SENTINEL brings the Edinburgh IBD research programmes together around a practical question: how can a clinical team recognise changing needs across its whole patient population and respond in time? We are developing clinician-supervised decision support and proactive monitoring, informed by long-term patient data and lived experience.
We are preparing a feasibility study. SENTINEL is not yet in routine clinical use.
Follow disease over time
IBD is lifelong, but its course is often viewed through separate appointments, test results and episodes of illness. A person can feel well while inflammation continues, or experience difficult symptoms without a matching change in inflammatory markers. Understanding the relationship between those signals takes context.
SENTINEL is designed to bring repeated blood and stool measurements together with treatment histories, steroid courses, admissions and operations. A companion app is intended to add patients’ accounts of symptoms and wellbeing. The aim is a shared view of disease over time that helps clinicians and patients understand what has changed and what needs attention.
Understand changing risk
Our published trajectory research identified distinct patterns of inflammation in Lothian and Danish cohorts, including rapid remission, delayed improvement, relapsing disease and persistent inflammation. These patterns provide a foundation for research on individual disease course.
The team’s landmaRk software supports methods that combine repeated measurements with time-to-event models. We are investigating how these approaches could update risk estimates as new information becomes available, and how those estimates might help teams decide when to review someone’s care. These predictive features remain under development and require clinical evaluation.
Support care, together
The intended dashboard would help teams consider who needs review, whose monitoring needs updating and where the available information is insufficient. The challenge is to direct attention where it can help, while respecting the preferences of people who are well and avoiding unnecessary appointments or tests.
Preparation for feasibility work brings patients, clinicians, nurses, pharmacists and researchers into this design. Questions include whether information is understandable, whether suggested priorities fit clinical workflows and how patients experience monitoring between appointments.
SENTINEL’s purpose is earlier, more consistent support, with clinical teams responsible for decisions and patients involved in their care. We want the platform to make the space between appointments safer and the next conversation more useful.