Map-based Visualisation and Statistical Inference with Dynamic Health Data

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Whenever someone visits their GP or the hospital, their medical condition (incl. test results, vaccinations, etc.) is recorded in their personal NHS health file. This process generates a largely untapped wealth of data on the nation's health. A health atlas uses this medical information to generate maps in order to show which areas of a region (eg. town or country) are at a low or high risk of a particular disease. When assessing the risk of disease it is common to account for factors such as poverty, age and coexisting diseases. Such health atlases already exist, but are inflexible as they use old historical data and take a long time to produce. Consequently they do not display the present health landscape.The fundamental aim of the project is to develop methods and tools for creating 'real-time' health atlases; as an example it will use the NHS medical records of the population living in the city of Salford, UK (over 200,000 people). The reason for targeting Salford is that it has over twenty years of records stored in a central state-of-the-art computer system, everyone's NHS records are regularly collected therefore they are completely up-to-date (over 200 million events have been recorded). This therefore opens the opportunity to create the first 'real-time' health atlas which will display, partly through maps, the current health state of the Salford population in 'real-time' via user-friendly interactive web applications. There will be two versions of the atlas one for the general public as described above. The other version will convey more detailed/specialist information so will only be available to health care professionals and scientists. In both cases great care will be taken to ensure the information displayed is sufficiently straightforward to understand. Privacy will be strictly protected; individuals will not be identifiable on this atlas.Within the lifetime of the project, the real-time health atlas will focus on kidney disease which affects approximately 5% of the adult population in the UK although it is far more prevalent in some sectors eg. in the elderly. Furthermore, people who suffer from other medical conditions, such as cardiovascular disease, high blood pressure and diabetes, have a higher risk of developing kidney disease. Certain ethnic groups are more likely to have these medical conditions, consequently are more likely to develop kidney disease, hence this disease is an important public health concern. Therefore mapping this disease's distribution on a real-time health atlas is a timely development.The real-time health atlas is to be developed by a Research Fellow based in the 'Combining Health Information, Computation and Statistics' Group in the School of Medicine at Lancaster University. The Fellow will work with colleagues at the Farr Institute of Health Informatics Research, based within The University of Manchester, and also with the tertiary care group for kidney disease within the Salford Royal NHS Foundation Trust. These three institutions, each with strong research records in their own fields, will lend their expertise to advise on the statistical and software development behind the real-time health atlas. This atlas sits at the interface between statistics and information technology where the funder, The Medical Research Council, recognises there is a need to invest, partly due to a UK skills shortage. This real-time health atlas will be designed so that in the future, beyond the lifetime of this project, it can be used both for other diseases and in different geographical regions. The atlas will be up to date and interactively display disease specific information on the internet therefore everyone, from individuals to health care professionals to policy makers, will have the opportunity to improve people's quality of life by targeting specific areas where there is a greater likelihood of certain diseases; in general this should reduce long-term health care costs.