Developing a risk profile for asthma readmission in children to allow targeted preventive management (Don Vicendese)

Developing a risk profile for asthma readmission in children to allow targeted preventive management (Don Vicendese)

Dr Don Vicendese University of Melbourne Dr Don Vicendese is a mathematician and an accredited statistician with the Statistical Society of Australia. He completed his PhD in 2015 on environmental impacts on child asthma hospitalization, for which he was awarded a Nancy Millis Medal. He is a Research Fellow at the Centre for Epidemiology and Biostatistics, in the Melbourne School of Population and Global Health at the University of Melbourne, and Adjunct Research Fellow with the School of Engineering and Mathematical Sciences at La Trobe University. He has received over $5Mil in funding from NHMRC Grants and has worked on projects to do with prediction of ambient pollen levels using satellite data, impact of early life exposures on allergy and asthma outcomes, bronchiectasis treatment and phenotypes, and individual risk prediction of COPD at middle age. Project Status: In progress, commenced 2023 Grant Type: Project grant

Readmissions to hospital for asthma have been increasing for children in Victoria. Whilst risk factors for readmissions to hospital have been identified, research has been based mainly on a ‘one size fits all’ approach. That is, that the impact of risk factors is, on average, the same for each child with asthma and independent of each other.

That’s why we are funding Dr Don Vicendese at the University of Melbourne to understand and develop a risk profile for readmission in children. This will help us to produce a model to take a targeted approach to reduce the risk of children going to hospital again.

About the research

Every child has their own individual story of living with asthma. Therefore, the research team thinks that there are likely a distinct number of broad patterns that can typify the experiences of children living with asthma.

The research team will use a statistical modelling technique called ‘Latent Class Analysis’ to identify subgroups of children, or subtypes, based on these broad patterns. Each of these groups will have a distinct combination of factors that will holistically characterise their experiences of living with asthma.

To do this the team will use data that has already been collected from 767 Victorian children. This includes information from the hospital, GP, caregiver, MBS and PBS about the child’s asthma control and management, comorbidities, hospitalisations, medications, and environmental risk factors.

The research team will also use this analysis to understand which factors are increasing or decreasing the risk of readmission for each group.

“This research leverages comprehensive data, to generate new insights into broad patterns of the experience of children living with asthma, with the aim of preventing hospital readmissions.” – Dr Don Vicendese

This will enhance our understanding of which children are at higher risk and why, informing more effective, targeted preventive management beyond the one size fits all approach. 

Why was funding this research important?

Readmissions to hospital for asthma have been increasing for children in Victoria. About 8% of children will return to hospital with another asthma attack within a month and one third will return within a year.

Admissions to the hospital can have impacts on children’s physical and mental health, and their ability to participate in normal activities.

Whilst risk factors for readmissions to hospital have been identified, research has been based mainly on a ‘one size fits all’ approach. That is that the impact of risk factors is, on average, the same for each child with asthma and independent of each other. In reality, there are many different types of asthma, and it can look different for everyone.

This project aims to address this, by taking a child centred approach that understands, in a holistic way, the varied experiences of children living with asthma. It will provide a more nuanced and deeper insight into children’s varying risk profiles for readmission to hospital, to allow a more targeted preventive approach. Crucially, this project includes many factors which are modifiable to help reduce risk.

This research will produce a model that could be used in healthcare to take a targeted approach to reduce the risk of children going to hospital again. However, further development with additional projects will be needed before the results can be used in healthcare.

The funding for this project was generously provided through the Ray O’Donnell Belgrave Lions Asthma Research.