Understanding clusters and mechanisms of complex multimorbidity in people with common allergic conditions

多病是一个术语，用来指有两个或两个以上的长期身体或精神疾病。多发病很重要，因为它会影响人们一生中发生的事情以及医生如何治疗他们。可能与过敏相关的疾病，如哮喘和湿疹，在儿童和年轻人中非常常见（至少五分之一的儿童），并且已知对生活质量和NHS成本有重大影响。以前的研究表明，过敏性疾病患者有许多不同的精神和身体健康问题（多发病）的风险，可能是由于他们的过敏性疾病。我们还不知道这些疾病是如何聚集在一起的（“集群”），以及它们为什么会发生。我们的工作将帮助我们了解过敏性疾病如何以及为什么与其他精神和身体疾病（多发性硬化症）相关，以找出如何更好地治疗过敏性疾病的人。在这个准备阶段（也称为巩固补助金），我们将首先探讨过敏性疾病如何与多种其他医疗和精神疾病一起发生，以及这些“集群”如何随着时间的推移而发展。其中一些“集群”将包括我们已经知道的可能与过敏性疾病相关的疾病，但我们也希望我们可能会发现新的相关疾病。我们将使用作为常规医疗保健的一部分收集的数据进行此分析，这些数据已被剥离标识符（例如，姓名）。我们收集了大量人群（例如50万名患有湿疹的成年人）的长期数据，包括健康问题、药物、医生就诊以及人们是否吸烟或饮酒的信息。这项工作将是复杂的，因此我们需要举办涉及不同类型专家的研讨会，例如数据科学家，统计学家，治疗过敏性疾病患者的医生和患者代表。在这个准备阶段，我们还将花时间完成主要工作中最重要的问题（重点是弄清楚为什么过敏性疾病患者会有其他精神和身体状况），以及我们如何以最好的方式回答这些问题。在工作的主体（也称为“协作”补助金），我们将使用先进的统计技术来了解为什么常见的过敏性疾病与其他身心健康问题。我们将研究人们的环境和生活方式中的因素，或者医生用于治疗过敏性疾病的药物，看看这些因素是否可能在这些“集群”中发挥作用。这个合作项目将帮助我们摆脱医生一次只关注一个问题的做法，转向一种着眼于人们所有问题的方法，这种方法往往集中在一起。这种“联合”的思维将帮助我们更好地对待人们，并可能帮助我们避免未来的一些健康问题。

Multimorbidity is a term used to mean having two or more longterm physical or mental illnesses. Multimorbidity is important because it affects what happens to people throughout their life and how their doctors can treat them. Conditions which can be associated with allergy, such as asthma and eczema, are very common particularly in children and young adults (at least 1 in 5 children), and are known to have major effects on quality of life and costs to the NHS. Previous work has shown people with allergic diseases are at risk of lots of different mental and physical health problems (multimorbidity), possibly due to their allergic disease. We don't yet understand how these diseases group together ("cluster") and why they occur. Our work will help us understand how and why allergic diseases are associated with other mental and physical illnesses (multimorbidity) in order to work out how to treat people with allergic diseases better. In this preparatory phase (also called a consolidator grant), we will first explore how allergic diseases occur in groups together with multiple other medical and psychiatric conditions and how these "clusters" develop over time. Some of these "clusters" will include conditions we already know can be associated with allergic diseases, but we also expect that we might find new associated diseases. We will do this analysis using data collected as part of usual healthcare, which has been stripped of identifiers (e.g., names). We have data collected on large numbers of people (for example 500,000 adults with eczema) over long periods of time with information about health issues, medications, doctors' visits and whether people smoke or drink alcohol. This work will be complex, so we will need to run workshops involving different kinds of experts, such as data scientists, statisticians, doctors who treat patients with allergic diseases, and patient representatives. In this preparation phase, we will also spend time finalising the most important questions for the main body of work (focusing on working out why people with allergic diseases have other mental and physical conditions) and how we can answer those questions in the best possible way. In the main body of work (also known as a "collaborative" grant), we will use advanced statistical techniques to understand why common allergic disorders are associated with other physical and mental health problems. We will look at factors in people's environment and lifestyle, or medications that doctors use to treat allergic conditions to see if these might play a role in these "clusters". This collaborative programme will help us move away from doctors focusing on only one problem at a time, to an approach that looks at all of the problems that people have that tend to cluster together. This "joined up" thinking will help us treat people better and might help us avoid some of those health problems in future.