What mo­ti­vates you? Q & A |

Dig­i­tal Doc

Ottawa Magazine - - THIS CITY -

Can fruits and veg­gies ex­tend your life­span? That’s the sort of ques­tion a new on­line life-ex­pectancy cal­cu­la­tor answers with in­creased ac­cu­racy, thanks to data from mil­lions of Cana­di­ans. The cal­cu­la­tor is free, it’s used world­wide, and it’s based in Hin­ton­burg, home to the 16-mem­ber Ot­tawa Hos­pi­tal mHealth Re­search Team. Their Project Big Life on­line cal­cu­la­tor takes min­utes to com­plete and in­cludes ques­tions about diet, ex­er­cise, smok­ing, and more. It even mea­sures the ef­fect of air pol­lu­tion (a loss of 0.9 years for a 20-year-old liv­ing in down­town Ot­tawa). In re­turn, it spits out an age: your life ex­pectancy. The re­searchers, led by Dr. Doug Manuel, use data from fed­eral agen­cies such as Statis­tics Canada, as well as the In­sti­tute for Clin­i­cal Eval­u­a­tive Sci­ences (it helps that Manuel holds po­si­tions at ICES and Stat­sCan). Bar­bara Sib­bald caught up with Manuel, an in­trepid year-round cy­clist, at the team’s house-turned-lab on Stir­ling Av­enue.

Where did you get the idea for Project Big Life?

In 2012, we did a re­port with Pub­lic Health On­tario, called “Seven More Years,” about health be­hav­iours and the bur­den of mor­tal­ity. Some­one said, “Why don’t we do a web thing and go right to the in­di­vid­ual, rather than only ad­dress­ing pol­icy-mak­ers and pub­lic health?” We didn’t ask per­mis­sion, and it wasn’t bud­geted; we kind of did it qui­etly on the side. Then when we pub­lished “Seven More Years,” it made the Globe and Mail, and the servers crashed. There were 50,000 peo­ple in the first hour. And that’s how it started. Over a mil­lion peo­ple have used the on­line cal­cu­la­tor now.

How sci­en­tific is it?

It’s tied to the re­search. Life ex­pectancy is from the Cana­dian Com­mu­nity Health Sur­veys, where about 100,000 peo­ple re­port how they are liv­ing and we fol­low up and see who dies or de­vel­ops, say, a heart at­tack. It’s pre­dic­tive an­a­lyt­ics. Our new al­go­rithms are based on mil­lions of as­sess­ments and fol­low-up. For me, as a re­searcher, it’s been re­ally great be­cause you have that im­age of the per­son on­line and how it’s go­ing to help them. It helps re­mind us of how pub­lic pol­icy is go­ing to af­fect the in­di­vid­u­als.

I found my­self go­ing back and re­cal­cu­lat­ing my life ex­pectancy with health­ier choices: more ex­er­cise, more veg­eta­bles. Do you think the cal­cu­la­tor changes be­hav­iour?

There’s con­tro­ver­sial ev­i­dence about whether the cal­cu­la­tor will change be­hav­iour or not. Our goal is to en­gage peo­ple in dis­cus­sion. It’s a risk as­sess­ment: if your doc­tor takes your blood pres­sure, that act doesn’t lower your blood pres­sure — you have to do some­thing else. If you do the cal­cu­la­tor, that’s not go­ing to change things.

Do health pro­fes­sion­als use it?

For sure, clin­ics use it as their risk strat­i­fi­ca­tion, but then it’s cou­pled with the di­a­betic preven­tion pro­gram or other things. As a fam­ily doc­tor, I think a lot of in­for­ma­tion could have been pro­vided by the pa­tient be­fore­hand us­ing the cal­cu­la­tor. Then when the pa­tient comes, we can help them right away to ac­cess a spe­cial clinic or ser­vice, like the Heart In­sti­tute. In pa­tient en­coun­ters, it re­ally makes the con­ver­sa­tion more tan­gi­ble and real. I’m amazed at how many of my pa­tients don’t eat fruits and veg­eta­bles.

What are your plans for the cal­cu­la­tor?

We’re work­ing on ver­sion 2.0 to make it more adap­tive. If you say you used to smoke, it will ask you for more de­tails about your smok­ing. We’re look­ing at de­vel­op­ing more around food and di­etary pat­terns. We want to link to sodium and other things. We’re mov­ing to­ward ar­ti­fi­cial in­tel­li­gence. It’s more cus­tom­ized, more per­son­al­ized.

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