Tsung-Ting Kuo

Early Career Tenure-track Researcher, University of California, San Diego

7 active projects

Systemic Disease and Glaucoma

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:

  • Francis Ratsimbazafy - Other, All of Us Program Operational Use
  • Nghia Nguyen - Research Fellow, University of California, San Diego
  • Joshua Morriss - Graduate Trainee, Virginia Commonwealth University

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:

Old Duplicate of Systemic Disease and Glaucoma

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 will develop predictive models using the All of Us dataset using multivariable logistic regression, random forests, and artificial neural networks.

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.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Research Team

Owner:

RacialEthnicDifferences_AnthropoLipidALT

Obesity is one of the most important risks for many diseases in the United States and across the world. Differences in body weight and shape across gender and race/ethnicity have been extensively described. We sought to replicate these differences and…

Scientific Questions Being Studied

Obesity is one of the most important risks for many diseases in the United States and across the world. Differences in body weight and shape across gender and race/ethnicity have been extensively described. We sought to replicate these differences and evaluate newly emerging data from the All of Us Research Program (AoU). In this project, we ask the scientific question: How do individuals from different genders and different racial/ethnic groups in the All Of Us dataset differ with respect to weight, waist and hip circumferences, cholesterol levels and levels of alanine aminotransferase?

Project Purpose(s)

  • Disease Focused Research (Obesity)
  • 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

Within each ethnic/racial group and each gender group, we first visually examine histograms of each outcome variable to determine the presence of any major outliers that may represent measurement errors. Then we tabulated the mean values and other descriptive statistics for continuous variables such as waist and hip circumferences. We also determined the proportion of individuals with abdominal obesity. To formally test for differences among groups and to adjust for age and other covariates, we will use linear regression, transforming variables to conform to assumptions of linear regression. Data for race and ethnicity was obtained from participants in participant-provided information (PPI). Biological sex at birth, height, weight, waist circumference (WC), and hip circumference measurements were obtained according to AoU baseline visit protocols. Levels of alanine aminotransferase (ALT) were obtained from the EHR records of participants.

Anticipated Findings

For this study, we anticipate that we will be able to replicate known differences in body weight and shape across gender and race/ethnicity. We anticipate that we will find racial/ethnic and gender disparities related to ALT, a surrogate marker of hepatic steatosis. We anticipate the ability to evaluate the consistency of the All of Us cohort with national averages related to obesity and indicate that this resource is likely to be a major source of scientific inquiry and discovery. This project will serve to demonstrate the quality, utility, and diversity of the All of Us data and tools and the power of gathering multiple data sources for a single set of phenotypes, providing researchers options for study design and validation.

Demographic Categories of Interest

  • Race / Ethnicity
  • Sex at Birth

Research Team

Owner:

Collaborators:

  • Lina Sulieman - Other, All of Us Program Operational Use
  • Jianglin Feng - Other, University of Arizona

DRC_Duplicate of for_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
  • 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

Research Team

Owner:

Collaborators:

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

DRC_Duplicate of For_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 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

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:

  • Francis Ratsimbazafy - Other, All of Us Program Operational Use
  • Guohai Zhou - Other, Mass General Brigham

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Scientific Questions Being Studied

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Project Purpose(s)

  • Other Purpose (Test for Webinar)

Scientific Approaches

Not available.

Anticipated Findings

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Demographic Categories of Interest

This study will not center on underrepresented populations.

Research Team

Owner:

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