A financial analysis to review the cost of current management with the cost of the incorporation of Nu-Life Programmes into General Practices.

II am looking for a Biomedical Statistician who will be able to do a multivariate analysis on a large database of information that I have collected.  Trig/HDL ratio- an Indicator of Primary Prevention Molecules are composed of particles of various size. LDL (Low density lipoprotein) is the molecule that puts cholesterol into tissue. The smaller the particle the greater the risk of increasing tissue cholesterol. Type B particles are small dense and contain large amounts of cholesterol. They are therefore recognised as being highly atherogenic. Nu-Life studies have demonstrated a direct correlation between Trig/HDL ratio and particle size whereas ratios > 2 are associated with significant small type B particles. Our hypothesis is therefore that patients with Trig/HDL > 2 are more likely to have significant atherosclerosis and premature death/coronary disease. Since 2000 we have studied over 1000 patients admitted into a Nu-Life Programme which has shown that patients with low HDL levels and moderately high triglyceride levels after six weeks (and over long term follow up) increase HDL and reduce triglycerides thereby reducing the incidence of coronary events and hospital readmission. LDL/HDL Ratio- an Indicator of Secondary Prevention The lower the LDL and higher the HDL (and hence the LDL/HDL ratio) reflects the amount of cholesterol in the plaques within arteries. As this ratio fall to below 1.7 cholesterol metabolism is reversed and cholesterol is taken out of atheromatous plaques. This ratio independently, (and in association with Trig/HDL) should therefore reflect the long term incidence of coronary disease and readmission Data Analysis Our excel data base includes Trig/HDL and LDL/HDL ratios amongst other parameters. Initial review of the data includes long term clinical pathological and end points of recurrence of cardiac events, hospital readmission rates and mortality information. Further analysis is required to test the hypothesis that Trig/HDL and LDL/HDL ratios are indicative of risk of further cardiac events and hospital readmission. A multivariate analysis is required to ascertain which parameters in the data base are associated with long term complications, readmission and death. Financial Benefits of Nu-Life Programme A review of the effect of Nu-Life Programmes has demonstrated a very significant reduction in hospital readmissions when compared to the traditional management of cardiac patients. The financial benefits of wise spread use of this programme needs to be demonstrated. Another paper in the Australian Medical Journal2   identified the financial burden on emergency departments reviewing patients with chest pain or discomfort only 11.1% of whom actually had coronary artery disease. 67% of whom had non cardiac disease. Project Title 1. A multivariate analysis of data to define which admission criteria are associated with definitive endpoints of death and readmission of cardiac patients. Programmes ensuring optimal medical therapy into clinical practice when compared to the current standard of care. 2. Ascertain the financial benefits, if any, of the introduction of Nu-Life