Following an episode of acute decompensation of cirrhosis, 5% of the patients die by day 28 and 14% of the patients die of ACLF within 3 months. The reason why certain patients die and others survive is unknown, but huge differences between patient individual genetics, medical history, precipitating events, clinical presentation and treatment response are suspected. These individual differences call for personalized treatments based on a better understanding of the pathophysiological mechanisms underlying acute decompensation of cirrhosis. 

High-throughput sequencing technologies together with powerful analytical techniques have allowed to identify changes at the molecular and cellular level associated to states of health and disease. Combined with computational and mathematical tools, integration and analysis of large multi-omics datasets are tranforming the way therapeutic biomarkers are identified. DECISION will use medicine systems approaches to gain a deep insight into the mechanisms of decompensated cirrhosis and develop better diagnostic and prognostic biomarkers. DECISION will guide more effective, personalized treatment of patients hospitalized with acute decompensation of cirrhosis preventing progression to ACLF and reducing mortality. 

DECISION – an acronym for Decompensated cirrhosis: Identification of new combinatorial therapies based on systems approaches has received €6 million funding within the framework of the EU’s Horizon 2020 research and innovation program to analyze clinical data and biological samples from 2200 patients with cirrhosis and more than 8600 time points from existing large studies sponsored by EF CLIF (i.e., CANONIC, PREDICT, and ACLARA). Diagnostic and prognostic tests based on the biomarkers identified and validated in pre-clinical studies will allow to select patients who most likely will benefit from combinatorial treatment. The efficacy and safety of most promissing combinatorial treatment will be further tested in a phase II clinical trial.