OPTIMAL research project

Doctors currently treat different diseases separately. They prescribe a different drug for each condition, which may not help people who have four or more complex multiple long-term conditions.

A medical treatment for one disease can make another disease worse or better, but there’s very little information on this. This means we are not sure which medical treatments will have the best outcomes for patients with multiple long-term conditions.

We can group such people based on their mixes of disease and study the effects of a medical treatment on each disease mix. 

This should help doctors prescribe medical treatments more efficiently, and that would benefit almost all people living with multiple long-term conditions.

Aims of OPTIMAL

• Find the mix of diseases and medical treatments that interact over time to worsen or improve a patient’s health
• Predict the next disease that people might develop
• Find medical treatments that help more than one disease
• With input from patient representatives and health professionals, produce computer programs to help doctors improve the choice of medical treatments in people with multiple long-term conditions

How will we do this?

1. Link large, detailed health records from a selection of patients who have attended GP services and hospitals since 2000.
2. Using artificial intelligence (AI) methods, model how the different mixes of diseases in these patients arise over time. The models will tell us which medical treatments cause /prevent a new disease, and predict who may be at risk of developing another disease soon.
3. Ask patient representatives and doctors about their views on using AI to guide clinical decisions. This will help us make the AI models better to use in practice.
4. Use AI computer techniques to combine data, and together with the input from patient representatives and doctors, develop a computer program. This will predict which medical treatment we should give and when, as well as what disease people may get next.
5. Examine the best way to present information in the computer program to patients, the public and doctors by finding out what is important to them and what options they prefer.

Our team includes patients, public members, and world leading experts from three universities with expertise in biology, AI, medicine, health service research, public health, and general practice.

University of Birmingham / University Hospitals Birmingham

• Dr Thomas Jackson - OPTIMAL Lead Applicant
• Professor Krishnarajah Nirantharakumar - OPTIMAL Joint Lead Applicant
• Dr Aditya Acharya – Research Fellow
• Dr Marco Canducci – Computer Science Research Fellow
• Dr Jenny Cooper – Academic Clinical Fellow
• Dr Francesca Crowe - Lecturer in Epidemiology and Health Informatics
• Professor Alastair Denniston - Consultant Ophthalmologist & Director of INSIGHT
• Dr Sarah Flanagan – Research Fellow
• Dr Suzy Gallier - Head of Informatics Research & Commercial Development 
• Professor Georgios Gkoutos - Chair of Clinical Bioinformatics
• Mr Krishna Gokhale – Health Informatics Research Fellow
• Dr Tiffany Gooden – Research Fellow
• Professor Sheila Greenfield – Professor of Medical Sociology
• Dr Shamil Haroon – Clinical Senior Lecturer
• Dr Ellie Hathaway – Academic Clinical Lecturer
• Dr Louise Jackson – Senior Lecturer
• Bob Jasper – Patient Co-applicant
• Dr Max Little – Senior Lecturer
• Professor Janet Lord CBE – Professor of Immune Cell Biology
• Professor Tom Marshall – Professor of Public Health & Primary Care
• Christine Michael – Patient Co-applicant
• Professor Elizabeth Sapey – Director of the Institute of Inflammation & Ageing
• Professor Peter Tino – Professor of Complex & Adaptive Systems
• Steven Wambua – PhD student

University of Oxford:

• Professor Christopher Yau – Professor of Artificial Intelligence
• Dr Charles Gadd – Research Associate
• Dr Kaspar Martens – Research Fellow

Univesity of St Andrews:

• Professor Colin McCowan – Professor in Health Data Science
• Dr Amaya Azcoaga-Lorenzo - Honorary Senior Lecturer
• Luciana Rocha Pedro – Research Fellow
• Muhammad Usman – Research Fellow

NHS Greater Glasgow & Clyde:

• Dr Chris Sainsbury – Consultant Physician, Diabetes & Endocrinology

MHRA CPRD:

• Dr Tim Williams – Head of Interventional Research
• Dr Puja Myles – Director of CPRD

Patient Advisory Group:

Our patient advisory group (PAG) consists of our 2 public co-applicants, plus 6 people with a range of diverse lived experiences of multiple long-term conditions, either managing their own conditions or supporting someone they are close to. Our PAG influences how the research is carried out across all work packages.

As the ageing population increases, larger numbers of older people will experience multiple long-term conditions which require medical treatment. 

A better understanding of how to manage these conditions with the best combination of medical treatments will help older people to manage their symptoms more effectively and improve their quality of life.

We hope that this work will mean that patients with multiple long-term conditions in the future receive the best possible combination of medical treatments.

Two Patient/Public partners have been involved with the development of the OPTIMAL programme from the application stage. Both partners attend regular management, executive and data meetings, as well as a Patient Advisory Group.

This project is funded by the National Institute for Health & Care Research (NIHR) under its Programme Artificial Intelligence for Multiple and Long-Term Conditions (NIHR202632). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

The OPTIMAL programme has received just under £2.5m in funding from the NIHR and will run until April 2025.

Public Involvement & Engagement enquiries: Leah Fitzsimmons (l.fitzsimmons@bham.ac.uk) 

Any other enquiries – optimal@contacts.bham.ac.uk 

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• Institute of Inflammation and Ageing (IIA) Twitter
  
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• NIHR Involvement Twitter
  
• AIM RSF glossary of terms