That is why this app, and its ability to personalise care for patients, is so exciting. It is there to potentially support the decision-making of every healthcare professional, from the paramedics who first treat a cardiac arrest patient to the clinicians who receive them at the hospital."
Dr Nilesh Pareek, Consultant Interventional Cardiologist at KCH and Adjunct Senior Lecturer at King’s College London
11 January 2023
King's clinicians help develop new app that transforms care for out-of-hospital cardiac arrest patients
The app uses a neurological risk score from an algorithm called MIRACLE2 to assess the risk of brain damage following an out-of-hospital cardiac arrest.
King’s clinicians have helped develop a new prototype application which aims to help healthcare professionals effectively triage patients who suffer a cardiac arrest outside of a hospital.
The app will enable paramedics and clinicians to calculate a patient’s risk of brain damage following an out-of-hospital cardiac arrest. The patient will then receive personalised treatment to match their individual needs.
Working over three days at a Microsoft Hackathon, the app was developed in a collaborative effort involving clinicians from King’s College London, King’s College Hospital (KCH) and a team from Ensono Digital – the cloud consulting and managed services business unit of company Ensono.
The app uses an algorithm called MIRACLE2 to calculate the risk of brain damage after healthcare professionals have input patient data, such as age, ECG scores, and heart rhythm. Strategic decisions about immediate care the patient receives will then be informed by their overall score.
In the United Kingdom, the probability of surviving an out-of-hospital cardiac arrest is approximately 10%. In comparison, in other countries, such as Denmark, this rate is as high as 20%.
Dr Nilesh Pareek, Consultant Interventional Cardiologist at KCH and Adjunct Senior Lecturer at King’s College London, is spearheading work in the UK to address this problem, aiming to revolutionise treatment for patients who suffer a cardiac arrest outside of a hospital.
Funded by Heart Research UK, he has organised a programme of research that resulted in the MIRACLE2 algorithm, which gives a neurological risk score that a cardiologist can easily apply to any patient based on a few simple features.
The new app aims to eventually make the MIRACLE2 algorithm accessible and useable for clinicians. However, the app remains in development and is not currently available for clinical use.
Dr. Nilesh Pareek said: “For a long time, I have been concerned about the poor outcomes of out-of-hospital cardiac arrest. In that critical first 72 hours after an incident, care currently looks very similar for most patients, potentially missing the chance for vital investigations into the wider impacts of cardiac arrests on the human body.
“Care in the future might be shaped to the patient’s needs: someone with a high risk of a poor neurological outcome, for example, might be treated with targeted and rapid intervention to reduce damage to the brain. Of course, there is more value we can add to the application, but we’re now one step closer to realising how this initiative can deliver better patient outcomes for the U.K. healthcare system.”
Over the three-day Microsoft Hackathon, the Ensono Digital team worked with academics from King’s College London to turn this ground-breaking initiative into an effective prototype. The team designed an app that presented the predictive information from MIRACLE2 in a clear format that clinicians could use to make informed decisions in difficult situations using the data.
The first step was to find a platform that could support the development of the app. After this, the team focused on making the user journey simple and accessible so that any user could engage with the algorithm easily and provide the best care solution based on the algorithm’s rankings. The result was a proof-of-concept web application, delivered pro-bono by Ensono Digital.
The next steps involve continuing development of the app, including circulating the tool with cardiologists at King’s College Hospital to get more user feedback.
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Adjunct Senior Lecturer