Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration

Fraser, S. D.S. et al. (2023) Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration. Journal of Multimorbidity and Comorbidity, 13, (doi: 10.1177/26335565231204544) (PMID:37766757) (PMCID:PMC10521301)

Abstract

Background: Most people living with multiple long-term condition multimorbidity (MLTC-M) are under 65 (defined as ‘early onset’). Earlier and greater accrual of long-term conditions (LTCs) may be influenced by the timing and nature of exposure to key risk factors, wider determinants or other LTCs at different life stages. We have established a research collaboration titled ‘MELD-B’ to understand how wider determinants, sentinel conditions (the first LTC in the lifecourse) and LTC accrual sequence affect risk of early-onset, burdensome MLTC-M, and to inform prevention interventions. Aim: Our aim is to identify critical periods in the lifecourse for prevention of early-onset, burdensome MLTC-M, identified through the analysis of birth cohorts and electronic health records, including artificial intelligence (AI)-enhanced analyses. Design: We will develop deeper understanding of ‘burdensomeness’ and ‘complexity’ through a qualitative evidence synthesis and a consensus study. Using safe data environments for analyses across large, representative routine healthcare datasets and birth cohorts, we will apply AI methods to identify early-onset, burdensome MLTC-M clusters and sentinel conditions, develop semi-supervised learning to match individuals across datasets, identify determinants of burdensome clusters, and model trajectories of LTC and burden accrual. We will characterise early-life (under 18 years) risk factors for early-onset, burdensome MLTC-M and sentinel conditions. Finally, using AI and causal inference modelling, we will model potential ‘preventable moments’, defined as time periods in the life course where there is an opportunity for intervention on risk factors and early determinants to prevent the development of MLTC-M. Patient and public involvement is integrated throughout.

• Item Type: Articles
• Additional Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute for Health Research(NIHR) under its Programme Artificial Intelligence for Multipleand Long-Term Conditions (NIHR203988).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Enright, Dr Jessica and Mair, Professor Frances and Macdonald, Professor Sara
• Authors: Fraser, S. D.S., Stannard, S., Holland, E., Boniface, M., Hoyle, R. B., Wilkinson, R., Akbari, A., Ashworth, M., Berrington, A., Chiovoloni, R., Enright, J., Francis, N. A., Giles, G., Gulliford, M., Macdonald, S., Mair, F. S., Owen, R. K., Paranjothy, S., Parsons, H., Sanchez-Garcia, R. J., Shiranirad, M., Zlatev, Z., and Alwan, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Science and Engineering > School of Computing Science
• Journal Name: Journal of Multimorbidity and Comorbidity
• Publisher: SAGE Publications
• ISSN: 2633-5565
• ISSN (Online): 2633-5565
• Copyright Holders: Copyright © The Author(s) 2023
• First Published: First published in Journal of Multimorbidity and Comorbidity 13:26335565231204544
• Publisher Policy: Reproduced under a Creative Commons licence