Dr Dexter Canoy: Understanding disease through big data in real world settings

Meet Dexter Canoy, Clinical Epidemiologist at The George Institute for Global Health, UK.

How long have you been working at The George Institute?

Since August 2017.

What is your professional background?

I'm an epidemiologist. After finishing medical school and further postgraduate research, I focused on epidemiological investigations involving large population-based cohort studies in the UK and birth cohort studies in the Nordic region. My research included investigations into modifiable risk factors of cardiovascular disease and respiratory health, impact of adiposity phenotypes on health, early life factors of adult disease, and women's health.

What attracted you to working at The George Institute?

Research scientists are always drawn to the 'next big thing', be it on the potential impact of the research output, how it might address current and major research issues, or the vision it provides about research that matters, in my case, to global health in the future. I had an opportunity to be part of the next big thing at The George Institute, hence why I joined.

What are you currently working on?

I am working on a number of projects. I am involved in the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC) to conduct individual patient-level data meta-analysis to address questions of clinical relevance such as around uncertainties in pharmacologic treatments to lower blood pressure. I'm also part of Deep Medicine, a research programme that aims to use machine learning methods to analyse large and complex electronic health records to provide insights into patterns and risk trajectories of chronic conditions such as in multimorbidity. I also support the work around urban and environmental health as part of the PEAK Urban project, which aims to examine biological and environmental health determinants in increasingly urbanised cities.

My research on chronic disease draws on the UK Biobank resource, such as in using genetic data and imaging-based phenotyping of body composition to improve causal inference about associations between exposure and disease outcomes. I'm also setting up a study to use big data to conduct research into women's vascular health. I will assess the feasibility of using existing health care databases from regions across the world to investigate how conditions occuring during pregnancy, such as preeclampsia, affect women's health in the long term and identify what we can do to reduce disease risk.

What is a recent highlight?  

A recent highlight happened long before research outputs were even realised. As part of the BPLTTC we engaged with researchers from across the world, inviting their participation. Collectively, they have generously shared more than half of all existing global data on drug trials aimed at lowering blood pressure. Our team are now very excited to be part of this research journey to address important clinical questions.

What difference will this make to healthcare and why?

While the use of blood pressure-lowering drugs to prevent the occurrence of cardiovascular disease has been well evidenced, questions around optimal treatment remain unanswered. For example, at what baseline blood pressure should we initiate treatment? At what levels should blood pressure be treated to maximise the balance between benefit and harm? What is the best strategy to lower blood pressure in the elderly or among those with multiple conditions to ensure potential adverse effects are minimised? We hope to provide valid and reliable evidence that could be used to inform the development of clinical guidelines.

Why do you enjoy working at The George Institute?

Because I get to work on the next big thing amongst a brilliant, interdisciplinary team.

To explain to people what I do, I say….

I do research in epidemiology, which is a field of research that is closer to the study of 'epidemics' than of the 'skin'.

To unwind at the end of the day I….

Eat. Drink. Sleep. (Oh, I should say something about fitness, otherwise I'll be setting a bad example! OK, the odd dose of running, swimming and fencing thrown into the mix. And opera.)

My first job was….

...to conduct epidemiological research as I do now.

My biggest achievement so far….

The global burden of cardiovascular disease remains high. Until this problem is solved, I don't think I have done anything substantial just yet! Perhaps what I have done to date is to provide novel insights into the aetiology of cardiovascular disease, such as how fat distribution in the body, weight at birth, and timing of menstruation, might influence the development of cardiovascular disease. Knowing what these factors are and how they influence disease development should help inform prevention efforts. My current focus on evaluating evidence for optimal treatment of hypertension should have direct relevance to patient care, so I'm hoping this will have clinical impact and improve vascular health for many patients globally.