I caught my aneurysm in time
A health-care executive’s personal journey into the world of precision health
Spending 30 years in the health-care industry couldn’t prepare me for what was about to happen in my own health journey.
Earlier this year, I fought and overcame cancer in my neck. On a trip to my doctor for a followup, I noticed something odd on one of my CT scans. I pointed it out to my doctor, who immediately realized it was an aneurysm. The 7.5-centimetre bulge on my abdominal aorta was ready to burst. A few days later I had a successful procedure and, again, was given a clean bill of health. Two very close calls.
Aneurysms are silent killers. They are notoriously hard to detect, and if one is lucky enough to have it preemptively detected, it’s even harder to know when it might rupture. Nearly 75 per cent of all patients with a ruptured aneurysm die from the condition — let that sink in.
After sharing the harrowing experience with my work colleagues, I learned my own company had launched a pioneering project in New Zealand to spot aneurysms in the general public, with the ultimate goal of identifying those in danger and giving them a chance to have lifesaving surgery.
Orion Health (the company I work for), together with the University of Auckland, and Waitemata District Health Board, created a machinelearning model to reduce the cost of health care and save lives by identifying patients at risk of an aneurysms. Based on epidemiological studies, 800 New Zealanders were identified as likely candidates for abdominal aortic aneurysms (AAAs) during a precision-screening trial. Of the patients, 632 took up the offer of an ultrasound, 36 were found to have an AAA, a prevalence rate of 5.5 per cent and almost exactly the rate that was predicted by the data analysis.
Precision health is an emerging approach for disease treatment and prevention that considers individual variability in general environments and lifestyles. With the explosion of health-care data, clinicians are better equipped to make care decisions based on data — rather than intuition, clinical visits or trials.
Tying artificial intelligence, data analytics and databases together, scientists use the information to identify at-risk populations. The information can help identify people at risk of aneurysms, asthma, diabetes and more. Giving way to a new era of care, precision health allows clinicians to catch diseases and conditions before they become more serious and much costlier to the healthcare system. It is an approach that has proven to improve health-care outcomes. It helps governments and administrators identify where to allocate money to treat at-risk patient populations through prevention measures or providing better care.
With the right resources, general practitioners can use a hand-held ultrasound to check an at-risk patient for an aneurysm right in the doctor’s office. It’s very easy to do, and just one example of an application or precision health.
The explosion of patient data in hospitals, labs, pharmacies and communities presents an immense opportunity. However, it is often unconnected and unshared, making it extremely difficult to take that extra step and utilize it for effective precision health. My colleague, Dr. Chris Hobson, wrote on the subject earlier this year, urging decision-makers to fix information gaps in the healthcare system.
Some regions and provinces across Canada have very rich databases of patient data and are in a position to mine them for the benefit of the patient. The combination of robust databases, funding and employment of more data scientists would go a long way toward improving health care through the lens of precision health.
The world is on the cusp of an astonishing change in how we approach health. Rather than racing to cure disease once it happens, we can progressively prevent it before it attacks. With the proper approach, Canada can prevent silent killers, improve outcomes for our populations and usher in a new era of care.