重口味SM

U of T global death study gets support to expand from Connaught Global Challenge Award

Photo of Prabhat Jha
鈥淲hy study the dead?鈥 asks Professor Prabhat Jha. 鈥淲ell, the dead are interesting to help the living by understanding the patterns of disease and the major killers, and you can actually form the way forward to reduce premature mortality"

How and why we die are questions that hold a lot of meaning for Prabhat Jha.

With support from this year鈥檚 , the professor in the University of Toronto's Dalla Lana School of Public Health is leading an interdisciplinary team to expand the collection of mortality statistics and develop innovative new tools to analyze the data for patterns.

The project 鈥 innovations to close the global mortality data divide 鈥 is one of five sharing $1.23 million from the Connaught Global Challenge. 

Read about the other Connaught Global Challenge Award winners

The internal award, provided by the Connaught Fund, is designed to support new collaborations involving leading U of T researchers and students from multiple disciplines, along with innovators and thought leaders from other sectors.

Every year, an estimated 60 million people die worldwide. Over 80 per cent of these deaths occur in low- and middle-income countries where many deaths occur at home and without medical attention. For example, only three per cent of the world鈥檚 children who died in 2010 had a medically certified death certificate.

That lack of information on deaths is itself a killer. But it鈥檚 a solvable challenge, says Jha, head of the Centre for Global Health Research at St. Michael鈥檚 Hospital and the professor of global health and epidemiology at Dalla Lana.

鈥淲hy study the dead?鈥 he asked rhetorically. 鈥淲ell, the dead are interesting to help the living by understanding the patterns of disease and the major killers, and you can actually form the way forward to reduce premature mortality. That鈥檚 true in India; it鈥檚 also true in Canada.鈥

With the $250,000 in Connaught funding, Jha said he鈥檚 going to be able to 鈥渂ring different types of science to the question鈥 of how the dead are counted, reported and their information analyzed and used to improve public health.

鈥淚t鈥檒l help us cement the 重口味SM鈥檚 leadership in global health, in particular, mortality statistics,鈥 said Jha.

Jha鈥檚 project is an expansion of his globally renowned , which has been knocking on doors in India since 2002 to collect first-hand accounts of the symptoms and circumstances leading up to a loved one鈥檚 death.

The personal narratives or 鈥渧erbal autopsies鈥 are independently reviewed and coded online by two doctors to determine cause of death. They鈥檝e been invaluable tools for public health policy both in India and globally.

For example, the study showed how deeply flawed global estimates were for malaria and snake bite deaths. It also helped document that one million additional children have been saved as a result of reductions in specific diseases from 2005.

鈥淭here鈥檚 a simple adage in epidemiology: You don鈥檛 know, unless you look,鈥 he said. 鈥淲hen you look, you often get surprised.鈥

Working with Graeme Hirst, a professor in U of T's department of computer science in the Faculty of Arts & Science, Jha鈥檚 Connaught-funded project is testing machine learning, specifically natural language processing (NLP), to see if it can improve and possibly replace the narrative coding by doctors.

鈥淲e also want to apply machine learning to be able to detect patterns in the data, not just the Indian data, but to about 110 million individual death records from Canada, USA, Mexico, Brazil 鈥 13 countries in all 鈥 to pick up specific patterns that help define the avoidability of death,鈥 he said.

Preliminary results have been promising, he said, adding 鈥渢his is opening up a new frontier in machine learning to use NLP to try to understand patterns of diseases so that we can improve the diagnostic capacity.鈥

A geospatial working group, which is part of the Connaught-funded project, is also studying the distribution of diseases to help understand risk factors. For example, Jha said in India they鈥檙e using geospatial science to document how many people are killed by air pollution and 鈥渢hen we can study other exposures in similar ways.鈥

The Connaught funding will also help U of T host a global symposium on closing the mortality data in 2019, as well as create a Challenge Scholars program for graduate students.

As the Millionth Death Study team draws close to recording their millionth death 鈥 something Jha expects this year or next 鈥 researchers are preparing to turn the day-to-day operation of the study over to the Indian government.

They are also working with the Canadian government, the Bill and Melinda Gates Foundation and others to expand the study鈥檚 verbal autopsy approach to Ethiopia, Sierra Leone and Mozambique.

鈥淭hat system has worked beautifully in India at very low cost. It鈥檚 one of those low-cost, high-impact interventions,鈥 he said. 鈥淚t should be thought about being like GPS for global health. If you have evidence and know what the patterns are, you can map out where to go鈥 with public health policies and interventions.

 

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