Our purpose in this study is to identify subtypes and the concurrence of some diseases that have overlapping symptoms. These diseases include asthma; the disease characterised by sudden breathing problem due to sudden airway restriction, chronic obstructive pulmonary disease (COPD; the disease marked by long-term breathing problem and poor airflow) and heart failure (HF; the disease in which heart pumps insufficient blood flow to meet bodys need). To achieve the aim, first, we will identify subtypes of diseases according to the classification generally used by physicians. Second, we will extract information on diagnoses, prescriptions, and laboratory measurements from medical records to create different groups of patients based on their coexistence and sequence of developing COPD and HF. Then we will compare the rate of death and features of patients, such as gender, age, history of long-term diseases, and health behaviours (such as smoking, and alcohol consumption) among groups. Lastly, we will examine whether COPD patients who further developed HF will have higher levels of inflammation, compared to individuals with COPD but did not further develop HF. Our results, which can lead to other research in this field, ultimately aim to improve the quality of patient care.
Data on accurate identification of disease sub-classification and coexisting from a large population-based real-world setting is still lacking. In this study, we aim to develop algorithms to classify subtypes of asthma, chronic obstructive pulmonary disease, and heart failure cases on electronic health records and explore the overlap and distinguish between COPD and HF. To achieve these, first, we will identify subtypes, including HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), different degrees of asthma and COPD severity. Second, we will develop algorithms to investigate the temporal relationship between COPD and HF in which patients will be categorised into six groups (i.e., having either COPD or HF, having COPD then develop HF or vice versa, having both simultaneously, and not enough evidence to prove both). Then risk factors and prognosis of each group will be compared. Lastly, we will examine the changes in inflammation markers, including c-reactive protein, lymphocyte, neutrophil, eosinophil, and uric acid between COPD patients who do and do not develop HF. This study will provide an insight into characteristics and burden of disease coexisting, and plausible biological mechanism, which can ultimately result in an improvement in a quality of patient care.
Chronic Obstructive Pulmonary Disease (COPD)
Cardiovascular mortality
Chronic Heart Failure (HF)
Non-cardiovascular mortality
Asthma
Standardised mortality ratio (SMR)
All-cause mortality
Harry Hemingway - Chief Investigator - University College London ( UCL )
Nat Na-Ek - Corresponding Applicant - Farr Institute of Health Informatics Research
Amitava Banerjee - Collaborator - University College London ( UCL )
Nat Na-Ek - Collaborator - Farr Institute of Health Informatics Research
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Practice Level Index of Multiple Deprivation