Guohai Zhou

Mass General Brigham

10 active projects

V6 asthma biologic utilization

This research is to evaluate the real-world use, switches, and discontinuations of biologics in the treatment of asthma. Although 6 biologics are currently approved for asthma treatment, relatively little is known about their real-world use and effectiveness. Additionally, there is…

Scientific Questions Being Studied

This research is to evaluate the real-world use, switches, and discontinuations of biologics in the treatment of asthma. Although 6 biologics are currently approved for asthma treatment, relatively little is known about their real-world use and effectiveness. Additionally, there is some evidence that there may be inequitable use and access to these biologics. Furthermore, the patterns of use in individuals who are eligible for two or more of these biologics is currently unknown.

Project Purpose(s)

  • Disease Focused Research (asthma)

Scientific Approaches

Study population: individuals ≥18 years with diagnosis of asthma who were on any of the biologics approved for asthma treatment (omalizumab, benralizumab, mepolizumab, reslizumab, dupilumab) between 2005 to date. We will be using summary statistics in characterizing the incidence of initiation of these biologics, switches from one biologic to another (and when the switch occurred), and/or discontinuation. To evaluate if these switches were due to effectiveness of these biologics, we will evaluate asthma exacerbations while on the biologics. In addition, we will evaluate if these patterns differ by age, sex, or race and ethnicity.

Anticipated Findings

This study will improve our knowledge of real-world use and patterns of use of these biologics and can inform future studies and/or interventions in optimizing the benefits of these biologics.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

obesity_mansucript_rerun

National obesity prevention and intervention strategies may benefit from precision medicine approaches that incorporate integrated data on environments, social determinants of health, and genomic factors. We examined the quality and utility of the All of Us Research Hub Workbench for…

Scientific Questions Being Studied

National obesity prevention and intervention strategies may benefit from precision medicine approaches that incorporate integrated data on environments, social determinants of health, and genomic factors. We examined the quality and utility of the All of Us Research Hub Workbench for accelerating precision medicine by replicating methods from existing studies that examine the prevalence of obesity at the population level. We evaluated the measurements of obesity in the participant measurement (PM) data set and the electronic health record (EHR) data set using methods similar to the Ward et al. NEJM December 2019 publication that assessed prevalence of obesity in the US by state using BRFSS data.

Project Purpose(s)

  • Disease Focused Research (obesity)
  • Educational
  • Methods Development
  • 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

For this population-based cross-sectional study of All of Us Research Workbench participants, we excluded individuals with measurements obtained during pregnancy or inpatient visits and individuals from states with fewer than 100 participants. Physical measurements (PM) of height and weight at the time of program enrollment of 142,116 participants and measured weight and height extracted from electronic health records (EHR) of 40,885 individuals were used to calculate body-mass index (BMI). We did a complete case analysis for All of Us participants with known sex (male or female), race, income and education levels and estimated state-specific and demographic subgroup-specific prevalence of categories of BMI [obesity (BMI ≥30) and extreme obesity (BMI ≥ 35)] nationwide and for each state: overall and by subgroups, male and female. We examined the difference between EHR and PM calculated BMI by state.

Anticipated Findings

Using states with at least 100 participants, PM data included 142,116 individuals (mean [SD] age, 51.2 [16.6] and EHR data on height and weight included 40,885 individuals (mean [SD] age, 52.5 [16.5]. The median BMI for PM participants was 28.4 [24.4 to 33.7]; the median BMI for EHR was 29.0 [24.8 to 34.5]. The PM national prevalence for obesity (includes BMI>30 and BMI >35) and extreme obesity (BMI >35) were 41.2 % (95% Confidence Interval [CI], 40.9 to 41.4) and 20.8% (95% CI, 20.6 to 21.0), respectively, with large variations across states. Women had higher prevalence of extreme obesity than men in all selected states. Subgroups with extreme obesity (BMI, >35) prevalence greater than 25% included subgroup, N, prevalence %, (95% CI): Black NH, 8913, 28.9 (25.8 to 32.0) , individuals with income less than $25,000, 13,244, 25.1 (22.1 to 28.1); education of high school to some college, 17, 272, 26.1 (23.1 to 29.1) and the region of the South, 6,639, 25.3 (22.3 to 28.3).

