Grant: Catalyst Grant: Personalized Health Catalyst Grants

Acute Lower Respiratory Illness (ALRI) continues to be a leading cause of morbidity and mortality in young children, and respiratory Syncytial Virus (RSV) is the most common pathogen implicated in ALRI. It infects virtually 100% of infants by age 3, with 10% requiring medical attention, and 1 to 2% experiencing illness severe enough to require hospitalization. Currently, the only treatment that can reduce RSV risk is palivizumab, a drug which contains RSV antibodies. Palivizumab is extremely costly and is limited to specific high-risk populations (e.g. congenital heart disease, preterm birth), so it is presently provided to less than 2% of Ontario children at a yearly cost exceeding $20M CAD. Our research has shown that between 2006 and 2013, there were about 1500 hospital admissions per year for Ontario infants, or approximately 10% of non-birth-related admissions before age one. Our findings demonstrated that more than 85% of these infants do not have one of the major risk factors that would make them eligible to receive palivizumab. In order to reduce the burden of severe RSV, there is an urgent need to improve the identification of high-risk infants in order to better target treatment to those infants most likely to benefit. By linking together health administrative data, newborn screening metabolite data, lab tests, palivizumab prescription data, pregnancy and birth registry data, and additional data sources, our proposed project aims to develop a much more accurate prediction model that can get medicine and information to the parents and doctors caring for infants at highest risk, and result in reduced illness, reduced burden on infants, parents and the health system, as well as reduce health system costs.