At the heart of Project Big Life are algorithms that predict the risk of developing diseases, dying, or using health care. There are three types of predictions at Project Big Life:
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"Unhealthy behaviours place a major burden on Canadian life expectancies," said lead author Dr. Doug Manuel, senior scientist at The Ottawa Hospital and professor at The University of Ottawa, and a senior core scientist at the Institute for Clinical Evaluative Sciences (ICES). "This study identified which behaviours pose the biggest threat."
Manuel’s team created the life-expectancy calculator as part of a 2012 report that found six out of 10 deaths in Ontario are linked to five controllable habits: smoking, alcohol consumption, physical inactivity, unhealthy eating and stress.
Nearly all Ontarians have at least one of these five unhealthy behaviours. If each Ontarian addressed at least one of these habits, the average life expectancy would increase by up to 3.7 years, Manuel concluded.
"People are interested in healthy living, but we don't often have that discussion in the doctor's office," says Dr. Manuel. "Doctors will check your blood pressure and cholesterol levels, but they don't necessarily ask about lifestyle factors that could put you at risk for a heart attack and stroke. We hope this tool can help people—and their care team—obtain better information about healthy living and options for reducing their risk of heart attack and stroke."
Cardiovascular disease, a group of conditions that include heart attack and stroke, is the number 1 killer in Canada. While risk calculators already exist, they usually focus on factors that require medical tests, like blood pressure and cholesterol levels.
Based on survey data from over 100,000 Canadians, the calculator lets individuals accurately predict their risk of hospitalization or death due to cardiovascular disease within the next five years. For example, if their risk is 5%, it means that five in 100 people like them will experience a serious cardiovascular event in the next five years. The calculator also provides heart age, an easy-to-understand measure of how healthy the heart is.
Factors in the Cardiovascular Disease Population Risk Tool (CVDPoRT) calculator include:
“When I asked the neurologist [at the time of] diagnosis… are we looking at one year, five years, ten years?... He couldn’t tell me. My mom’s been sick my whole life and that’s the first time that someone’s ever given me a predict[ion].” – Focus Group participant
RESPECT is short for Risk Evaluation for Support: Predictions for Elder-life in the Community Tool for the End of Life. RESPECT End-of-Life will be the first of a suite of tools that the team will develop for older people needing supports in their homes. Technically, it is a predictive algorithm that calculates your survival (that is, how long you will live) based on five to 25 questions you answer such as what diseases you have and how difficult it is to care for yourself.
Part of the challenge is talking about when a person will die. Dr. Amy Hsu, along with their colleagues from research institutions across Canada, have developed a web-based tool – the RESPECT End-of-Life calculator – specifically for this need. They are now refining and evaluating the tool before public release in Canada. This calculator identifies when a person may be nearing the end of life and provides information that helps to determine their care needs.
On average, Canadians consume 3,400 mg of salt every day, which is more than two times the recommended amount. Too much sodium can lead to high blood pressure and is a major factor for stroke, heart disease and kidney disease. High sodium intake has also been linked to an increased risk of osteoporosis, stomach cancer and severe asthma.
The salt calculator allows Ontarians to track how much salt they are eating and identify the main sources of sodium in their diet. The calculator, among the first of its kind in North America, was developed by analyzing the sodium levels of more than 20,000 grocery and restaurant foods and is based on Canadian eating patterns aand the most up-to-date data on sodium levels.
The calculator asks questions such as:
Dr. JoAnne Arcand, a nutritional scientist at Ontario Tech University created the sodium calculator with other colloborators on Project Big Life.