DOCUMENT

In order to upgrade the existing algorithm, Valery and his team will need to analyse additional data. The tool’s algorithms were originally based on broad international studies like the Framingham Heart Study, a long-term, US- based multigenerational study of cardiovascular disease. “So the unique health challenges faced by New Zealanders, especially among Māori and Pacific communities, haven’t been reflected,” he explains. His team plans to use data collected from general practitioners and public health organisations across the country. Initially, they’ll use modelling tools to assess risk. Valery says the Neurological Foundation grant is critical for this part of the study. They then plan to validate the findings using a New Zealand study population. The end goal is to have a revised app that will offer more accurate risk assessments based on ethnicity and socio- economic variables – a meaningful step towards addressing the current stark inequities in health outcomes. “Each ethnicity will have its own estimated coefficients, allowing for appropriately-tailored recommendations for stroke prevention,” Valery says. He hopes this will not just halt the rising stroke rates, but will reverse them. Dr Michael Kravchenko, a neurologist and Senior Research Fellow at AUT, is working with Valery, Dr Bala Nair and Professor Rita Krishnamurthi on various digital technologies to improve stroke and other non- communicable disease prevention. He says clinicians have a vital role to play – they can help motivate a patient and ensure they receive expert advice in understanding their own estimated risk, and they can also provide follow-up care. For that reason, the project will include devising a desktop application for clinicians to use. For example, PreventS-MD, a software for stroke and other non-communicable diseases prevention, will be integrated with outpatient and hospital management systems. It will also be available via community health providers and pharmacies, to open as many doors as possible to what Michael calls the preventive ecosystem. He believes it’s essential because changing behaviour is the most challenging task of all – and yet, the biggest opportunities lie in preventing the disease in the first place. “Prediction is not prevention,” he says. “Just knowing the risk is not enough. That’s why we’re paying a lot of attention to things like diet, physical activity and other important lifestyle factors.” The tool will help clinicians and patients develop a bespoke plan for each individual based on their own risk factors and preferences, making it easy to track people’s choices. Michael calls this “guided prevention.” He says the Stroke Riskometer and PreventS-MD won’t replace clinicians, but rather will act as a helpful assistant for them. “We have choices every day, so we can do prevention every day. It’s not a one-time thing – it’s continual,” he says. He adds that family and loved ones have an important support role to play, too. From left to right: Brigitte van Gils, Sarah Bellairs, Shabnam Jalili-Moghaddam, Valery Feigin, Rita Krishnamurthi, Michael Kravchenko, Jesse Dyer, Devaki De Silva 8 Headlines