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. 2022 Oct 17;6(2):e37437.
doi: 10.2196/37437.

Digital Health Solutions to Reduce the Burden of Atherosclerotic Cardiovascular Disease Proposed by the CARRIER Consortium

Bart Scheenstra  1   2 , Anke Bruninx  3 , Florian van Daalen  3 , Nina Stahl  4 , Elizabeth Latuapon  5 , Maike Imkamp  6 , Lianne Ippel  7 , Sulaika Duijsings-Mahangi  7 , Djura Smits  8 , David Townend  4 , Inigo Bermejo  3 , Andre Dekker  3 , Laura Hochstenbach  9   10 , Marieke Spreeuwenberg  10 , Jos Maessen  1   2 , Arnoud van 't Hof  2   11   12 , Bas Kietselaer  2   11
Affiliations

Digital Health Solutions to Reduce the Burden of Atherosclerotic Cardiovascular Disease Proposed by the CARRIER Consortium

Bart Scheenstra et al. JMIR Cardio. .

Abstract

Digital health is a promising tool to support people with an elevated risk for atherosclerotic cardiovascular disease (ASCVD) and patients with an established disease to improve cardiovascular outcomes. Many digital health initiatives have been developed and employed. However, barriers to their large-scale implementation have remained. This paper focuses on these barriers and presents solutions as proposed by the Dutch CARRIER (ie, Coronary ARtery disease: Risk estimations and Interventions for prevention and EaRly detection) consortium. We will focus in 4 sections on the following: (1) the development process of an eHealth solution that will include design thinking and cocreation with relevant stakeholders; (2) the modeling approach for two clinical prediction models (CPMs) to identify people at risk of developing ASCVD and to guide interventions; (3) description of a federated data infrastructure to train the CPMs and to provide the eHealth solution with relevant data; and (4) discussion of an ethical and legal framework for responsible data handling in health care. The Dutch CARRIER consortium consists of a collaboration between experts in the fields of eHealth development, ASCVD, public health, big data, as well as ethics and law. The consortium focuses on reducing the burden of ASCVD. We believe the future of health care is data driven and supported by digital health. Therefore, we hope that our research will not only facilitate CARRIER consortium but may also facilitate other future health care initiatives.

Keywords: ASCVD; CVRM; atherosclerotic cardiovascular disease; big data; cardiovascular risk management; clinical prediction models; digital Health; eHealth; federated data infrastructure; personalized e-coach.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
The 5 iterative phases of design thinking.
Figure 2
Figure 2
Proposed digital health solution.
Figure 3
Figure 3
Federated data infrastructure. GP: general practices; SN: Statistics Netherlands.
Figure 4
Figure 4
Homomorphic encryption of two fictive glucose levels.
See this image and copyright information in PMC

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