2020s man (not to mention 2020s woman) has a problem.
Our bodies – and our genes – are not fit for our current, sedentary, inactive, calorie-dense lifestyles. We’re built to hunt and gather, forage and collect, in conditions that can be feast but are also very often famine.
How very unlike the high-fat, high-sugar, ultra-processed reality of much of the contemporary world, particularly “the West” and those – increasingly everyone – who eat a Western diet. A diet characterised by far too much high-fructose corn syrup (frankly, any amount of HFCS is too much), excessive calories, and refined carbohydrates, piled high and sold cheap in supermarkets everywhere.
The result? The Pixar villain, Metabolic Syndrome. A cluster of life-altering, life-shortening conditions brought on by weight gain (and so obesity), by insulin resistance, and by storage of fat in and around the liver. Syndrome manifests a cluster of diseases of our most vital organs – the heart and the whole cardiovascular system, the brain, the kidneys, and of course the liver.
Non-alcoholic fatty liver disease has historically been a bit of a Cinderella affliction. Despite its recent rebranding to Metabolic Dysfunction-Associated Steatotic Liver Disease (MALSD), it lacks the glamour of heart disease. It doesn’t attract the funding of cancer. And it doesn’t have the burning platform of dementia. But it’s reckoned that up to 14m Britons alone could be well on the way to this silent, usually symptomless, life-shortening disease which only makes itself known when it’s too late and the end is all-too-needlessly nigh. A disease that disproportionately affects the most deprived in society, who are three times more likely to be admitted to hospital with MALSD than the least deprived.
With our appetite for HFSS UPF unabating, what’s a healthcare system to do?
Please welcome to the stage Predictive Health Intelligence, a pioneering partnership of the Consultant Gastroenterologist (Tim Jobson), an NHS and healthcare data whizz (Neil Stevens), and Somerset NHS Foundation Trust. A few years ago, PHI developed from Tim’s brainchild into a practical reality – a delightfully-simple case-finding search tool for MALSD called hepatoSIGHTTM. PHI was given pump-prime funding by the National Institute for Health & Care Research to trial hepatoSIGHT in Somerset, looking for undiagnosed patients among the county’s 600,000 residents.
The trial was a huge success. By just (and I say “just”, but it’s been a labour of love, skill, and deft navigation of data compliance rules and regulations, and rightly so) applying hepatoSIGHT to historical blood test data on Somerset NHS databases, PHI has achieved remarkable things. It’s helped liver doctors identify more than 200 patients with rare and viral liver disease and more than 500 with progressive liver disease, avoiding dozens of transplants and cancers that would otherwise have happened. It has saved and prolonged lives.
Earlier this week, it was my enormous honour and pleasure to give the opening keynote at the South West NHS launch of hepatoSIGHT, talking about the real world impact of clear and simple data storytelling in preventive medicine. The very principles by which PHI is governed in everything it does with its radically impactful, case-finding search engine.
The launch makes this tool available to liver specialists covering six million Britons served by NHS Trusts across Cornwall, Devon, Dorset, Wiltshire, and Somerset – not forgetting Bristol, Gloucester, and the Scilly Isles. There’s now the potential that almost one in ten UK citizens will have their historical blood test data analysed by hepatoSIGHT and – if the areas under the curve are of concern like the real cases shown below – receive a letter from a liver expert, copied to their GP, asking them to come and see them.
In the Somerset trial, the great majority of patients reacted positively to “the doctor coming to them”. As well as reporting being (understandably) “nervous”, “concerned”, “worried”, and “shocked”, once they were seen and heard by liver experts, they were “grateful”, “interested”, felt “supported”, “optimistic”, and “happy”.
“I’m just surprised you weren’t doing this already!” said more than one. “After all, I gave you my blood …”
Indeed, caught early enough – as hepatoSIGHT has proved itself more than able to do already – MALSD is simple and cheap to treat, giving patients the chance to add years (sometimes decades) to their lives, halt the disease, re-enter the workforce, and play football with their grandchildren.
During COVID times, I worked with Tim, Neil, and the PHI team, to brand the company and the tool, and to create simple, straightforward language to describe what they do, how it works, and the benefits it brings. Our work together at that time brought light and hope to dark moments.
Coming back to the launch at Health Innovation South West earlier this week – to a room packed to the rafters with liver doctors, key NHS personnel with local, regional, and national responsibilities, the ever-growing PHI team, and most importantly of all real patients and patient advocates – brought a lump to the throat and a tear to the eye.
Your scribe with PHI’s Jobson and Stevens
What PHI has achieved already is remarkable, from its crystal-clear data storytelling to (rather more importantly) saving and prolonging lives, though the two are clearly connected. And all because of the idea that occurred to Tim – made real by Neil and PHI’s data and tech partners, Stalis – that it simply must be possible to join up the historic blood test data languishing in NHS records to identify those at risk of MALSD. As an early adopter from within the NHS said at this week’s launch, one of the reasons for hepatoSIGHT’s success so far is that “it’s as easy as using Airbnb or Right Move”.
What’s next? The rest of the country, other countries, the world. Not to mention other diseases and other organs ravaged by metabolic syndrome and our too-too-wrong diet – the heart, the circulatory system, the kidneys.
And all thanks to making smarter use of data.
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Tim was my guest on Data Malarkey – the podcast about using data, smarter – back in July 2023. Have a listen here, in an episode titled “How can smarter use of data mean that the doctor comes to you”.
