odsc hackathon for health october 2016

© Bill & Melinda Gates Foundation |

▪ Multiple variables may affect each outcome

▪ Relative impact of different variables may vary in different contexts

▪ It’s difficult to know how to intervene most effectively

5

These problems are extremely complex and affected by multiple, interrelated variables

© Bill & Melinda Gates Foundation | 7

HBGD is seeking the answers to five critical questions

Interaction Between Growth & Development Outcomes

Growth Outcomes Determinants

Pathways

1Can we quantitatively characterize the relation and interaction between preterm birth, physical growth, and brain development?

To what extent is growth faltering explained by pre- vs postnatal insults?

What kind of recovery can we expect in infants born small for gestational age (SGA)?

Are there disproportionately large contributions on growth faltering from certain pathways, and can we rank-order risk factors?

Are there specific pathways directly impacting linear growth faltering that coincide with increased risk of noncommunicable diseases such as cardiovascular disease, obesity, and diabetes?

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3

4

5


HBGDki is building a knowledge base to help answer the questions

Region No. of Studies No. of Subjects No. of Countries

United States 66 8,684,868 1

Asia/Pacific 33 590,641 7

Americas (except USA) 13 56,652 5

Africa 12 55,340 10

Europe/Middle East 7 111,952 2

Total 122* 9,499,453 25

*Total < sum of different regions because some studies spanned several regions.


HBGDki moves from data to discovery to decisions

KNOWLEDGE BASE

CAUSAL

POPULATION

EMPIRICAL

MECHANISTIC

NEW INSIGHTS

Multiple Modeling Methods

Data

Build a knowledge base of existing research data

Discovery

Apply multiple modeling methods to answer questions faster and deeper

Decisions

Inform comprehensive intervention decisions to prevent preterm birth, growth faltering, and neurocognitive deficits


▪ Nadir extremes: ▪ Fraction of children

below HAZ=-2 at nadir.

▪ Recovery age: ▪ Age (after nadir) at

which less than 10% of children are below HAZ=-2.

HBGDki analyses are already yielding new insightsA 600 gram difference in birth weight can cost ~8 years in growth recovery


HBGDki can help promote precision public health: the right intervention for the right child at the right time WHO

WHAT

WHEN

HOW

WHERE

Preterm, small for gestational age, growth faltering, and others

Nutrition, vaccines, sanitation, vector control, and others

Fetal growth and development, birth, and motor milestones

Preventive and/or therapeutic

Urban vs rural, wet vs dry, and others


Precision public health pinpoints the right dose to get the best response

max

min

Dose

Beneficial Childhood Response

Adverse Adult Response

Physical Growth

Diabetes Obesity Cardiovascular

too hightoo low optimal

min

max

Neurocognitive Development

odsc hackathon for health october 2016

Technology