REDUCE-HF, an Electronic Health Records study in OpenSAFELY: Using big data, machine learning and community co-production to reduce inequalities in the primary care diagnosis of heart failure

PI Title: Clare Goyder

Co-PI: Emily McFadden

Lead member: Oxford

Some people are healthier than others because of things like where they live, how much money they have or the healthcare they get. This is unfair. Everyone should have the same chance to be healthy and get good NHS care. One way to help is by finding health problems early so treatment can start sooner. This is particularly important for General Practitioners (GPs), the
first doctors people usually see.
Heart failure (HF) happens when the heart cannot pump blood properly. This can make people tired and have trouble breathing. Around 65 million people are living with HF worldwide, including one million in the UK. It is a common reason why people go into hospital or die. The best way to help is to find and treat HF early, when medicines work best. But most people
are only diagnosed when they are unwell and need emergency hospital care. This happens more to women, people with long-term illnesses (like lung disease), and those from poorer backgrounds. However, no research has looked at how these things combine to increase the risk of hospital diagnosis.

When people visit their GP, information collected as part of their care, goes into electronic health records (EHRs). EHRs can be used by researchers to improve the care of future patients. We will use EHRs to find out who is most at risk of hospital HF diagnosis by describing how different factors like having long-term illnesses or learning disabilities, or being from different ethnicities, social backgrounds and geographical areas, change HF risk when combined together. We will find out if people had a HF blood test at their GPs and how often they have NHS appointments. We will combine all this information to develop a “risk prediction tool” (like a calculator) for doctors to find which of their patients have a high risk of hospital HF diagnosis, so they can help them to avoid this.
Patients, carers, doctors, researchers and community groups will work together. Patients from different backgrounds have already shaped this project and will continue to help us focus on what matters to them. Together, we will create a video, explaining why early HF diagnosis matters, who is most at risk of hospital diagnosis, and what they can do about this.
Together, we will also design how a follow-up project using new technology to diagnose HF could help the people that need this the most.
Findings from this study will improve current guidance for doctors and will lead to working with technology companies to develop new solutions. Early GP diagnosis of HF matters because it can help people live longer, healthier lives, reduce the need for people to go into hospital and save the NHS money.