Supervisory team
LSHTM
- Dr. Anoop Shar (Anoop.Shah@lshtm.ac.uk, Faculty of Epidemiology and Population Health)
- Dr. Poppy Mallinson (Poppy.Mallinson1@lshtm.ac.uk)
- Prof. Sanjay Kinra (Sanjay.Kinra@lshtm.ac.uk)
Nagasaki University
Lead: Dr. Hirotomo Yamanashi (yamanashi@nagasaki-i.ac.jp)
Project
In global rapid aging societies, aortic stenosis (AS) is expected to become more common. However, current estimates of its natural history and prevalence are based on historical studies with potential sources of bias and robust prevalence studies are conducted in the limited countries in Europe. According to the ACC/AHA guidelines for patients aged ≥ 80 years, transcatheter aortic valve implantation (TAVI) has become the first choice of treatment. So, TAVI is a promising treatment option for patients with older patients or in those who are high-risk or unsuitable for surgery.
However, to screen AS by echocardiography is not feasible, and we need no-invasive, no-time consuming, cost-effective tools, especially resource-limited settings. Stethoscopic phonocardiograph “Super StethoScope” is developed as a telemedicine-compatible stethoscope equipped with various vital sign measurement functions featuring aortic stenosis automatic diagnosis using Artificial Intelligence (AI) assist algorithm (AMI Inc., https://ami.inc/en). It has already obtained medical device approval in the Pharmaceuticals and Medical Devices Agency in Japan.
Our aim was to assess the feasibility to screen AS using this novel device, to clarify prevalence of AS, and to assess economic burden to detect TAVI candidates in the aged population in Japan.
Nagasaki Islands Study: In 2014, we launched a population-based prospective open-cohort study, the Nagasaki Islands Study (NaIS), which was conducted in Goto City, located in the remote islands of Nagasaki Prefecture, Japan, mostly involving middle-aged and older residents. We conducted our own health checkups along with the annual standardized checkups organized by the municipality; recruited study participants (~5000 people); and started to follow-up with them for vital status (death), migration, and occurrence of diseases such as myocardial infarction, stroke, fracture, and human T-cell leukemia virus type 1 (HTLV-1) -associated uveitis. (Miyata J, et al. Profile of Nagasaki Islands Study (NaIS): A Population-Based Prospective Cohort Study on Multi-disease. J Epidemiol. 2023) In the coming three years, we will screen ~1600 participants.
The project sites could expand to home care settings in Nagasaki City. Nagasaki university team is providing primary-care home care service in Nagasaki collaborating with Tanigawa Clinic (https://tanigawa.clinic), which carry on over 400 home care visits per month in the city. The clinic can routinely provide electrocardiogram and echocardiography examinations by echotechnician at home. The potential plan is to implement the stethoscopic phonocardiograph in the home care setting in Nagasaki City, too. The potential benefit to expand the stethoscopic phonocardiograph into the clinical settings are that it can allow us not only to detect AS, but also to assess chronic heart failure by using AI assist phonocardiograph data. It can detect symptomatic AS patients who need to be treated by TAVI.
The role of LSHTM and NU in this collaborative project
The supervisors are already collaborating well on cross-cohort research (see, Yamanashi H, et al. Association between atherosclerosis and handgrip strength in non-hypertensive populations in India and Japan. Geriatr Gerontol Int 2018; Yamanashi H, et al. Human T-cell lymphotropic virus type-1 infection associated with sarcopenia: community-based cross-sectional study in Goto, Japan. Aging (Albany NY). 2020).
NU supervisors will have a role on conducting on going NaIS cohort. LSHTM supervisors will provide a epidemiological advice. We will make the PhD student be treated as a core member of the research team and be involved in all aspects of the study including data collection and analysis. Based on the PhD student’s background and interests, we may identify an appropriate research topic within the overarching theme of cardiology and AI.
Particular prior educational requirements for a student undertaking this project
- A graduate degree in Public Health discipline with a strong component of epidemiology, biostatistics and health economics
- Verbal and written English proficiency
Skills we expect a student to develop/acquire whilst pursuing this project
- Research methods and epidemiology
- Management and analysis of large datasets
- Scientific communication and writing skills including paper and grant writing