Projects Delivered

Edinburgh is a regional and national referral centre for patients with disease of the aorta, the main blood vessel carrying blood away from the heart. Patients being considered for surgery on the aorta undergo thorough assessment, because these operations come with significant risk. 

This project will use data collected routinely during these assessments and later clinical care to understand the complications faced by patients undergoing operations on the aorta. It will use the data collected during assessment for surgery to better understand the individual risk posed to patients.  

This information will allow healthcare professionals to make better decisions in planning patient care, and to better inform patients of the individual risks they face undergoing these complex operations. 

Complications such is lung clots and irregular heart rhythm have been reported both during the acute course of the COVID-19 infection and in the months following the infection. From previous research we know that these complications are also associated with other acute illnesses. Using data from hospital records we aim to evaluate and compare the rate of complications following confirmed COVID-19 infection and other acute illnesses requiring hospitalisation.

Liver, pancreas and bile duct (hepatopancreatobiliary) cancers are the third most common cause of death from cancer worldwide. In Scotland, the incidence of liver cancer alone has increased by 274% over the past 20 years, with 578 liver cancer deaths recorded in 2018. The reason for this increase is not clear. Liver, pancreas and bile duct cancers may develop in people who already have risk factors and therefore, we need to know who is most likely to develop these cancers. The purpose of this project is to identify which patient groups benefit from early detection of hepatopancreatobiliary cancers. We will use cutting-edge analytical techniques including machine learning to identify how we can predict and detect cancer far earlier. The analysis will support future projects using DataLoch’s high quality linked datasets aimed at prevention, early detection and treatment of liver, pancreas and bile duct cancers.

Survivors of cancer diagnosed when young show a substantial increase in the risk of dying during adult life when compared to the general population. Treatment for cancer can also leave long term health problems, including those that only come to light in later life.  There is currently insufficient research into the wider physical and mental health of childhood cancer survivors. This is despite these topics being ranked as top priority by survivors and their families in two recent UK-wide research priority setting exercises.  

The project responds to the increasing demand from the government, patients and their carers to quantify the impact of a childhood cancer diagnosis on later life. It makes use of recent NHS investment in electronic health data for research. The study will analyse data from the Scottish Cancer Registry linked with other routine health data. Statistical approaches and more sophisticated methods in network science will be used to understand which patients are at higher risk of long-term problems after treatment for their cancer. The research will form the basis of design recommendations for an NHS surveillance programme for survivors of childhood cancer.

Five people are diagnosed with Parkinson’s in Lothian each week, with 2,500 people living with the condition. There are four recognised stages of the condition: Diagnostic, maintenance, complex and palliative, with the latter stage lasting up to 2.2 years. As the disease progresses, the medications for it become less effective, and non-movement manifestations of the condition (continence issues / psychiatric changes / dementia) become more prevalent. In the later stages, standard medication for Parkinson’s becomes less effective and may be reduced or withdrawn. We kept a record of all people with Parkinson’s in Lothian dying since 2019, and wish to examine the cause(s) of death from the death certificates, and correlate these with the stage and duration of the disease. By doing so, we aim to better identify the trajectory of illness and how best, and when, to intervene to ensure that the palliative stage of the disease is optimised for the patient. 

When the heart is damaged troponin is being released in the bloodstream. High-sensitivity troponin tests measure the troponin level in the blood and are the preferred choice for the diagnosis of a heart attack. In clinical practice either a high-sensitivity troponin I or T test is being used. They are both recommended in current guidelines, but limited data is available about the agreement between the diagnostic cut offs of high-sensitivity troponin I and T.  

NHS Lothian hospitals are scheduled to change from a high-sensitivity troponin I to a T test. As part of this process, it is standard laboratory practice for NHS Lothian to verify the performance of the new test. Therefore, we will evaluate in patients who present at the Emergency Department with a suspicion of a heart attack whether the diagnostic cut offs of troponin I and T will identify the same patients for having a heart attack.  

Hip fractures are an unfortunately common injury, particularly affecting older people. Over 1,200 cases are managed in the Royal Infirmary of Edinburgh each year, and these numbers are rising. Most people receive an operation to fix their hip fracture, but the road to recovery is often long and fraught with difficulty for the frailest patients. Sadly, many people develop new disability after hip fracture, and up to 1 in 4 have died within a year. In this study, we want to better understand which patients are at risk of harms and decline after hip fracture, and use data to develop prediction tools to help identify this group earlier in their recovery. To do this, we will combine audit data from the national Scottish Hip Fracture Audit, with local Lothian data from primary and secondary healthcare records. We will be able to look at longer term outcomes than are currently available in the national audit, which stops after 60 days of care. If our prediction tools are successful, we would work with NHS Lothian to provide these to clinicians early in a patient’s hip fracture admission, to help target high-intensity care and monitoring to those at the highest risk of decline.

The aim of this study is to produce a validated model which will predict the risk of caesarean section in women undergoing IOL for the UK population. Such a model will be valuable in counselling patients undergoing or considering induction of labour.