Data Driven Approaches to Improving Risk Prediction of Pulmonary Complications After Major Inpatient Surgery

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ABSTRACT BACKGROUND: Postoperative pulmonary complications (PPCs) are common and major drivers of morbidity and mortality after major inpatient surgery. Various risk prediction scores identify patients at high risk of developing PPCs and observational research has connected peri-operative care practices with subsequent risk. However, anesthesia providers do not have patient specific evidence based interventions to prevent pulmonary complications. RESEARCH: The proposed research will draw on a wealth of perioperative information available to identify the interactions of patient, procedure and process of care factors which place patients at risk of PPCs. This will incorporate advances in data science to the pre-operative prediction of PPCs (Aim 1). We will then revise and improve this estimate in light of the high fidelity intraoperative data stream from ventilators, monitors and patient response to real life decisions being made during the delivery of anesthesia care (Aim 2). This will allow understanding of what features most contributed to patient specific risk (Aim 3). The proposed research and training will provide Dr Colquhoun with the skills in data science to his transition to an independent researcher. CANDIDATE: Dr Douglas A Colquhoun is a tenure track Assistant Professor of Anesthesiology at the University of Michigan. He is board certified in Anesthesiology and Critical Care Medicine and maintains an active clinical practice in the perioperative care of patients undergoing major surgery. During a T32 Research Training Grant, Dr Colquhoun developed expertise in the derivation of outcomes and processes of care from electronic medical record data. His long term career goal is to prevent postoperative pulmonary complications by offering anesthesia providers data driven strategies for management delivered at the point of care. ENVIRONMENT: The University of Michigan is the coordinating center for the Multicenter Perioperative Outcomes Group (MPOG) an international consortium of 50 anesthesiology and surgical departments with perioperative information systems. Sachin Kheterpal, MD, MBA is the primary mentor for Dr. Colquhoun, and is the Director for MPOG. Dr Kheterpal and the Department of Anesthesiology have a rich history of developing and deploying innovative software solutions to address problems in perioperative medicine and research. Dr Colquhoun will additionally be advised from expert co-mentors drawn from across the institution and a scientific advisory panel expert in the prevention and management of postoperative complications.