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EVidenced based management of hearing impairments: Public health pΟlicy making based on fusing big data analytics and simulaTION.

Periodic Reporting for period 2 - EVOTION (EVidenced based management of hearing impairments: Public health pΟlicy making based on fusing big data analytics and simulaTION.)

Période du rapport: 2018-05-01 au 2020-01-31

Disabling hearing loss, according to the World Health Organization, affects 466 million people in the world and is predicted to rise to 900 million by 2050, unless action is taken. It is estimated that age-related and other hearing loss is the 4th most prevalent condition and 3rd leading cause of years lived with disability (YLD) in 2016.

Hearing loss may have a detrimental impact on life quality, and has huge socioeconomic costs, as it increases the risk of cognitive decline, mental illness and depression, and leads to social isolation, unemployment/early retirement and work discrimination. Robust public health methods are required to address hearing loss on a large scale throughout the world. Sound, evidence-based public health policy decisions are essential to develop and implement effective and cost-effective programmes.

Currently, the main intervention for hearing loss is the provision of hearing aids. However, despite accumulating evidence that hearing aids provide considerable benefits in many situations and indications that provision of hearing aids slows down cognitive decline, the treatment is considered costly. Thus, there is a need for increased integration of scientific evidence and policy making within this area of hearing health care.

The overall objective of EVOTION is the development of an integrated platform as shown in Figure 1, with components that enable public health policy makers to prepare policy proposals, simulate impact of policy proposals, and monitor implemented policies within the area of public hearing health policies. The objectives also include the development of decision and simulation models, a high-level language and transformation tool for specifying and implementing health policy decision making models on the platform, components for secure collection and processing of data, and finally to carry out technical, clinical, and policy evaluations of the platform.

The size and diversity of the collected data is significant, as it contains more than 60 Gb data, more than 200 parameters that can be utilized in the context of Workflow or Policy definition. The data collected through EVOTION activities includes personal health records via the clinical study and specific applications, real time HA-device data and audiometry mobile test data. The PHPDM Model Specification tool as an integrated part of the EVOTION platform that utilises platform’s underneath components to support the “evidence-informed health policymaking”, by allowing policy makers to back/evaluate their policy actions by concrete evidences derived from the collected data.
EVOTION collected requirements, designed the architecture, reviewed security, implemented the platform components for collecting data according to the architecture specifications and developed a novel specification language for the formulation of public health policy decision models (PHPDMs). EVOTION also developed a unified protocol for managing 1000 patients across the clinical sites in Greece, the UK and Denmark.

EVOTION completed the clinical study, the data was stored in the EVOTION Platform, and used in the development of the complex processing for analysis of static and dynamical data. In addition, the clinical activities included substantial follow up with patients to ensure that data collection was completed despite technical challenges with Android phones, Bluetooth, and coverage from mobile network providers.

EVOTION implemented the PHPDM specification tool, the PHPDM transformation tool, the Social Media component, and the Platform Dashboard. This ensured that the EVOTION Platform reached TRL-7. The platform components was also utilized to clean the data, specifying and implementing the PHPDM with the policy tools, and for developing the complex analytics for handling the data. All with the common goal to reach the objectives for EVOTION.

Policy making evaluation included stakeholder involvement with policy makers from local, regional, national, and international level in four workshops in UK, Croatia, Poland, and Bulgaria. This work also informed the planning and execution of the dissemination activities for EVOTION. Further, these activities impacted the planning and execution of the EVOTION technical, clinical, and policy making evaluations.

By use of the components in the integrated EVOTION platform the following was achieved:

Public health decision support simulated for real-life regional development policy-making and local data at one of the project partners (Pazardzhik Regional Administration) by means of the developed platform functionalities.

Findings from EVOTION appeared in 12 peer-review papers (6 journal publications and 6 Peer reviewed Conference proceedings) all available under open access all accessible via the EVOTION website and OpenAire. EVOTION was also presented in 40 presentations and 11 posters at international conferences. EVOTION also organized events with European citizens, e.g. by participating in a Pint of Science in UK and People’s Democratic Festival in Denmark.
EVOTION represents the largest ever research study of hearing problems with concurrent collection of dynamic data as part of the standard clinical pathway and with patients. The combination of the novel EVOTION PHPDM Language together with the platform’s implementation in standard clinical pathways enables EVOTION to a set a new standard for working with public hearing health policies based on big data. The socio-economic impact of hearing problems is currently undergoing intensive investigation as hearing problems become more widespread due to the increased life span, the effects of excessive noise, and increasing awareness of the size of the problem. The EVOTION platform and lessons learned from it and from its development are highly relevant for all such studies in the field of hearing problems as well as other chronic health areas.

The multi-focal actor approach in EVOTION, e.g. that the requirements of both patients and health care professionals are included in its architecture and design, which together with the feedback obtained to the analyses and outcomes, indicates that the EVOTION platform is very suitable for utilizing big data to support patients and health care professionals in an integrated manner whilst also enabling public health policy makers to make better, faster and more strongly evidence-based decisions. Thus, both by means of its design and its implementation, EVOTION brings patients, health care professionals, and public health policy makers closer together in a single platform, where each collected data point contributes with information for analysis at the personal level, clinical level, and the public policy making level.

This combination of contributions from EVOTION has e.g. enabled the assessment of impact of recent legislation for preventing noise induced hearing loss in France. In related work, the noise induced hearing loss modelling has been used to assess the impact on public health of public transport. Likewise, the work has been adopted by lobbyists at European and International level to provide WHO and its partners with evidence that can secure safe listening for citizens.
Figure 1: EVOTION platform