Demographic Categories of Interest

  • Race / Ethnicity
  • Age
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

Collaborators:

  • Francis Ratsimbazafy - Other, All of Us Program Operational Use
  • Karthik Natarajan - Other, All of Us Program Operational Use

asthma biologic utilization

This research is to evaluate the real-world use, switches, and discontinuations of biologics in the treatment of asthma. Although 6 biologics are currently approved for asthma treatment, relatively little is known about their real-world use and effectiveness. Additionally, there is…

Scientific Questions Being Studied

This research is to evaluate the real-world use, switches, and discontinuations of biologics in the treatment of asthma. Although 6 biologics are currently approved for asthma treatment, relatively little is known about their real-world use and effectiveness. Additionally, there is some evidence that there may be inequitable use and access to these biologics. Furthermore, the patterns of use in individuals who are eligible for two or more of these biologics is currently unknown.

Project Purpose(s)

  • Disease Focused Research (asthma)

Scientific Approaches

Study population: individuals ≥18 years with diagnosis of asthma who were on any of the biologics approved for asthma treatment (omalizumab, benralizumab, mepolizumab, reslizumab, dupilumab) between 2005 to date. We will be using summary statistics in characterizing the incidence of initiation of these biologics, switches from one biologic to another (and when the switch occurred), and/or discontinuation. To evaluate if these switches were due to effectiveness of these biologics, we will evaluate asthma exacerbations while on the biologics. In addition, we will evaluate if these patterns differ by age, sex, or race and ethnicity.

Anticipated Findings

This study will improve our knowledge of real-world use and patterns of use of these biologics and can inform future studies and/or interventions in optimizing the benefits of these biologics.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

V5 Demo - Hypertensive Disorders of Pregnancy

1. What is the prevalence of hypertensive disorders during pregnancy? 2. What is the prevalence of hypertensive disorders during pregnancy by demographics? Of those diagnosed with a hypertensive disorder during pregnancy, what is the epidemiology of the risk factors associated…

Scientific Questions Being Studied

1. What is the prevalence of hypertensive disorders during pregnancy? 2. What is the prevalence of hypertensive disorders during pregnancy by demographics? Of those diagnosed with a hypertensive disorder during pregnancy, what is the epidemiology of the risk factors associated with hypertension in pregnancy? 3. Are there racial disparities in hypertension during pregnancy, when adjusted for these risk factors? 4. How can one use heterogeneous data sources within the All of Us dataset to explore disease associations using self-reported exposures (Participant Provided Information, or “PPI”) and exposures captured in the electronic medical record (EHR).”

Project Purpose(s)

  • Disease Focused Research (Hypertensive disorder of pregnancy)
  • Social / Behavioral
  • 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

Our sample was pulled from the 78,938 females in the AoU cohort who had EHR and PPI data. Females were identified as participants with female sex assigned at birth. Of these, only the 13,155 females who had at least 1 SNOMED code in their EHR as "pregnancy finding" were included in the analysis. For our analyses, a participant was classified as having a hypertensive disorder of pregnancy if they had at least one SNOMED code for gestational hypertension, pre-eclampsia with or without severe features, eclampsia, or HELLP Syndrome. We used published risk factors for preeclampsia as described by the United States Preventive Services Task Force in our univariate and multivariate analysis. Odds ratios were calculated for the risk factors. Descriptive statistics for the overall pregnant female cohort and the hypertensive disorder of pregnancy cohort were also classified. We used both EHR and PPI data to identify the risk factors for hypertensive disorders of pregnancy.

Anticipated Findings

We anticipate to see racial disparities in the prevalence of hypertensive disorders during pregnancy. Similar to previous literature, we anticipate our results will show participants who identify as African American are at greater odds of being diagnosed with hypertensive disorder of pregnancy compared to White participants. We also anticipate finding higher odds of being diagnosed with hypertensive disorders of pregnancy among participants who have at least one risk factor for preeclampsia as described by USPSTF compared to participants without any risk factors. This study will serve to demonstrate the quality, utility, and diversity of the All of Us data and tools, providing researchers options for study design and validation.

Demographic Categories of Interest

  • Race / Ethnicity
  • Access to Care
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

Collaborators:

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

V5 data Demo - Uterine Fibroids

From this analysis, we hope to observe if there are differences in age, racial and risk distribution between both fibroids diagnostic cohorts. We also will determine the odds of this condition in both cohorts, based on modifiable risk factors such…

Scientific Questions Being Studied

From this analysis, we hope to observe if there are differences in age, racial and risk distribution between both fibroids diagnostic cohorts. We also will determine the odds of this condition in both cohorts, based on modifiable risk factors such as age, race and menopausal state and non-modifiable risk factors like obesity, use of hormones and smoking. These findings will be compared to findings from pre-existing data.

