Big data gives heart research a boost

A healthcare system under pressure requires new methods for making the right diagnosis in good time and selecting the best possible treatment. Heart researchers and mathematicians are now coming together to use artificial intelligence and register-based research to usher Sweden’s hospitals into a new era.

DOG OWNERSHIP IS linked to a lower risk of death from heart disease. A cancer diagnosis, on the other hand, increases the risk sixfold, at least during the first week. Researchers using data from Sweden’s population-based registers and biobanks are able to supply important knowledge about a wide range of common diseases. The results of their

Johan Sundström, cardiologist and Professor of Epidemiology. work provide practical support to healthcare professionals, as well as a basis for public policy.

“Sweden’s healthcare model and national quality registers offer unique conditions. These days we have access to such vast quantities of medical data that new tools are required to fully utilise them. Above all, we see the potential in artificial intelligence (AI) and machine learning, which allows computers to complete tasks without being explicitly programmed to do so. With the correct input, we can push forward the boundaries of our entire field and during the autumn we will be beginning our commitment to AI for Research – a five-year interdisciplinary initiative,” says Johan Sundström, cardiologist and Professor of Epidemiology.

THANKS TO A donation from Åland philanthropist Anders Wiklöf, the group has been able to recruit two data scientists. Stationed at the new research environment, in collaboration with Thomas Schön, Beijer Professor of Artificial Intelligence, they will develop an AI tool with the capacity to interpret ECGs and diagnose abnormalities. In parallel, they will develop and validate the algorithms for detailed register studies.

“The meeting of mathematical and clinical competences creates great synergies. They will build systems and algorithms, we will provide the relevant questions, data and knowledge about how the methods need to be tested before they can be clinically applied. Together, we can generate new knowledge for even better healthcare recommendations.”

THAT SAID, THE path from research findings to medical advice is not without obstacles. Region Uppsala’s evidence

Using register-based studies, the researchers hope to identify new risk factors so as to contribute to improved care for cardiovascular disease.

group, which Sundström chairs, is part of a national network that evaluates methods before their implementation in healthcare, and the fact is, many results are never translated into therapies.

“The safest conclusions about causation and therapeutic effectiveness are achieved by randomly allocating different treatments to equivalent patient groups and then comparing the results. All the same, register-based studies are sometimes our best oppor-

ILLUSTRATION: MATTON

Stefan James, Professor of Cardiology.

tunity to provide healthcare with information; for example, our study demonstrating that a patient who stops taking snuff after a heart attack doubles their chances of survival received immediate attention at the country’s health clinics. We therefore hope that, by using Swedish Big Data, within the foreseeable future we will identify new risk factors that can contribute to improved care of cardiovascular diseases.”

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Facts

• Cardiovascular disease is the most common cause of death and has the highest drug treatment costs in Sweden.

• Cardiology research at Uppsala University includes register-based studies, cell biology research and large clinical trials with patients and healthy controls from many countries.

• Uppsala Clinical Research Center has the expertise and technology necessary to transform innovative ideas into translational research projects, clinical studies and register-based improvement projects.

The Swedish model proves effective

“Determining which of two medical treatments is most effective has long been a challenge to science.” So says Professor of Cardiology STEFAN JAMES.

“The best results are achieved in randomised studies comparing outcomes between equivalent patient groups; however, as these are often deemed to be far too demanding and expensive, we have developed a method that utilises patient data from the Swedish National Quality Registries.”

The concept requires that both the doctor and patient consent to the random allocation of treatment. Thus far, the vast majority have chosen to participate and, at present, some 20 studies are underway focusing on various strategies, drugs and medical technical products.

“This arrangement is mainly suited to common ailments such as heart attacks and blood clots, which provide the requisite quantities of data. We act on both our own initiative and on behalf of others and the fact is, our results do have a broad impact in healthcare – which we believe is related to the fact that this arrangement involves healthcare providers in the study phase.”

In 2015, the Stefan James model won the Athena Award, the world’s most prestigious prize for innovative clinical research, and today the concept is causing ripples far beyond Sweden’s borders.

“When we demonstrated that giving oxygen has no benefit in the event of an acute myocardial infarction, it had an immediate impact on guidelines worldwide. The regulatory authorities in the United States, which normally only follow domestic studies, recently announced that they will implement our recommendations from an ongoing study; so, perhaps our method will also help to strengthen Sweden’s reputation in medical science.”