School of Population Health


VIEW research

Research objectives

  • Develop and disseminate accurate risk prediction tools to identify New Zealanders at high CVD risk
  • Quantify evidence-practice gaps and disparities in CVD and diabetes risk profiles, in appropriate CVD and diabetes risk management and in CVD burden in New Zealand and map these data in an interactive vascular atlas
  • Model interventions (in whom/where/when) that are likely to have the greatest impact on improving equity in vascular outcomes

 

Research streams

  • PREDICT: PREDICT is a clinical decision-making tool used during primary care patient consultations. It provides a predicted 5-year risk of a new CVD event, recommendations for patient care, and patient advice that can be printed or emailed directly to the patient. PREDICT data are stored both in the patient’s electronic medical record held by their GP and on secure web servers operated by Enigma Solutions Ltd who developed the software in partnership with University of Auckland researchers. The data are unidentifiable and not available to anyone, including VIEW researchers, without permission from the patient's health provider and national ethical approval. At the University, VIEW researchers link these data to national health datasets (mortality, hospitalisations, drug prescribing, laboratory test claims and Primary Health Organisation enrolment) and regional datasets (Auckland laboratory test results). The linked data make up the PREDICT cohort study. This large, and growing, cohort has been used to develop New Zealand-specific risk prediction tools and assess the quality of CVD and diabetes care for patients. New CVD risk prediction equations, developed by the VIEW team were published in the Lancet in 2018 (Pylypchuk R, et al. Cardiovascular disease risk prediction equations in 400 000 primary care patients in New Zealand: a derivation and validation study. 2018:391 (10133):1897-1907). 
  • ANZACS-QI: The All New Zealand Acute Coronary Syndromes Quality Improvement (ANZACS QI) registry was set up in 2012 and is includes all patients admitted to hospitals in New Zealand with ACS. The research goal is to develop risk prediction tools that can inform inpatient and post-discharge care of ACS patients who are responsible for a disproportionate burden of cardiovascular disease. It is funded by the Ministry of Health and is a collaboration between cardiologists from each District Health Board, the National Cardiac Network, the New Zealand Cardiac Society and the University of Auckland VIEW research team. ANZACS-QI project management, data management and research support is provided by the National Institute for Health Innovation and the software is licenced and supported by Enigma Solutions.
  • VARIANZ National Cohort Studies (VAscular Risk in Adult New Zealanders): This national cohort is based on linking routinely collected national data including hospitalisations, mortality, pharmaceutical dispensing, laboratory utlisation and PHO enrolment, using the National Health Index (NHI). VARIANZ is a ‘health contact’ cohort because it is dependent on a person having contact with the NZ health service and this contact being recorded in a routinely collected national database.
  • New Zealand Vascular Atlas: This is an interactive online atlas which allows the user to explore patterns of vascular health outcomes and determinants, as geographic maps, graphs or tables. It was based on a new national ‘cohort’ which combines national and regional routine health databases, the 2013 Census or the Integrated Data Infrastructure. This national cohort is linked to the PREDICT Primary Care Cohort and the ANZACS QI register using nationally agreed encryption protocols. We have developed a series of interactive atlases of CVD outcomes and associated risk factors by District Health Board for the whole country. View interactive online atlases.

 

Funding

VIEW research is mainly funded by the Health Research Council of New Zealand with grants also from the National Heart Foundation of New Zealand, the University of Auckland, the Ministry of Health, Waitemata DHB, Counties Manukau DHB, ProCare Health and PHARMAC. The PREDICT software was developed, and is supported, by Enigma Solutions Ltd, a New Zealand health informatics company that is funded through licenses with user organisations such as DHBs.