Project Purpose(s)

  • Disease Focused Research (Uterine fibroids or leiomyomas)
  • Population Health
  • Social / Behavioral
  • 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

Participants were eligible if they were assigned female sex at birth and had both Electronic Health Records (EHR) data and Patient Provided Information (PPI). Two fibroids cohorts were created based on: 1. Presence of at least one SNOMED code for uterine fibroids in their Electronic Health Records 2. Presence of one ICD-9 or CPT code for pelvic imaging (e.g., pelvic ultrasound) and one diagnostic code for uterine fibroids Variables of interest were identified from the EHR and PPI and imported as concept sets into the notebook, otherwise they were created in the notebook. Data was analyzed in R software version 3.6.2, 2019.

Anticipated Findings

We anticipate that black females will have higher odds of fibroids compared to white women and that smokers will have lower odds of fibroids compared to non-smokers. While findings from this analysis are not novel, they validate existing knowledge and underscore the importance of the AoU data cohort in research. Furthermore, AoU cohort data represents females in the United States and Canada and, importantly, populations that are underrepresented in research.

Demographic Categories of Interest

  • Sex at Birth
  • Geography
  • Access to Care
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

Collaborators:

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

earlyonsetcolorectcalcancer

Examine the demographic ,geographic, inflammatory biomarker differences of early onset versus late-onset colorectal cancer to determine potential biomarkers for identification of individuals at increased risk for colorectal cancer that may benefit from early screening.

Scientific Questions Being Studied

Examine the demographic ,geographic, inflammatory biomarker differences of early onset versus late-onset colorectal cancer to determine potential biomarkers for identification of individuals at increased risk for colorectal cancer that may benefit from early screening.

Project Purpose(s)

  • Disease Focused Research (colorectal cancer)

Scientific Approaches

Compare individuals with and without colorectal cancer overall in the All of Us cohort by demographics, geography, and biomarkers associated with increased risk of CRC (ESR, triglycerides, BMI, systolic blood pressure, waist circumference, ApoB100, hemoglobin A1C) . Look at biomarkers at least 2 years prior to year of diagnosis.

Anticipated Findings

Identify biomarkers that may guide future research into the biology of early onset colorectal cancer.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

Collaborators:

  • Elisabeth Rosenthal - Project Personnel, University of Washington

For_DRC_obesity_code_review

National obesity prevention and intervention strategies may benefit from precision medicine approaches that incorporate integrated data on environments, social determinants of health, and genomic factors. We examined the quality and utility of the All of Us Research Hub Workbench for…

Scientific Questions Being Studied

National obesity prevention and intervention strategies may benefit from precision medicine approaches that incorporate integrated data on environments, social determinants of health, and genomic factors. We examined the quality and utility of the All of Us Research Hub Workbench for accelerating precision medicine by replicating methods from existing studies that examine the prevalence of obesity at the population level. We evaluated the measurements of obesity in the participant measurement (PM) data set and the electronic health record (EHR) data set using methods similar to the Ward et al. NEJM December 2019 publication that assessed prevalence of obesity in the US by state using BRFSS data.

Project Purpose(s)

  • Disease Focused Research (obesity)
  • Educational
  • Methods Development

Scientific Approaches

For this population-based cross-sectional study of All of Us Research Workbench participants, we excluded individuals with measurements obtained during pregnancy or inpatient visits and individuals from states with fewer than 100 participants. Physical measurements (PM) of height and weight at the time of program enrollment of 142,116 participants and measured weight and height extracted from electronic health records (EHR) of 40,885 individuals were used to calculate body-mass index (BMI). We did a complete case analysis for All of Us participants with known sex (male or female), race, income and education levels and estimated state-specific and demographic subgroup-specific prevalence of categories of BMI [obesity (BMI ≥30) and extreme obesity (BMI ≥ 35)] nationwide and for each state: overall and by subgroups, male and female. We examined the difference between EHR and PM calculated BMI by state.

