25 April 2019

Big data in healthcare

How can you further improve healthcare with the use of ‘big data’? That question is central to many scientific studies worldwide. Last month, two PhD candidates at Maastricht University defended their theses based on this same key question. They share a theme (cancer and big data), and a mission (to show that more is possible than what was previously thought). The rest of their stories show how big the world of big data really is.

Timo Deist

Analysing data from 20,000 patients

During Deist’s PhD, the network was expanded with hospitals in, for instance, the US, UK, China, Australia and Italy. For one of his studies, eight of these hospitals were connected with the network and the challenge then was to do an analysis on more than 20,000 patient samples in only three to four months. For a scientific study, that is quite a short time span. “It was about lung cancer. We collected tumour staging information of the patients and we built a prediction model to predict two years survival of patients, based on the tumour staging.”

“This is not just some crazy idea”

The goal of this study was to show that it’s possible to scale up to 20,000 patients and speed up scientific research this way, without the risk of data leaks for hospitals. “The technology is usable; it’s not just some crazy idea”, Deist says. “The technology I’ve helped create can be further developed for applications in medical practice. A PhD colleague built an interface for doctors to do fast queries in the databases to answer specific questions for their new patients.” For personalised medicine to become a reality, you need an understanding of lots of patient data and AI can help with that, Deist explains. “But you also need trust, from the participating hospitals and from doctors who have to rely on an algorithm. And since we are not computers, my supervisors have invested many years in that.”

Timo Deist obtained his PhD on 5 April 2019 with his thesis ‘Distributed learning and prediction modelling in radiation oncoloy’.


Parisa Kamali: big data essential for optimum care

Her frustration about the fact that as a doctor in training she could not distinguish a good from a bad scientific study led Parisa Kamali to the United States a few years ago. She would gain six months of experience in scientific research, but this led to an almost three-year stay at Harvard University and a PhD. She was a senior research fellow in the lab of Prof. Lin, supervised students from home and abroad, worked with inspiring people and developed a passion for big data. “As doctors, we’re not offering our patients optimal care if we’re not using big data”, she is convinced. In order to get her message across in the best way, after her PhD defence at UM she organised a symposium with all stakeholders based on the question: How can we further transform healthcare using big data?


Data in the US is more accessible (and there’s more of it)

Access to databases with patient information for scientific research is already somewhat further developed in the US than in the Netherlands. “In that the Dutch Elektronisch Patiëntendossier (Electronic Patient Record, EPD) is still relatively new and we do not yet work together very often to optimise care. In addition, you have much larger numbers in America, of course”, says Kamali. Determined and with a lot of trial and error, she familiarised herself with the world of big data research. She primarily studied the care given to women with breast cancer and in particular women who underwent breast reconstruction.

Complications do not appear to increase with age

More than 60% of women who get breast cancer are over the age of 60 and only 4% to 14% of them undergo breast reconstruction. Doctors think that the chance of complications is greater the older you are, and therefore don’t offer it as standard care. “In the database, we researched how many complications occur in each age category. This was found to remain the same across all ages, while the number of reconstructions decreases significantly as the patient’s age increases. The data actually support the message that as a doctor you should mainly look at the patient in front of you. One 60-year-old is not the same as another.”

With big data, the facts are there for the taking

Another notable finding from her thesis has to do with the use of innovative, more patient-friendly reconstruction techniques. It turns out that women with a higher income, from a wealthy region and with more expensive insurance, were offered this new technique more often than women with darker skin and a lower income. “Facts like that are there for taking in the data and you can use this to implement governmental policy to create more awareness among those involved.”

Experience from the work of an emergency room doctor

Because of her work at the Emergency Department, Kamali also clearly sees the importance of sharing patient records. She is regularly confronted with patients for whom no medical history is available, which often makes diagnosis difficult. Calling and faxing with other hospitals delays care provision unnecessarily, according to the young doctor. “We’re late to the game. To be able to offer optimal care to our patients, we have to take advantage of the digital revolution and steer it in the right direction. Sharing patient data nationwide, while still guaranteeing privacy, is part of that.”

Parisa Kamali Sadeghian obtained her PhD on 17 April 2019 with her thesis ‘Breast reconstruction: Trends and variation using big data’.

By: Femke Kools (text)