Richard Boyce

Mid-career Tenured Researcher, University of Pittsburgh

3 active projects

Mental health and deaf patients - registered tier

We propose to study if there are any measurable differences between deaf, Deaf, or Hard of Hearing (d/DHH) patients and hearing patients with respect to mental health treatment. As primary goal, we are interested in how doctors treat the d/DHH…

Scientific Questions Being Studied

We propose to study if there are any measurable differences between deaf, Deaf, or Hard of Hearing (d/DHH) patients and hearing patients with respect to mental health treatment. As primary goal, we are interested in how doctors treat the d/DHH patients with medication compared to hearing people. Evidence suggests that d/DHH patients have a greater health burden compared to hearing people. Of particular concern, d/DHH who have mental health disorders including bipolar, major depressive disorder, and PTSD (with or without diagnoses) face barriers to proper treatment such as:

- Language barriers
- Lack of interpreters who understands medical background / literacy
- Discrimination
- Lack of counselors / psychologists who has knowledge about Deaf culture and ASL
- Discomfort; some deaf people are uncomfortable with going to counseling with an interpreter because of privacy reasons

Project Purpose(s)

  • Disease Focused Research (disease of mental health, social and behavioral health)
  • Social / Behavioral
  • Methods Development

Scientific Approaches

- Describe the prevalence of d/DHH patients within the All of Us cohort using electronic health record phenotype definitions

- Describe the prevalence of patients with bipolar, major depressive disorder, and PTSD (with or without diagnoses) using electronic health record phenotype definitions

- Describe the demographics of d/DHH patients with bipolar, major depressive disorder, or PTSD

- Describe the demographics of hearing patients with bipolar, major depressive disorder, or PTSD

- Compare medication treatment pathways for the three mental health disorders between d/DHH patients and hearing patients. The comparison will be primarily descriptive and based on evidence-based recommendations for treatment by professional societies.

Anticipated Findings

The primary hypothesis is that d/DHH patients receive less evidence-based mediation therapy for the three conditions of interest then hearing patients with a similar mental health status and background (i.e., accounting for age, sex at birth, sociodemographic variables, and disease co-morbidity).

Demographic Categories of Interest

  • Disability Status
  • Access to Care

Data Set Used

Registered Tier

Research Team

Owner:

  • Richard Boyce - Mid-career Tenured Researcher, University of Pittsburgh

Collaborators:

  • Olga Kravchenko - Research Fellow, University of Pittsburgh
  • John Maier - Other, University of Pittsburgh
  • Ivy Baker - Undergraduate Student, University of Pittsburgh

Exposure PGx drugs

Pharmacogenomics (PGx) is the study of how variability in drug response may correlate with the presence of certain sets of genetic variants within an individual or across a population. A significant challenge facing clinicians is how to best apply PGx…

Scientific Questions Being Studied

Pharmacogenomics (PGx) is the study of how variability in drug response may correlate with the presence of certain sets of genetic variants within an individual or across a population. A significant challenge facing clinicians is how to best apply PGx information to optimize medication therapy for their patients. PGx has been studied for more than two decades and two organizations maintain current PGx clinical guidelines for drug-gene interaction pairs. However, these guidelines generally focus on the pharmacokinetics or pharmacodynamics of a drug and there remain gaps in evidence in the scientific literature on the real-world outcomes of drug therapy for patients with known PGx variants. The goal of this methods study is to attempt to develop phenotype definitions that identify patients in the controlled tier dataset with known PGx variants and then test if known associations between PGx phenotype and treatment outcomes can be reproduced in the dataset.

Project Purpose(s)

  • Methods Development
  • Ancestry

Scientific Approaches

This analysis will be conducted in the controlled tier of the All of Us research enclave. We will first attempt to identify patients with known PGx variants that affect the activity of important enzymes, transporters, or proteins (e.g., CYP2C9, CYP2C19, CYP2D6, SLCO1B1, HLA-B). We will apply existing PGx variant definitions to the genomic data present in the controlled tier. We will describe the population of patients with known variants and the range of structured data present across the All of Us data domains (i.e., drug orders, procedures, conditions, observations, surveys, etc.). This description will also examine the extent that longitudinal data is available for patients with PGx variants relative to averages within the entire All of Us cohort. The findings from this stage will inform the next stage that will then test if known associations between PGx phenotype and treatment outcomes can be reproduced in the dataset.

Anticipated Findings

The results of this project will inform future studies that seek to use All of Us data to discover novel associations between PGx phenotype and treatment outcomes. For example, evidence exists that patients carrying the CYP2C19*2 or CYP2C19*3 alleles treated with clopidogrel may have a significantly may have an increased risk for adverse cardiac and cerebrovascular events as compared to patients with two normal function alleles. It is unknown if it is possible to reproduce this finding or other known PGx - outcome associations in the All of Us cohort. Lessons learned from attempting to reproduce these findings will benefit future PGx related research by identifying strengths, limitations, and key methodological considerations.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Controlled Tier

Research Team

Owner:

  • Richard Boyce - Mid-career Tenured Researcher, University of Pittsburgh

Collaborators:

  • Olga Kravchenko - Research Fellow, University of Pittsburgh

Test - concomitant colchicine-CYP3A4 inhibitor exposure

We will be exploring the data at this stage to study interactions between colchicine and drugs that inhibit cytochrome P450 3A4 . Clarithromycin is one drug but there are several others. The outcome of interest will be evidence of toxicity…

Scientific Questions Being Studied

We will be exploring the data at this stage to study interactions between colchicine and drugs that inhibit cytochrome P450 3A4 . Clarithromycin is one drug but there are several others. The outcome of interest will be evidence of toxicity which will include lab measures and other indicators

Project Purpose(s)

  • Population Health

Scientific Approaches

We plan to use a self-controlled pharmacoepidemiologic design comparing outcomes before and after exposure within patients. We might find this infeasible as we try to make progress. We will revise the approach if needed. We will compare outcomes to exposure to drugs that we expect will not have the outcome (negative controls).

Anticipated Findings

Colchicine toxicity is highly fatal and it is critical for researchers to identify which drug combinations place the patients at greatest risk. With only case evidence present in the scientific literature, and clinical trials unable to answer the question, researchers need to rapidly generate evidence to inform drug interaction decision support. This study will determine if it is feasible to use data from the All of Us Cohort to generate evidence for the research question.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

  • Richard Boyce - Mid-career Tenured Researcher, University of Pittsburgh
1 - 3 of 3
<
>
Request a Review of this Research Project

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.