Ashley Able

Vanderbilt University Medical Center

5 active projects

Systemic Disease and Glaucoma (Cloned)

We have previously published a predictive model of glaucoma progression using electronic health record (EHR) data pertaining to systemic attributes from a single institution. We aim to use the All of Us dataset to 1) serve as external validation for…

Scientific Questions Being Studied

We have previously published a predictive model of glaucoma progression using electronic health record (EHR) data pertaining to systemic attributes from a single institution. We aim to use the All of Us dataset to 1) serve as external validation for this single-center model and 2) to train new models focused on predicting glaucoma progression using systemic predictors. This is important to understand whether the original findings are generalizable and provide additional knowledge about the utility of systemic predictors on a national-level dataset.

Project Purpose(s)

  • Disease Focused Research (Primary open angle glaucoma)
  • Other Purpose (This work is the result of an All of Us Research Program Demonstration Project. Demonstration Projects are efforts by the All of Us Research Program designed to meet the goal of ensuring the quality and utility of the Research Hub as a resource for accelerating precision medicine. This work has been approved, reviewed, and overseen by the All of Us Research Program Science Committee and Data and Research Center to ensure compliance with program policy. )

Scientific Approaches

We plan to primarily work with EHR data contained in All of Us for a cohort of adult participants diagnosed with primary open-angle glaucoma. We will extract data on systemic conditions and medications for this cohort, as well as physical measurements and vital signs. We will clean the data such that the format is consistent with the data from our previously published model. Then, we will use this data as an external validation of a logistic regression model derived from our prior study that was based at a single academic center. Next, we will use All of Us data to train a new set of models, using techniques such as logistic regression, random forests, and artificial neural networks. We will optimize these models using feature selection methods and class balancing procedures. By evaluating performance metrics such as area under the curve (AUC), precision, recall, and accuracy, we will assess whether we can achieve superior predictive performance when training models using All of Us.

Anticipated Findings

We anticipate that the All of Us data will validate the findings from the model, which demonstrated that blood pressure-related metrics and certain medication classes had predictive value for glaucoma progression. In addition, we anticipate that the models trained with All of Us data will outperform the model trained with single institution data due to larger sample size and greater diversity. These findings will support further investigation in understanding the relationship between systemic conditions like blood pressure with glaucoma progression.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Research Team

Owner:

Collaborators:

  • Chenjie Zeng - Research Fellow, NIH

D16_HTN_revision_after_code_review

We are using the All of Us Researcher Workbench interface to answer the question, "Is hypertension prevalence in the All of Us Research Program similar to hypertension prevalence in the 2015–2016 National Health and Nutrition Examination Survey (NHANES) ?". Clinical…

Scientific Questions Being Studied

We are using the All of Us Researcher Workbench interface to answer the question, "Is hypertension prevalence in the All of Us Research Program similar to hypertension prevalence in the 2015–2016 National Health and Nutrition Examination Survey (NHANES) ?". Clinical approaches to understanding and treating hypertension may benefit from the integration of a precision medicine approach that integrates data on environments, social determinants of health, behaviors, and genomic factors that contribute to hypertension risk. Hypertension is a major public health concern and remains a leading risk factor for stroke and cardiovascular disease.

Project Purpose(s)

  • Other Purpose (This work is an AoU demo project. Demo projects are efforts by the AoU Research Program designed to meet the program goal of ensuring the quality and utility of the Research Hub as a resource for accelerating discovery in science and medicine. As an approved demo project, this work was reviewed and overseen by the AoU Research Program Science Committee and the AoU Data and Research Center to ensure compliance with program policy, including policies for acceptable data access and use. )

Scientific Approaches

In this cross-sectional, population-based study, we used All of Us baseline data from patient (age>18) provided information (PPI) surveys and electronic health record (EHR) blood pressure measurements and retrospectively examined the prevalence of hypertension in the EHR cohort using Systemized Nomenclature of Medicine (SNOMED codes and blood pressure medications recorded in the EHR. We used the EHR data (SNOMED codes on 2 distinct dates and at least one hypertension medication) as the primary definition, and then add subjects with elevated systolic or elevated diastolic blood pressure on measurements 2 and 3 from PPI. We extracted each participant’s detailed dates of SNOMED code for essential hypertension from the Researcher Workbench table ‘cb_search_all_events’. We calculated an age-standardized HTN prevalence according to the age distribution of the U.S. Census, using 3 groups (18-39, 40-59, ≥ 60).

