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

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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.