Cleveland Clinic and The MetroHealth System Receive Grant to Enhance Heart Disease Risk Calculators
$2.2 Million National Institute on Aging Award to Develop New Model Incorporating Environmental and Neighborhood-Level Characteristics
Following its study showing that current clinical prediction models underestimate cardiovascular risk in socioeconomically disadvantaged neighborhoods, a research team led by investigators from Cleveland Clinic and The MetroHealth System has been awarded a $2.2 million National Institute on Aging grant to reduce health disparities for patients at risk for heart disease.
The award supports the development of a comprehensive risk calculator that incorporates an individual’s clinical risk factors in addition to environmental and neighborhood-level characteristics to better predict major cardiovascular disease, such as stroke and heart attack. Current risk assessment tools rely on clinical indicators alone such as weight, age and smoking history, and do not consider factors associated with where patients live.
“Poorer Americans are more likely to suffer from heart attacks and stroke, and are expected to live 10 fewer years than wealthier Americans,” said Jarrod Dalton, Ph.D., of Cleveland Clinic’s Lerner Research Institute and co-primary investigator of the grant. “Accurate risk assessment is critical for identifying high-risk patients so that prevention strategies or targeted therapies can be used. We aim to understand better the complexity of residential, economic and clinical factors, and how they contribute to cardiovascular disease risk.”
The four-year grant is based on the team’s recently published paper in Annals of Internal Medicine analyzing electronic health data of nearly 110,000 Cleveland Clinic patients. The team found that current models severely underestimate risk in socioeconomically disadvantaged neighborhoods.
The study showed that in patients from poorer communities, major cardiovascular events occurred at more than twice the rates predicted by existing risk assessment tools. According to the researchers, socioeconomic inequalities in healthcare are complex and could be related to barriers such as environmental exposure to toxins, financial stress, less healthy eating options and lack of safe places to exercise.
To develop the statistical model, the team will establish a new combined research registry based on electronic health records of more than 200,000 Cleveland Clinic and MetroHealth patients. They will supplement that data with neighborhood-level information from the U.S. Census Bureau and other government organizations. They will overlay this data to build a new comprehensive, systems-based tool for risk prediction.
“Cardiovascular disease remains the leading cause of death for most Americans,” said MetroHealth’s Adam T. Perzynski, Ph.D., co-principal investigator. “Our collaboration on this project will help healthcare providers identify which of their patients could have poor heart disease outcomes. By incorporating non-clinical factors related to where people live, we can enhance personalized approach and target more effective interventions for specific subpopulations, and, ultimately reduce health disparities.”
The research team includes faculty from Case Western Reserve University School of Medicine and the Jack, Joseph and Morton Mandel School of Applied Social Sciences. The NIA grant number is R01AG055480.
The MetroHealth System, Cuyahoga County’s public health system, is honoring its commitment to create a healthier community by building a new hospital on its main campus in Cleveland. The building, and the 25 acres of green space around it, are catalyzing the revitalization of MetroHealth’s West Side neighborhood.
MetroHealth will break ground on the new hospital in late 2018, using nearly $1 billion it borrowed on its own credit after dramatically improving its finances. In the past five years, MetroHealth’s operating revenue has increased by 44.5 percent and its number of employees by 21 percent. Today, its staff of 7,700 provides care at MetroHealth’s four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. In the past year, MetroHealth has served 300,000 patients at more than 1.4 million visits in its hospitals and health centers, 75 percent of whom are uninsured or covered by Medicare or Medicaid.
The health system is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and the only adult and pediatric burn center in the state of Ohio.
As an academic medical center, MetroHealth is committed to teaching and research. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine and its main campus hospital houses a Cleveland Metropolitan School District high school of science and health.
For more information, visit metrohealth.org.