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

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Simon DS Fraser, Sebastian Stannard, Emilia Holland, Michael Boniface, Rebecca B Hoyle, Rebecca Wilkinson, Ashley Akbari, Mark Ashworth, Ann Berrington, Roberta Chiovoloni, Jessica Enright, Nick A Francis, Gareth Giles, Martin Gulliford, Sara Macdonald, Frances S Mair, Rhiannon K Owen, Shantini Paranjothy, Heather Parsons, Ruben J Sanchez-Garcia, Mozhdeh Shiranirad, Zlatko Zlatev, Nisreen Alwan
Format: Article
Language:English
Published: SAGE Publishing 2023-09-01
Series:Journal of Multimorbidity and Comorbidity
Online Access:https://doi.org/10.1177/26335565231204544
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846157906537349120
author Simon DS Fraser
Sebastian Stannard
Emilia Holland
Michael Boniface
Rebecca B Hoyle
Rebecca Wilkinson
Ashley Akbari
Mark Ashworth
Ann Berrington
Roberta Chiovoloni
Jessica Enright
Nick A Francis
Gareth Giles
Martin Gulliford
Sara Macdonald
Frances S Mair
Rhiannon K Owen
Shantini Paranjothy
Heather Parsons
Ruben J Sanchez-Garcia
Mozhdeh Shiranirad
Zlatko Zlatev
Nisreen Alwan
author_facet Simon DS Fraser
Sebastian Stannard
Emilia Holland
Michael Boniface
Rebecca B Hoyle
Rebecca Wilkinson
Ashley Akbari
Mark Ashworth
Ann Berrington
Roberta Chiovoloni
Jessica Enright
Nick A Francis
Gareth Giles
Martin Gulliford
Sara Macdonald
Frances S Mair
Rhiannon K Owen
Shantini Paranjothy
Heather Parsons
Ruben J Sanchez-Garcia
Mozhdeh Shiranirad
Zlatko Zlatev
Nisreen Alwan
author_sort Simon DS Fraser
collection DOAJ
description 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.
format Article
id doaj-art-bcab6518375d40b2be0adf70b50e44bf
institution Kabale University
issn 2633-5565
language English
publishDate 2023-09-01
publisher SAGE Publishing
record_format Article
series Journal of Multimorbidity and Comorbidity
spelling doaj-art-bcab6518375d40b2be0adf70b50e44bf2024-11-25T00:03:45ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652023-09-011310.1177/26335565231204544Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaborationSimon DS FraserSebastian StannardEmilia HollandMichael BonifaceRebecca B HoyleRebecca WilkinsonAshley AkbariMark AshworthAnn BerringtonRoberta ChiovoloniJessica EnrightNick A FrancisGareth GilesMartin GullifordSara MacdonaldFrances S MairRhiannon K OwenShantini ParanjothyHeather ParsonsRuben J Sanchez-GarciaMozhdeh ShiraniradZlatko ZlatevNisreen AlwanBackground 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.https://doi.org/10.1177/26335565231204544
spellingShingle Simon DS Fraser
Sebastian Stannard
Emilia Holland
Michael Boniface
Rebecca B Hoyle
Rebecca Wilkinson
Ashley Akbari
Mark Ashworth
Ann Berrington
Roberta Chiovoloni
Jessica Enright
Nick A Francis
Gareth Giles
Martin Gulliford
Sara Macdonald
Frances S Mair
Rhiannon K Owen
Shantini Paranjothy
Heather Parsons
Ruben J Sanchez-Garcia
Mozhdeh Shiranirad
Zlatko Zlatev
Nisreen Alwan
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
title Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration
title_full Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration
title_fullStr Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration
title_full_unstemmed Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration
title_short Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) – protocol for a research collaboration
title_sort multidisciplinary ecosystem to study lifecourse determinants and prevention of early onset burdensome multimorbidity meld b protocol for a research collaboration
url https://doi.org/10.1177/26335565231204544
work_keys_str_mv AT simondsfraser multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT sebastianstannard multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT emiliaholland multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT michaelboniface multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT rebeccabhoyle multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT rebeccawilkinson multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT ashleyakbari multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT markashworth multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT annberrington multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT robertachiovoloni multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT jessicaenright multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT nickafrancis multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT garethgiles multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT martingulliford multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT saramacdonald multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT francessmair multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT rhiannonkowen multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT shantiniparanjothy multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT heatherparsons multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT rubenjsanchezgarcia multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT mozhdehshiranirad multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT zlatkozlatev multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration
AT nisreenalwan multidisciplinaryecosystemtostudylifecoursedeterminantsandpreventionofearlyonsetburdensomemultimorbiditymeldbprotocolforaresearchcollaboration