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.

An Improved Infrastructure for Privacy-Preserving Analysis of Patient Data.

Incorporating healthcare data from different sources is crucial for a better understanding of patient (sub)populations. However, data centralization raises concerns about data privacy and governance. In this work, we present an improved infrastructure that allows privacy-preserving analysis of patient data: vantage6 v3. For this new version, we describe its architecture and upgraded functionality, which allows algorithms running at each party to communicate with one another through a virtual private network (while still being isolated from the public internet to reduce the risk of data leakage). This allows the execution of different types of algorithms (e.g., multi-party computation) that were practically infeasible before, as showcased by the included examples. The (continuous) development of this type of infrastructure is fundamental to meet the current and future demands of healthcare research with a strong emphasis on preserving the privacy of sensitive patient data.