Anticipated Findings

The prevalence of hypertension in the All of Us cohort is similar to that of published literature. All of Us age-adjusted HTN prevalence was 27.9% compared to 29.6% in National Health and Nutrition Examination Survey. The All of Us cohort is a growing source of diverse longitudinal data that can be utilized to study hypertension nationwide. The prevalence of hypertension varies in the United States (U.S.) by age, sex, and socioeconomic status. Hypertension can often be treated successfully with medication, and prevented or delayed with lifestyle modifications. Even with these established hypertension intervention and prevention strategies, the prevalence of hypertension continues to be at levels of public health concern. The diversity within All of Us may provide insight into factors relevant to hypertension prevention and treatments in a variety of social and geographic contexts and population strata in the U.S.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Research Team

Owner:

Collaborators:

  • Roxana Loperena Cortes - Other, All of Us Program Operational Use
  • Elizabeth Karlson - Late Career Tenured Researcher, Mass General Brigham

Duplicate of AFib epidemiology

The overall goal of this study, as a Demonstration project, is to evaluate the ability of the All of Us Research Program data to replicate epidemiologic patterns of atrial fibrillation (AF), a common arrhythmia, previously described in other setting. We…

Scientific Questions Being Studied

The overall goal of this study, as a Demonstration project, is to evaluate the ability of the All of Us Research Program data to replicate epidemiologic patterns of atrial fibrillation (AF), a common arrhythmia, previously described in other setting. We will address this goal with these two aims:
• Specific Aim 1. To determine the association of race and ethnicity with the prevalence and incidence of atrial fibrillation (AF). We hypothesize than non-whites will have lower prevalence and incidence of AF than whites.
• Specific Aim 2. To estimate associations of established risk factors for AF with the prevalence and incidence of AF. We hypothesize that increased body mass index, higher blood pressure, diabetes, smoking and a prior history of cardiovascular diseases will be associated with increased prevalence and incidence of AF.

Project Purpose(s)

  • Population Health
  • Other Purpose (This work is a result of an All of Us Research Program Demonstration Project. The projects are efforts by the Program designed to meet the program's goal of ensuring the quality and utility of the Research Hub as a resource for accelerating discovery in science and medicine. This work was reviewed and overseen by the All of Us Research Program Science Committee and the Data and Research Center to ensure compliance with program policy, including policies for acceptable data access and use.)

Scientific Approaches

We will select all All of Us participants who self-reported sex at birth male or female, whose self-reported race was white, black or Asian, as well as those who self-reported being Hispanics.

Atrial fibrillation (AF) will be identified from self-reports in the medical survey or from electronic health records (EHR).

Clinical factors will be identified from EHR and study measurements (blood pressure, weight, height).

We will evaluate the association of demographic (age, sex, race/ethnicity) and clinical (body mass index, blood pressure, smoking, cardiovascular diseases) factors with prevalence of self-reported AF and prevalence of AF in the EHR, as well as incident AF ascertained from the EHR.

Anticipated Findings

The overall goal of this project is to evaluate the prevalence and incidence of atrial fibrillation (AF), overall and by race/ethnicity, as well as to confirm the association of established risk factors for AF in the All of Us Research participants. We expect to confirm associations between demographic and clinical variables previously reported in the literature, demonstrating the value of the All of Us Research Program data to address questions regarding this common cardiovascular disease.

