PRECISION CRITICAL CARE H OW DATA CAN HELP US FIND THE ZEBRA IN A - PowerPoint PPT Presentation

PRECISION CRITICAL CARE H OW DATA CAN HELP US FIND THE ZEBRA IN A HERD OF HORSES D AVID M ASLOVE , MD, MS, FRCPC D EPARTMENT OF C RITICAL C ARE M EDICINE Q UEEN ’ S U NIVERSITY SEAMO I NNOVATION S HOWCASE K INGSTON , O NTARIO J UNE 6, 2018

“When you hear hoofbeats, think of horses not zebras.” —Dr. Theodore Woodward

DATA TO ENABLE DISTINCTIONS 46 KB 59 KB

DATA TO ENABLE DISTINCTIONS

DATA TO ENABLE DISTINCTIONS

DATA TO ENABLE DISTINCTIONS PRECISION Genomics R x Physiology E & B

Genomics COmbining Novel Physiology Datasets to Understand Illness Trajectory E & B www.conduitlab.org

Genomics 400 Placebo Lactoferrin ! 300 ! ! ! ! ! ! ! ! ! ! 200 ! ! ! ! ! ! ! ! ! ! 100 ! ! ! ! 0 Day 0 Day 3 Day 7 Day 14 Day 21 Day 28 Transcriptomic clusters of sepsis Transcriptomic e ff ects of lactoferrin

Physiology BedmasterEX Centre for Advanced Computing 20TB

Physiology Phenylephrine infusion Patient1 − SDTT ● ● ● 0.100 ● ● ● ● ● ● ● ● ● ● ● ● ● 0.0040 ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● 0.075 0.0035 ● ● ● ● status status SDNN SDNN ● ● 0.0030 ● 0.050 ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● 0.0025 ● ● ● ● ● ● ● ● ● ● ● 0.025 ● ● ● ● ● ● ● ● ● ● ● ● ● ● 0.0020 ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● 0.000 − 2 0 2 4 − 2 0 2 4 Time(hours) Courtesy of V. Tolls Time(hours)

E & B STEPS STAIRS HEART RATE SLEEP 0 125 250 375 500

PRECISION CRITICAL CARE NEED FOR AVAILABILITY PRECISION OF DATA Right Patient Right Treatment Right Time

QUESTIONS & COMMENTS david.maslove@queensu.ca @DavidMaslove