What’s next for nzRISK?

Landscape image of Luke Boyle, Kevin Ross and Doug Campbell with the Hi-Tech Award

What’s next for nzRISK?

With the kick-off event for the 2021 Hi-Tech Awards held last week, it was an opportunity to remind ourselves of the fantastic work of the individuals, companies and organisations who were recognised in 2020, while looking to the future.

Precision Driven Health (PDH) was incredibly proud to win the 2020 Visa Best Hi-Tech Solution for the Public Good for its work on nzRISK, a freely available surgical risk calculator. Since then, the team – including data scientist Luke Boyle and anaesthetist Dr Doug Campbell – have not been resting on their laurels; instead they are continuing their work to broaden the scope of the surgical risk calculator and make it accessible for a wider population of New Zealanders. So, what’s next for nzRISK?

While the nzRISK project was particularly recognised for its application to non-cardiac surgery, the team has been developing and validating specialised models for additional high-risk procedures, such as neurosurgery and vascular surgery.

The neurosurgery model was published in Neurosurgery in May 2020, demonstrating a robust, multivariate calculator validated for the New Zealand population and requiring only eight readily available predictors that surgeons and anaesthetists can use to generate data-driven individualised risk estimates for their patients. The vascular model was published in the European Journal of Vascular & Endovascular Surgery in January 2021, again demonstrating a simple and accurate multivariable risk calculator validated using the New Zealand national dataset, with excellent discrimination and calibration for 30-day, one-year, and two-year mortality.

Orion Health data scientist Luke Boyle and Dr Doug Campbell were joined by anaesthetists Dr Stephanie Clark, Dr Caroline Deng and Dr Jee-Young Kim, as well as neurosurgeons Dr Phoebe Matthews and Dr Patrick Schweder and vascular surgeon Dr Manar Khashram, to develop and validate the models. Luke says collaboration is key to the models’ success.

The team has grown to include specialists in each of these high-risk surgical specialties to be sure that the models reflect robust clinical practice.

Luke Boyle, Data Scientist, Orion Health

“With this collaborative approach the multi-disciplinary team continues to output high-quality work that will benefit patients in New Zealand,” says Luke.

Not settling for the models only being applicable to an adult population, the core nzRISK team has a roadmap for their work, with the next step being to develop a paediatric model. Currently nzRISK is limited to use on patients who are over 18, but this doesn’t account for the roughly 80,000 surgeries performed each year on children and young people under 18.

“People under 18 often have different risk profiles than adults and may also undergo different operation types than those older than them. It makes sense, therefore, that they need a tool tailored to their needs,” explains Luke.
 

The neurosurgery, vascular surgery and paediatric models will all be incorporated into nzRISK and made freely available on the nzRISK.com website. The team is looking forward to ‘nzRISK 2.0’ being available in early 2022.

“People having surgery with special risk profiles, such as people undergoing high-risk surgeries or people under 18, will be asked a few extra questions and then get access to extended risk calculators tailored to them.

“Once nzRISK 2.0 is live everyone in New Zealand will continue to be able to freely access the risk assessment information they need for making informed decisions, says Luke.

Stay tuned for the sequel, nzRISK 2.0!