It’s generally accepted that the first five years of a person’s life are the biggest determinant as to how healthy they will be throughout their lives, but the greatest impact occurs in the first 13 months.
That’s according information cited in a clinical review of the Precision Driven Health Initiative – a private-public programme researching ways that machine learning and other data-driven applications can transform the delivery of healthcare.
As part of the research Dr Robyn Whittaker and Dr Kim Fong interviewed 25 clinicians and health experts around New Zealand to get their perspective on the Precision Driven Health partnership initiative. Every single one agreed that PDH research should aim to reduce inequities, protect the vulnerable, and prevent illness, and there is a fascinating range of suggestions – such as examining how PDH research can help ensure all babies and toddlers benefit from a healthy start to life.
They outlined three key demographics who could benefit most from precision health:
- Māori and Pacific people
- Those over 75 years old
- Children under five years old
There were also three key condition groups mentioned:
- Neuropsychiatric disorders
- Long term conditions like diabetes
- Multi-morbidities (having two or more chronic illnesses)
Despite oncology and cardiovascular diseases being two of the three major health concerns in New Zealand, those interviewed suggested that there is already plenty of research in these areas. It was mentioned however that PDH could assist with specific subgroup research, such as within the key demographics mentioned above.
Genetic testing was also touched on in the interviews. The consensus amongst clinicians is that steps should be taken to make genetic testing more accessible in this country, as it is becoming in the USA. It was noted that New Zealand researchers are already international leaders in the genetics of the form of inflammatory arthritis known as gout. We could expand on this within our unique population, leading the way towards Māori and Pacific disease profiling, mapping of genetic variants, and rheumatic fever research. The most cost-efficient research is considered to be Māori/Pacific genomic research, including pharmacogenomics, and more targeted screening (at population-wide and individual levels).
All the clinicians and health experts interviewed agreed that healthcare research in New Zealand had to be more pragmatic, with a specific practical clinical goal in mind. They also suggested we work “smarter” with the data we already have, improving care within existing pathways and systems. New Zealand could also learn from innovations in areas such as machine learning and pharmacogenomics.
PDH has the ability to offer to both clinicians and patients tailored, more precise risk/benefit information about their conditions and treatment options. This facilitates the end goal of patient-centred care.