PhD Studentship: AI4Heart: Fractional Flow Reserve-CT in Stable Heart Disease and Coronary Computed Tomography Angiography Helps Improves Patient care and Societal Cost

Following NICE Guidance, NHS England (NHSE) has advocated using Coronary Computed Tomographic Angiography (CCTA) as the first line diagnostic test for suspected symptomatic coronary artery disease (CAD) since 2016 and CT- Fractional Flow Reserve (CT-FFR) as a second line test since 2017. In 2018 a national health technology programme funded CT-FFR utilisation with the aim of improving patient pathways and reducing costs. 

FISH&CHIPS is a multi-centre, observational analytic cohort study of all patients that underwent a CCTA for the assessment of coronary artery disease over a 3-year period (2017-2020). Patients were followed up at a median of 3.3 years for clinical outcomes (All-cause death, myocardial infarction, revascularization), resource utilization (downstream tests) and costs. 

25 NHSE sites returned 102,347 unique patient CCTA scan identifiers. 5,673 patients withdrew consent and 5,780 CCTA were multiple scans, leaving 90,553 patients who had received a CCTA during the study time period. Patient demographics were; Age 58.1±13.2, 51.5% male, 47.9% female. Of this population 9,179 (10.1%) patients received a CT-FFR as a second line test. Overall 4,731,216 clinical episodes occurred; 334,124 emergency room attendances, 480,300 episodes of admitted patient, 1,093,978 diagnostic imaging tests. Clinical outcomes included 4,884 deaths, 4000 myocardial infarcts and 6,615 revascularizations. 

The student will perform ‘big data’ analysis of patient cohorts including time-based evaluation of the impact of introducing CT-FFR as a national health intervention into a healthcare system. Exploratory outcomes analysis will include determining the impact of patient factors (social class, gender, co-morbidities), healthcare provider factors (site, geographical location, GP practice) and AI technology factors (learning curve). These will be linked with the CCTA imaging biomarker data (quantitative plaque analysis) that is being collected as part of the EU HORIZON TARGET study to determine personalised risk for future cardiac events. 

This project is in partnership with Liverpool Heart and Chest Hospital (LHCH). The successful PhD candidate will benefit from working with a multidisciplinary team in which there exists extensive experience in the areas of machine learning, biostatistics, and medicine: Dr Yanda Meng and Dr Tianjin Huang (Machine Learning), Prof Yalin Zheng (AI in Healthcare), A/Prof Timothy Fairbairn (Cardiovascular Medicine), Prof Gregory Lip (Cardiovascular Medicine). 

If you have any specific questions regarding this studentship, please contact:

Dr Yanda Meng at y.m.meng@exeter.ac.uk  

Funding

For eligible students the studentship will cover Home tuition fees plus an annual tax-free stipend of at least £20,780 for 4 years full-time, or pro rata for part-time study. 

The student would be based in Exeter in the Faculty of Environment, Science and Economy at the Streatham Campus in Exeter, and expected to spend majority of their time (approximately 9 months per year) in Liverpool Centre for Cardiovascular Science, William Henry Duncan Building, University of Liverpool. 

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