University of Cambridge

3

Lois Kim

CCU092

Many public health policies (i.e. decisions relating to healthcare for the whole population) could be altered to improve health outcomes, value for money, or both. For example, in heart disease we could change the timing or frequency of risk assessments. In England, statin medicine to help lower cholesterol is offered if the risk of heart disease is high, but for some people it could be better to do this earlier. There are many possibilities and it is not ethical or practical to conduct multiple clinical trials to find the best strategy. Instead, computer modelling can be used to simulate what might happen given different decisions for assessment and treatment. In the light of the impact of COVID19 on both cardiovascular disease risk and overall service burden, it is particularly important that cardiovascular risk assessment and intervention strategy is re-evaluated and optimised, including consideration of the impact of COVID19-related inequalities on outcomes. We will develop a computer model for the progression of heart disease risk, using information from the CVD-COVID-UK database to estimate rates of significant health issues such as diabetes. We will include information about age, sex, ethnicity and risk factors such as smoking and blood pressure. We will check how our model performs against real data, and if successful, use it to evaluate the health outcomes and costs of different public health policies, including: (1) the current England policy offering treatment to people at high risk of heart disease, (2) varying the definition of high risk according to age, and (3) treating people based on their age. We will further conduct a range of analyses relating to inequalities, including (1) exploring whether pre-existing inequalities in assessment and management of heart disease have been exacerbated post-COVID19, and (2) exploring the impact of policy changes on inequalities.

This work will benefit the public and patients through: • Identifying policies that reduce heart disease by improving early detection and treatment. • Encouraging policy change by providing the cost estimates needed by decision-makers. • Identifying the extent to which COVID19 has impacted inequalities in assessment and management of cardiovascular disease. • Enabling policies to be identified that reduce differences in health outcomes according to factors associated with inequalities such as sex, ethnicity and region. • Enabling future advances in genetics and other measurements to be rapidly tested and put into practice.

03/09/2024

02/09/2025

20/12/2024

De-Personalised

20/12/2024

TRE