The NHS Health Check programme is one of the largest disease prevention initiatives in England. It was introduced in 2009 to help prevent heart attacks and strokes. A Health Check provides people with information about their risk of having a heart attack or stroke and offers lifestyle advice, referral and/or medication as needed. It now covers risks of other conditions like diabetes, kidney disease and dementia and includes looking for atrial fibrillation (an irregular heart rate). Many of the recommended lifestyle changes lower the risk of other diseases, such as cancer and lung disease.
People aged between 40-75 years, who have not had a stroke and do not already have heart disease, diabetes or kidney disease are invited for an NHS health check every five years. However, it has been recommended to prioritise initial and repeat invitations to people with the greatest health need. Furthermore, it may be more cost-effective to target the repeat programme to people with higher risks of future disease and have longer time-intervals between invitations for those with lower risks of future disease.
We aim to develop methods which use existing electronic heath records to help identify people with greatest health needs for prioritisation for the NHS health check. We will use measurements of "risk factors" that are known to be linked with greater risk of disease (eg, older age, being male, smoking, high blood pressure, high cholesterol, above healthy weight) recorded at repeat general practice visits to estimate how likely someone is to develop future diseases and to also estimate when the person should next be invited for an NHS health check.
It has been recommended to prioritise the NHS Health Check programme to people with the greatest health need, although there is no guidance on how this should be achieved. The benefits of using existing electronic health records for disease risk pre-screening and personalized heath care decisions is becoming increasingly recognized. We aim to develop methods which use existing electronic heath records to (i) identify people with greatest health needs for prioritisation for the NHS health check and (ii) estimate when a person should next be invited for an NHS health check.
We will develop a computationally feasible approach to handle the methodological challenges in utilizing historical repeat measures of multiple risk factors recorded in electronic health records to systematically identify patients at high risk of multiple future diseases. The models will incorporate use of multivariate repeat risk factors, measurement errors, missing data, competing risks, dynamic risk prediction, time-to-event data, and internal validation techniques (eg, cross validation).
Cardiovascular disease (Ischaemic heart disease and stroke) - Chronic kidney disease
- Atrial fibrillation
- Type 2 diabetes
- Dementia
Angela Wood - Chief Investigator - University of Cambridge
Angela Wood - Corresponding Applicant - University of Cambridge
Alexis Bellot - Collaborator - University of Cambridge
Alicia Curth - Collaborator - University of Cambridge
Amine M'Charrack - Collaborator - University of Cambridge
Daniel Jarrett - Collaborator - University of Cambridge
Danyang Yin - Collaborator - University of Cambridge
David Stevens - Collaborator - University of Cambridge
Ellie Paige - Collaborator - The Australian National University
Eoin McKinney - Collaborator - University of Cambridge
Evgeny Saveliev - Collaborator - University of Cambridge
Francesca Gasperoni - Collaborator - Medical Research Council - MRC
Jessica Barrett - Collaborator - University of Cambridge
Jiaying Yao - Collaborator - University of Cambridge
Juliet Usher-Smith - Collaborator - University of Cambridge
Kamile Stankeviciute - Collaborator - University of Cambridge
Luanluan Sun - Collaborator - University of Cambridge
Michael Sweeting - Collaborator - University of Leicester
Mihaela van der Schaar - Collaborator - University of Oxford
Rutendo Mapeta - Collaborator - University of Cambridge
Ryan Chung - Collaborator - University of Cambridge
Stephen Kaptoge - Collaborator - University of Cambridge
Zhaozhi Qian - Collaborator - University of Cambridge
Zhe Xu - Collaborator - University of Cambridge
Carmen Petitjean - Collaborator - University of Cambridge
Lisa Pennells - Collaborator - University of Cambridge
Owen Taylor - Collaborator - University of Cambridge
Robson Machado - Collaborator - University of Cambridge
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Townsend Score