studies focused on identification and validation of specific biomarkers by the integration of different digital technologies, machine learning approaches and digitalized medicine supported by Information and Communication Technology (ICT) infrastructures. The major aim for all these pilots is the integration of ICT tools into clinical protocols capable of identifying biomarkers in a number of different diseases, from orthopaedic, to diabetes, to oncology, to brain diseases.
The pilots incorporate a spectrum of tools, spanning from wearable devices to algorithms supporting clinical decision-making processes. The principal hurdle hindering the maximization of ICT tools lies in the absence of their integration into systemic interventions—this is precisely the challenge that the Spoke 3 pilots strive to surmount.
These seven pilots employ diverse studies, ranging from observational approaches to randomized study designs. They encompass a wide array of patient groups, including those with diabetes, oncological conditions, transplant recipients, psychiatric and cognitive disorders, as well as adults with and without chronic diseases. The overarching focus of these studies revolves around various cross-cutting issues related to identifying biomarkers for early disease diagnosis and prognostication. The efficacy of these methodologies stands as a pivotal determinant for the success of the pilot studies. Throughout the initial 12 months of the project, December 2022 to December 2023, the pilot concepts were meticulously formulated also in collaboration with Spoke 1 experts. Simultaneously, a comprehensive list of indicators was developed to gauge the proposal's impact.
Deliverable: D5.1 Concept and relevant design of the models
WP Number: WP5
Dissemination Level: Public, fully open
Publishable Summary: Within the Spoke 3 of the DARE project, entitled 'Digitally-enabled secondary and tertiary prevention', WP5 deals with the continuity of care interventions through innovative ICTninfrastructures. The main obstacle to harnessing the enormous potential of ICT tools is the lack of integration of these tools in systemic interventions at the clinical level, precisely what the Spoke 3 pilot studies aim to overcome. In particular, WP5 activities will be carried out
pursuing the specific objectives of six pilot studies. The common denominator among these pilots is the need of integration of ICT tools into protocols capable of exploiting their characteristics to achieve the goals of secondary and tertiary prevention. The six pilots integrate various tools, spanning from wearable devices to algorithms supporting clinical decisions, with different methodologies, ranging from observational to randomized study designs, involving diverse groups of patients such as infants, older adults, diabetics, Inflammatory bowel disease (IBD) patients, and chronic kidney disease patients. As documented in detail below in this document, the six pilots address various transversal issues, such as the risk of higher use of hospital services or the calculation of caloric intake. The proposed solutions will build upon previous experiences of the responsible research groups. All the six pilots are intended to open new clinical and prevention pathways to improve both the quality of life of the patients and the effectiveness of health services. During the first 12 months of the project, the pilot concepts have been defined in detail in collaboration with the Spoke 1 staff, along with the list of indicators to measure the impact of the proposal. The robustness of the methodologies will be a crucial factor for the success of the pilot studies.
Deliverable: D6.1 Plan for enhanced educational programming
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: D6.2 Plan for Advanced Training Courses
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: D7.1 Sustainability Management Plan for Spoke 3
WP Number: WP7
Dissemination Level: Public, fully open
Publishable Summary: This Deliverable Report is the sustainability plan related to the DARE initiative - Digital Lifelong Prevention, funded by the Ministry of University and Research as part of the National Complementary Plan PNC-I. The plan focuses on the sustainability of the National Health Service, prevention as a service, digital health technologies, and the financial framework of digital healthcare in Italy. Additionally, it presents the canvas methodology, the analysis of the stakeholders, and the organization of the DARE Foundation, as well as the vision and missions of the initiative. The document also examines the path towards sustainability, including monitoring of the pilot studies involved in the overall initiative, the financial sustainability, and the overall sustainability.
Deliverable: D7.2 IPR management and exploitation services
WP Number: WP7
Dissemination Level: Public, fully open
Publishable Summary: Management of intellectual property rights plays an important role in all research projects. Based on guidance by the European Commission as well as the applicable EU law framework, aim of this report is to map the intellectual property options and tools available to the DARE Initiative partners for protection of the IP created during the project execution. To this end the analysis includes a presentation of protection and exploitation methods of IP Rights (such as trademarks, patents, copyright and transfer and licensing agreements). This generic presentation is followed by a first approach of how DARE’s results could be protected and exploited in the future. Given the early stage of project development, this report’s main purpose is not to bring forward a final protection and exploitation plan but instead to provide project partners with timely and comprehensive guidance on efficient and competent protection of their project-related IP rights. This includes for instance advice on a dissemination policy, confidentiality and trade secret practices, as well as exploitation strategy. It is recommendable that these suggestions are finalized in the final Spoke Affiliates Agreement.
Deliverable: D1.2 End-users and Stakeholders' Engagement
WP Number: WP1
Dissemination Level: Public, fully open
Publishable Summary: This deliverable reports on the stakeholder engagement activities conducted within DARE Spoke 3 pilot studies. The engagement process represents a cornerstone of the PNRR-funded Extended Partnership's commitment to developing patient-centered digital health solutions that address real clinical needs. Through systematic data collection via a dedicated REDCap survey, comprehensive information has been gathered from 32 respondents (31 pilot studies plus one Work Package) studies regarding their stakeholder engagement strategies, methods employed, and outcomes achieved.
The findings demonstrate a robust and multifaceted approach to stakeholder engagement across diverse clinical domains including oncology, diabetes and metabolism, orthopedics and biomechanics, neurology and psychiatry, organ transplantation, and cardiovascular diseases. Analysis of pilot studies with validated quantitative data (N≤10 stakeholders and specified stakeholder types) reveals 82 potential stakeholders identified across 16 pilots, 55 stakeholders already actively engaged across 14 pilots, and 61 planned for future involvement across 17 pilots.
