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

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.

Efficient Standard Errors in Item Response Theory Models for Short Tests.

In dichotomous item response theory (IRT) framework, the asymptotic standard error (ASE) is the most common statistic to evaluate the precision of various ability estimators. Easy-to-use ASE formulas are readily available; however, the accuracy of some of these formulas was recently questioned and new ASE formulas were derived from a general asymptotic theory framework. Furthermore, exact standard errors were suggested to better evaluate the precision of ability estimators, especially with short tests for which the asymptotic framework is invalid. Unfortunately, the accuracy of exact standard errors was assessed so far only in a very limiting setting. The purpose of this article is to perform a global comparison of exact versus (classical and new formulations of) asymptotic standard errors, for a wide range of usual IRT ability estimators, IRT models, and with short tests. Results indicate that exact standard errors globally outperform the ASE versions in terms of reduced bias and root mean square error, while the new ASE formulas are also globally less biased than their classical counterparts. Further discussion about the usefulness and practical computation of exact standard errors are outlined.

A Privacy-Preserving Infrastructure for Analyzing Personal Health Data in a Vertically Partitioned Scenario.

It is widely anticipated that the use and analysis of health-related big data will enable further understanding and improvements in human health and wellbeing. Here, we propose an innovative infrastructure, which supports secure and privacy-preserving analysis of personal health data from multiple providers with different governance policies. Our objective is to use this infrastructure to explore the relation between Type 2 Diabetes Mellitus status and healthcare costs. Our approach involves the use of distributed machine learning to analyze vertically partitioned data from the Maastricht Study, a prospective population-based cohort study, and data from the official statistics agency of the Netherlands, Statistics Netherlands (Centraal Bureau voor de Statistiek; CBS). This project seeks an optimal solution accounting for scientific, technical, and ethical/legal challenges. We describe these challenges, our progress towards addressing them in a practical use case, and a simulation experiment.