Anticipated Findings

Using states with at least 100 participants, PM data included 142,116 individuals (mean [SD] age, 51.2 [16.6] and EHR data on height and weight included 40,885 individuals (mean [SD] age, 52.5 [16.5]. The median BMI for PM participants was 28.4 [24.4 to 33.7]; the median BMI for EHR was 29.0 [24.8 to 34.5]. The PM national prevalence for obesity (includes BMI>30 and BMI >35) and extreme obesity (BMI >35) were 41.2 % (95% Confidence Interval [CI], 40.9 to 41.4) and 20.8% (95% CI, 20.6 to 21.0), respectively, with large variations across states. Women had higher prevalence of extreme obesity than men in all selected states. Subgroups with extreme obesity (BMI, >35) prevalence greater than 25% included subgroup, N, prevalence %, (95% CI): Black NH, 8913, 28.9 (25.8 to 32.0) , individuals with income less than $25,000, 13,244, 25.1 (22.1 to 28.1); education of high school to some college, 17, 272, 26.1 (23.1 to 29.1) and the region of the South, 6,639, 25.3 (22.3 to 28.3).

Demographic Categories of Interest

  • Race / Ethnicity
  • Age
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

Duplicate_for_DRC_obesity_code_review

National obesity prevention and intervention strategies may benefit from precision medicine approaches that incorporate integrated data on environments, social determinants of health, and genomic factors. We examined the quality and utility of the All of Us Research Hub Workbench for…

Scientific Questions Being Studied

National obesity prevention and intervention strategies may benefit from precision medicine approaches that incorporate integrated data on environments, social determinants of health, and genomic factors. We examined the quality and utility of the All of Us Research Hub Workbench for accelerating precision medicine by replicating methods from existing studies that examine the prevalence of obesity at the population level. We evaluated the measurements of obesity in the participant measurement (PM) data set and the electronic health record (EHR) data set using methods similar to the Ward et al. NEJM December 2019 publication that assessed prevalence of obesity in the US by state using BRFSS data.

Project Purpose(s)

  • Disease Focused Research (obesity)
  • Educational
  • Methods Development

Scientific Approaches

For this population-based cross-sectional study of All of Us Research Workbench participants, we excluded individuals with measurements obtained during pregnancy or inpatient visits and individuals from states with fewer than 100 participants. Physical measurements (PM) of height and weight at the time of program enrollment of 142,116 participants and measured weight and height extracted from electronic health records (EHR) of 40,885 individuals were used to calculate body-mass index (BMI). We did a complete case analysis for All of Us participants with known sex (male or female), race, income and education levels and estimated state-specific and demographic subgroup-specific prevalence of categories of BMI [obesity (BMI ≥30) and extreme obesity (BMI ≥ 35)] nationwide and for each state: overall and by subgroups, male and female. We examined the difference between EHR and PM calculated BMI by state.

Anticipated Findings

Using states with at least 100 participants, PM data included 142,116 individuals (mean [SD] age, 51.2 [16.6] and EHR data on height and weight included 40,885 individuals (mean [SD] age, 52.5 [16.5]. The median BMI for PM participants was 28.4 [24.4 to 33.7]; the median BMI for EHR was 29.0 [24.8 to 34.5]. The PM national prevalence for obesity (includes BMI>30 and BMI >35) and extreme obesity (BMI >35) were 41.2 % (95% Confidence Interval [CI], 40.9 to 41.4) and 20.8% (95% CI, 20.6 to 21.0), respectively, with large variations across states. Women had higher prevalence of extreme obesity than men in all selected states. Subgroups with extreme obesity (BMI, >35) prevalence greater than 25% included subgroup, N, prevalence %, (95% CI): Black NH, 8913, 28.9 (25.8 to 32.0) , individuals with income less than $25,000, 13,244, 25.1 (22.1 to 28.1); education of high school to some college, 17, 272, 26.1 (23.1 to 29.1) and the region of the South, 6,639, 25.3 (22.3 to 28.3).

Demographic Categories of Interest

  • Race / Ethnicity
  • Age
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

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.

Data Set Used

Registered Tier

Research Team

Owner:

Collaborators:

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

Revision_after_HTN_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.

Data Set Used

Registered Tier

Research Team

Owner:

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You can request that the All of Us Resource Access Board (RAB) review a research purpose description if you have concerns that this research project may stigmatize All of Us participants or violate the Data User Code of Conduct in some other way. To request a review, you must fill in a form, which you can access by selecting ‘request a review’ below.