Key engagement methods included focus groups (43.8% of pilots), workshops (34.4%), interviews (31.2%), co-design activities (28.1%), and surveys (28.1%). The perceived usefulness of engagement activities was rated as "High" or "Very High" by 59.3% of pilot leads, demonstrating the value attributed to stakeholder involvement in shaping research direction and clinical tool development.
Deliverable: D2.2 Models preliminary assessment and validation
WP Number: WP2
Dissemination Level: Public, fully open
Publishable Summary: Not available
Deliverable: D3.2 Report on the preliminary validation of the tools
WP Number: WP3
Dissemination Level: Restricted
Publishable Summary: The Work Package 3 of the DARE initiative, titled “Digitally-enabled Biomarker Discovery”, is part of the Spoke 3 “DIGITALLY-ENABLED SECONDARY AND TERTIARY PREVENTION” and includes 14 pilot studies focused on the identification and validation of specific biomarkers useful for secondary and tertiary prevention, together, in some cases, with the development of machine learning models able to support prediction of outcomes of clinical interest.
Deliverable: D4.2 Report on Biomarker Discovery activities preliminary validation
WP Number: WP4
Dissemination Level: Restricted
Publishable Summary: Not available
Deliverable: D5.2 Models preliminary assessment and validation
WP Number: WP5
Dissemination Level: Public, fully open
Publishable Summary: This section offers a succinct outline of the content of deliverable S3.D5.2, including objectives, methodologies employed, key findings and their implications. While, for confidentiality reasons the deliverable is flagged with 'restricted access,' the present summary is designed to be publishable, ensuring that relevant insights and highlights on the results provided within the DARE initiative can be timely shared with a wide audience. In Spoke 3 of the DARE project, WP 5, titled “Continuity of care interventions for secondary and tertiary prevention,” focuses on developing new Information and Communication Technologies (ICT) solutions for continuous care interventions. WP5 comprises six tasks which integrate various technological tools, from wearable devices to algorithms supporting clinical decisions, with different clinical research methodologies, including observational and randomized study designs. Six pilot studies (one for each task) are ongoing. They involve diverse patient groups, such as infants, older adults, diabetics, Inflammatory Bowel Disease (IBD) patients, and chronic kidney disease patients. The solutions developed in the DARE project build upon the experiences of the responsible research groups and aim to open new clinical and prevention pathways, ultimately improving patient quality of life and the effectiveness of health services. A first deliverable, handling concept and relevant design of the models, was produced for WP5 at month 12. During the second phase of the activities, between month 12 and month 30, significant progress has been made in the development and initial assessment of the digital tools for screening and early diagnosis. Prototypes have been deployed in real-world settings, and patient enrollment has either begun or is imminent. Preliminary data collection and stress testing have informed refinements in system interfaces, clinical reporting, alerting logic, and backend integration. The six pilot studies are designed not only to improve care quality and decision-making but also to enhance patient engagement and reduce unnecessary hospital use. The present deliverable report, for each task of the WP, the current state of implementation, the initial results, and the planned next steps.
Deliverable: D6.3 Intermediate update on the educational and training plans
WP Number: WP6
Dissemination Level: Public, fully open
Publishable Summary: WP6 “Education, Training and Career Pathways” coordinates all training and retraining activities of the DARE project. The activities developed within Spoke 3 have been coordinated with the WP6 activities of Spokes 1 and 2. The main aim is to address the lack of qualified personnel and improve the level of digital skills in the context of health prevention, which employers and employees require.
Deliverable: D7.3 Business Oriented Services
WP Number: WP7
Dissemination Level: Public, fully open
Publishable Summary: This deliverable describes the implementation of Task 7.3 for Spoke 3, which focuses on secondary and tertiary prevention through advanced clinical decision support, digital diagnostics, in-silico modelling and therapeutic or biomarker innovation. These projects operate in highly specialised medical domains such as oncology, orthopaedics, diabetes, transplantation and neurodegeneration, where exploitation depends not only on technical maturity but also on regulatory compliance, clinical workflow integration and evidence generation.
Within the WP7 framework, Spoke 3 teams participated in the ReActorPro entrepreneurial and translational programme, gaining a clearer understanding of feasible exploitation routes. The activities showed that startup formation is realistic only for a limited subset of solutions, particularly telemedicine platforms or data-driven decision support tools with lower regulatory constraints. Most innovations—especially AI-based diagnostics, digital biomarkers, in-silico models and therapeutic candidates—are instead more suited to institutional adoption, technology transfer or co-development with industrial or clinical partners. These pathways reflect the regulatory requirements of the MDR and the AI Act, as well as the need for clinical validation environments and strong stakeholder engagement.
The deliverable also recognises the functional value of the enabling frameworks developed in Spoke 1. While not universally adopted by all pilots, these interoperability, MLOps, data-processing and governance components provide optional but relevant capabilities that can support exploitation readiness and reduce the translational burden for many Spoke 3 innovations.
Overall, Spoke 3 contributes a set of clinically significant and scientifically advanced innovations to the DARE programme. Through the structured WP7 funnel—awareness, entrepreneurial training and exploitation pathway assessment—these projects have strengthened their translational positioning and identified realistic routes toward long-term adoption in healthcare and research ecosystems.
No Deliverables submitted under this objective yet