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RiskApps annual report 2020

Our 2019 ‘annual report’ for RiskApps contained almost passing reference to “a new coronavirus originating in China.” Since then, COVID-19 has changed the lives of almost everyone.

One of the most notable additions to the medical content of RiskApps, then, was a new topic called Coronavirus. And after the original release the topic was updated in the light of developing knowledge of the virus and its behaviour (including so-called long COVID), and of evolving underwriting practice. We continued to monitor developments with the possibility of further updating in mind.

In fact we published seven new medical topics in mid-2020:

  • Cannabis
  • Cocaine
  • Chronic pain
  • Coronavirus
  • Cyst
  • Ehlers-Danlos syndrome
  • Joint hypermobility
  • Syncope.

The Cannabis and Cocaine topics were part of an overhaul we made to Recreational drugs, now re-named Drug abuse; the latter now includes opioid use/abuse and anabolic steroids. And Cyst deals with cystic lesions not covered more specifically elsewhere.

There were two significant updates to existing topics:

  • Proteinuria – some simplification of ratings and improvements to the severity classification table; and
  • Simple renal cyst – new severity classification and clearer guidance.

Subsequently our continuous programme of research and development for the manual resulted in the release of some important updates in early 2021:

  • Attention-deficit hyperactivity disorder (ADHD)
  • Ankylosing spondylitis
  • Autism
  • Coronary heart disease (CHD)
  • Coronavirus infection (as referred to already)
  • Down’s syndrome
  • Obstructive sleep apnoea.

By far the most significant of these was CHD, being based on extensive research and detailed analysis of 20 journal articles reporting mortality and survival in series of CHD patients in a clinical setting. We revised the rating categories to enable easier grading of risks, revised the rating schedule accordingly (and included more specific ratings for older age groups) and differentiated between risks for which detailed imaging information is available and those for which it is not. All in all, the revised CHD topic makes finding the right rating guideline easier and reflects the latest research.

Obstructive sleep apnoea was researched and updated to reflect widely accepted severity levels based on apnoea-hyopopnoea index in the risk classification table; ratings have been updated accordingly.

Development of the new platform for RiskApps continues and currently we have one client using the ‘new look’ manual.

And we are coming to the end of an extensive review of dementia, a medical condition of growing significance given the increasing rate of diagnosis and the sharper focus on the financial needs of older age groups.