Demographic Categories of Interest

  • Race / Ethnicity
  • Age

Research Team

Owner:

  • Jun Qian - Other, All of Us Program Operational Use
  • Ashley Able - Other, Vanderbilt University Medical Center
  • Alvaro Alonso - Late Career Tenured Researcher, Emory University

Duplicate of Demo Project - Family History in EHR & PPI Data

As a demonstration project, this study will summarize structured data elements available in the All of Us registered tier and compare to published survey results to describe data for reuse in disease specific outcomes. Specific questions include: 1. Could harnessing…

Scientific Questions Being Studied

As a demonstration project, this study will summarize structured data elements available in the All of Us registered tier and compare to published survey results to describe data for reuse in disease specific outcomes. Specific questions include:

1. Could harnessing informatics tools like predictive modeling and clinical decision support to detect and alert healthcare providers to these preventative measures significantly improve the precise care we deliver to patients?
2. How can one evaluate the availability of family medical history information within the All of Us registered tier data and characterize the structured data elements from both data sources?

Project Purpose(s)

  • Methods Development
  • Other Purpose (This work is a result of an All of Us Research Program Demonstration Project. The projects are efforts by the Program designed to meet the program's goal of ensuring the quality and utility of the Research Hub as a resource for accelerating discovery in science and medicine. This work was reviewed and overseen by the All of Us Research Program Science Committee and the Data and Research Center to ensure compliance with program policy, including policies for acceptable data access and use.)

Scientific Approaches

We utilize the Family Medical History PPI survey to capture self-reported information but exclude participants who did not know any of their family history or who skipped every survey question. We pay particular attention to the disease/relative pairings that map to the American College of Medical Genetics and Genomics’ (ACMG) list of important diseases.

We define EHR family history information as the collection of registered tier observations with "family+history" or "FH:" anywhere in their OMOP concept name. We exclude observations of “Family social history” and remove duplicate observation and value concept pairings from the same healthcare organization regarding the same participant as these were likely due to repeated entries across multiple routine annual physical exams.

We aim to compare the data sources by summarizing the type and amount of family history information gained.

Anticipated Findings

This description of the family medical history data in the All of Us registered tier database will assist future investigators in understanding All of Us data methods and give feedback to the program on the utility of participant survey and EHR data.

We hypothesize that the survey data will provide a more complete look at family medical history due to its structured nature. Though, we are also interested in determining how much overlap there is between the PPI and EHR data. It’s plausible that the free-form nature of EHR family history information yields more detailed records. We would ultimately like to determine if a gold standard method for defining a participant’s family medical history is attainable within the All of Us registered tier data.

We anticipate facing informatics challenges because of collecting data from different sources, mapping these data to a common data model, and attempting to harness data from these sources to find the common source of truth.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Research Team

Owner:

  • Melissa Patrick - Project Personnel, All of Us Program Operational Use
  • Robert Cronin - Early Career Tenure-track Researcher, Vanderbilt University Medical Center
  • Ashley Able - Other, Vanderbilt University Medical Center

Duplicate of Cancer

We intend to explore the difference in the prevalence of cancer between the AoU population. In particular, we will be looking at the difference between the entire population, the subset with medical records, and the subset with self-reported data.

Scientific Questions Being Studied

We intend to explore the difference in the prevalence of cancer between the AoU population. In particular, we will be looking at the difference between the entire population, the subset with medical records, and the subset with self-reported data.

Project Purpose(s)

  • Population Health

Scientific Approaches

We intend to select a list of SNOMED codes corresponding to primary cancers to get the subset with cancer in the medical record

We intend to select the survey question asking about self-reported cancer to get the subset with self-reported cancer

Anticipated Findings

We expect the difference of cancer to vary between self-report and medical record, which could have implications for how cancer is measured on a population-level.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Research Team

Owner:

Collaborators:

  • Jun Qian - Other, All of Us Program Operational Use
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