Date post: | 12-Feb-2017 |
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Big Data Big Picture
Professor Derek BellImperial College LondonPresident Royal College of Physicians of Edinburgh
Generating data on a massive scale
• Florence Nightingale, pioneer of statistics. In the 1890s she tried to get a Professorship of Statistics established at Oxford University, specifically for applying statistical analysis to social problems.
• At the time the scheme came to nothing, but her vision is now realised all over the world.
PD
Big data is not new there is just more of it !
And we can analyse it!
PrintArs Anatomica
•http://www.arsanatomica.lib.ed.ac.uk/
Digital imaging SearchCullen project
Big Data and the Health and Social care landscapepopulation – personal
• Planning• Prediction• Research• Diagnosis• Treatment Bi
g Da
ta a
naly
tics Global
National
Regional
Unit or organisational
Individual
Multiple data sources
The trick is to add value !
Volume Variety Velocity
Veracity
Frailty
BMJ 17th May 2013 Soong et al Letter to Editor:http://www.bmj.com/content/343/bmj.d4681/rr/645724
Frailty as a dynamic concept
High level frailty data
Frailty Syndromes50 million patient episodes
Mortality ReadmissionInstitutionalization
Theory
National HES Data
Soong et al.Developing and validating a risk prediction model for acute care based on frailty syndromesBMJ open. , 2015, Vol.5(10), p.e008457
Quantifying the prevalence of frailty in English hospitalsBMJ open. , 2015, Vol.5(10), p.e008456
Test(Big Data) Validation
Individual Point of Entry to acute
secondary Care
Provider Unit Level
BedsideFrailty Score
(FEWS)
Data from
C&W Hospital
Primary Care (CPRD ) data
Clinicallyapplicable
actions
“GeriatricGiants”
“Frailty Burden”
Frailty Approach
Validate and assess frailty
model
Develop simple frailty assessment
score
Assess the patient/carer acceptability of FEWS and the language
1601 18661601 1639 1677 1715 1753 1791 1829
Captain J Lancaster Lemon Juice 1 out of 4 ships1/1/1601 John Woodal
Father of Naval Hygiene1/1/1636
James Lind First Controlled Trial1/1/1747
Admiralty Adopt1/1/1795
Merchant Navy Adopt
1/1/1865
Scurvy and Vitamin CDescription to cure
Translational Gap
PREDICTION PREVENTION DIAGNOSIS AND TREATMENT
Cell 2012 148, 1293:
A day in the life !
726 days of continuous data
Personalised Medicine Chen et al Cell 2012
• Personalized medicine is expected to benefit from combining genomic information with regular monitoring of physiological states by multiple high-throughput methods.
• An integrative personal omics profile (iPOP), – combines genomic, transcriptomic, proteomic, metabolomic, and autoantibody profiles from a
single individual
• iPOP analysis revealed various medical risks, including type 2 diabetes.
• Uncovered extensive, dynamic changes in diverse molecular components and biological pathways across healthy and diseased conditions.
• This study demonstrates that longitudinal iPOP can be used to interpret healthy and diseased states by connecting genomic information with additional dynamic omics activity
Improving health: diabetes in Scotland
• Total Scottish Population 5.2m
• People with diabetes : 251,132 (4.9%)
• People with Type 1 DM : ~27,000 (0.5%)
• All patients nationally are registered onto a single register; the SCI-DC register
• SCI-DC used in all 38 hospitals
• Nightly capture of data from all 1043 primary care practices across ScotlandCourtesy of Andrew Morris
We still have work to do with patients and public
Patient and public views on electronic health recordsJ Med Internet Res. 2013 Aug 23
Access and environment: safe havens
• A safe haven for data is more like a traditional library, where controlled access is granted to people who have the right credentials.
• You lose some of the benefit of making data freely available over the internet, but the risk of malicious use is greatly reduced.
•Harm can be done by sharing and not sharing dAta
Credit: QTS
Health and care
• The computing power of big data analytics will allow new cures and better understanding and prediction of disease.
• Data from smart watches and wearable devices will link lifestyles and diseases.
• Monitor and predict epidemics and disease outbreaks, simply by listening to people i.e. “Feeling rubbish today - in bed with a cold” or searching for on the Internet, i.e. “cures for flu”.
Where next?Just scraping the surface
• No return – the world shaped by the digital revolution
• New methods to understand the population and the individual
• Major research and therapeutic opportunities
• There are unforeseen benefits and harms internet has no borders
• UK must stay at the leading edge
• Need a sophisticated level of debate – security and benefits.