Map-based Visualisation and Statistical Inference with Dynamic Health Data

每当有人去看全科医生或医院时，他们的医疗状况（包括检查结果、接种疫苗等）都会记录在他们的个人NHS健康档案中。这一过程产生了大量未开发的国民健康数据。卫生地图集利用这些医疗信息生成地图，以显示一个地区的哪些区域(例如：城镇或乡村)处于某种特定疾病的低风险或高风险。在评估疾病风险时，通常要考虑贫穷、年龄和共存疾病等因素。这种卫生地图集已经存在，但缺乏灵活性，因为它们使用旧的历史数据，需要很长时间才能生成。因此，它们不能显示目前的卫生状况。该项目的基本目标是开发创建“实时”卫生地图集的方法和工具；作为一个例子，它将使用居住在英国索尔福德市的人口（超过20万人）的NHS医疗记录。瞄准索尔福德的原因是它有超过20年的记录存储在中央最先进的计算机系统中，每个人的NHS记录都定期收集，因此它们是完全最新的（超过2亿的事件已被记录）。因此，这为创建第一个“实时”健康地图集提供了机会，该地图集将部分通过地图显示，通过用户友好的交互式网络应用程序“实时”显示索尔福德人口的当前健康状况。该地图集将有两个版本，一个是面向公众的，如上所述。另一个版本将传达更详细/专业的信息，因此仅供卫生保健专业人员和科学家使用。在这两种情况下，我们都会非常小心地确保所显示的信息足够简单易懂。隐私将受到严格保护；在这个地图集上，个人将无法识别。在该项目的生命周期内，实时健康地图集将重点关注肾脏疾病，它影响了英国约5%的成年人口，尽管它在某些部门更为普遍。在老年人中。此外，患有其他疾病的人，如心血管疾病、高血压和糖尿病，患肾病的风险更高。某些民族更容易患有这些疾病，因此更容易患上肾脏疾病，因此这种疾病是一个重要的公共卫生问题。因此，在实时卫生地图集上绘制这种疾病的分布是一项及时的发展。实时健康地图集将由兰开斯特大学医学院“结合健康信息、计算和统计”小组的一名研究员开发。该研究员将与曼彻斯特大学Farr健康信息学研究所的同事以及索尔福德皇家NHS基金会信托基金内肾脏疾病的三级护理小组合作。这三个机构在各自的领域都有很强的研究记录，它们将提供专门知识，为实时卫生地图集背后的统计和软件开发提供建议。该地图集位于统计学和信息技术的交汇处，资助者英国医学研究理事会（the Medical Research Council）认识到有必要对该领域进行投资，部分原因是英国的技能短缺。这一实时卫生地图集将被设计成，以便在未来，在这个项目的生命周期之后，它可以用于其他疾病和不同的地理区域。该地图集将是最新的，并在互联网上交互式地显示特定疾病的信息，因此，从个人到卫生保健专业人员再到决策者，每个人都将有机会通过针对某些疾病更有可能发生的特定领域来改善人们的生活质量；总的来说，这将降低长期医疗保健费用。

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.