Innovation, data science & risk in healthcare Bern Shen MD HISA - - PowerPoint PPT Presentation

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Innovation, data science & risk in healthcare Bern Shen MD HISA - - PowerPoint PPT Presentation

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Innovation, data science & risk in healthcare Bern Shen MD HISA Health Data Analytics Brisbane 11 Oct 2017 Policies & interventions Biology Physical Social Individual environment environment Behavior Technology Access to

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Innovation, data science & risk in healthcare

Bern Shen MD HISA Health Data Analytics Brisbane 11 Oct 2017

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Policies & interventions

Health status

Access to quality healthcare

Technology

Physical environment Behavior Biology Social environment

Individual

Adapted from Healthy People 2010

Source: : Mokdad, et al. 2004. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238-45.

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See Understand Predict Control

“Illness is about learning to live with lost control.”

  • Arthur Frank. The Wounded Storyteller: Body, Illness & Ethics.

“It may not be dying we fear so much, but the diminished self.”

  • Anatole Broyard. Intoxicated by My Illness.
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Analytics & algorithms are beautiful…

…but only useful if they effect benefit in the real world.

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(DCF startup valuation) (SVM classifier for machine learning)

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Population Health Framework Source: Care Continuum Alliance. Outcomes Guidelines Report, Vol. 5. Washington, DC: Care Continuum Alliance. 2010.

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Translation, implementation, dissemination

  • NIH National Center for Advancing

Translational Sciences (2011)

  • Centres in Australia including Queensland

Translational Research Institute

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Data science Risk Innovation

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Top risks

“Second on the list is the one we haven’t thought of, and at the very top is the one we can’t imagine.”

– David Morens, US NIAID

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Source: : Mokdad, et al. 2004. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238-45.

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Adapt (anticipate?) or die

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Identify the tree shrew Or better, be the next apex predator

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Context & Pasteur’s prepared mind

“Dans les sciences d'observation le hasard ne favorise que des esprits préparés.”

  • Louis Pasteur, 1854

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Data points (analytical) → data clouds (ecological)

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Data points (analytical) → data clouds (ecological)

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Time Disease signal Disease driver signal Signal strength Disease detected Disease anticipated (Noise)

Poverty, social inequality Weather, climate change Malnutrition, famine Crowding, human/wildlife contact Land use/ecosystem change Disaster …

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“Complexity rheostat”

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Doctor Patient Med

Similarly for diagnostics, devices, services…

Decision support, practice guidelines, care pathways, etc. Adherence, health beliefs & behaviors, social determinants, etc.

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Map of science derived from clickstream data

Bollen J, Van de Sompel H, Hagberg A, Bettencourt L, Chute R, et al. (2009) Clickstream Data Yields High-Resolution Maps of Science. PLoS ONE 4(3): e4803. doi:10.1371/journal.pone.0004803 http://127.0.0.1:8081/plosone/article?id=info:doi/10.1371/journal.pone.0004803

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Geographic → genomic

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Source: http://rocs.hu-berlin.de/complex_sys_2015/resources/Presentations/C_Mueller.pdf

a

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Kwang-Il Goh, and In-Geol Choi Briefings in Functional Genomics 2012;11:533-542

Human disease network graph

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  • 67% of disorders linked to

at least one other

  • Giant cluster contains 516
  • f 1284 (40%)
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Health risks…

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Source: Univ. of Washington IHME. http://vizhub.healthdata.org/gbd-compare/

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…change over time...

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1990 2010

Source: R Lozano, et al. 2012. Global & regional mortality from 235 causes of death for 20 age groups in 1990 & 2010. Lancet 380:2095-128.

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…with age...

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Source: R Lozano, et al. 2012. Global & regional mortality from 235 causes of death for 20 age groups in 1990 & 2010. Lancet 380:2095-128.

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…by gender & place…

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…by wealth & place

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Malaria Neonatal sepsis TB HIV/AIDS Diarrhea Malnutrition Meningitis Interpersonal violence Pancreatic cancer Breast cancer Dementias Prostate cancer Diabetes Neck pain Lung cancer Anxiety Drug use Colon cancer Alcohol use Self-harm Lung cancer Alcohol use Colon cancer Stomach cancer Forces of nature in Caribbean

Wealthier Poorer

Global

Liver cancer in China Interpersonal violence in Central & South America

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Technobiome

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“A House is a machine for living in.”

  • Le Corbusier. Vers Une Architecture. 1923.

“… joining and separation of human and nonhuman are everyday affairs.”

  • Suchman. Human-Machine Reconfigurations. 2007.
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Unintended consequences, ethics

“We are building a civilization that is deeply connected yet technologically insecure… in other words, we are constructing a world that is wired for crime.”

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Dealing with bad data

  • Unintended
  • Deliberate

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Toward Precision Medicine: Building a knowledge network for biomedical research & a new taxonomy of disease. National Academies Press, 2011.

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New data, new connections

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  • New data types
  • Beyond usual text, tracings, & images
  • New data sources
  • Outside of the hospital, clinic & lab
  • …create new information management challenges

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Data (test) Insight (diagnose) Action (treat)

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