Screening patients for life-threatening abdominal aneurysms by analysing their patient record data successfully led to 36 people being diagnosed, reports an Auckland research trial.
One of those patients, a 78-year-man who had an ultrasound scan after being alerted by the trial that he was a candidate for an abdominal aortic aneurysm (AAA), was found to have a 6cm bulge in his abdominal aorta which has since been successfully operated on.
The data analysis project, carried out by Precision Driven Health – a research partnership collaboration between Orion Health, Waitemata District Health Board and Auckland University – used an algorithm of AAA risk criteria to “precision screen” the records of patients at the Coast to Coast general practice near Wellsford.*
Dr Peter Sandiford of Waitemata DHB worked with data scientists at Orion Health and Professor Greg Jones of the University of Otago to develop the algorithm based on previous epidemiological studies of thousands of patient records. He said precision screening (the application of data science and machine learning) had the potential to save more people like Mr R.
“AAA is the silent killer.” says Dr Sandiford. “Big data makes it possible to create precise criteria to select those most at risk to AAA, and in the future to other preventable conditions.”
All of the 800 patients identified as potential candidates for AAA through the precision screening trial were invited to have an ultrasound and 632 took up the offer. Of those 632 patients 36 – including Mr R – were found to have AAA which was a prevalent rate of about 5.5 per cent which was almost exactly the rate predicted by the data analysis.
The vast majority of the AAA (97%) were founded in the 29 per cent of patients with a predicted AAA risk of 2 per cent or more.*
The precision screen trial ended in early November 2017 and the Ministry of Health’s National Screening Advisory Committee was being supplied with results. Further work on IT systems and modelling were also being carried out.
Orion Health Chief Executive Ian McCrae says there were plans to develop the AAA screening tool further so it could be adopted by general practice clinics throughout the country, and generalised to other medical conditions.
The AAA project is one of three main areas of interest for Precision Driven Help’s Project HOPE – Health Outcome Prediction Engine. The other two are in stroke recovery and patient-reported outcomes. HOPE is one of over forty research projects supported by Precision Driven Health – which is a seven year $38 milion research partnership aimed at improving health outcomes through data science.
*Maori patients at the practice were not included in the precision screening trial because they had already been screened in 2015 as part of a successful Waitemata DHB-funded pilot programme that showed Māori men and women are nearly three-times more likely to have AAA than non-Māori. That pilot was extended to all Maori living in the Waitemata and Auckland DHB catchment in mid-2017 and will conclude in March.