Jo-Hsuan Wu

Research Fellow, University of California, San Diego

5 active projects

Glaucoma healthcare access and utility

Questions: Is there a barrier ophthalmic care access and utility within the population of patients with glaucoma? What are the potential factors causing this barrier? Relevance: It is important to understand the underlying factors associated with barrier to healthcare in…

Scientific Questions Being Studied

Questions: Is there a barrier ophthalmic care access and utility within the population of patients with glaucoma? What are the potential factors causing this barrier?

Relevance: It is important to understand the underlying factors associated with barrier to healthcare in this patient group, as glaucoma is a chronic and irreversible disease requiring long-term and regular follow-up and management.

Project Purpose(s)

  • Disease Focused Research (glaucoma)
  • Population Health
  • Social / Behavioral

Scientific Approaches

Study population: patients with any type of glaucoma in the All of Us dataset
Methods: cross-sectional study
Tools:
- We will be collecting demographic and socioeconomic information of the patients, as well as their responses to the "Participant Surveys: Healthcare Access & Utilization"
- A cross-sectional analysis will be performed to identify the prevalence of barrier to ophthalmic care reported by the patients and the underlying reasons
- A risk analysis may be performed to identify risk factors associated with increased barrier to healthcare access and utility

Anticipated Findings

Barrier to ophthalmic care may include poor daily functional ability (related to older age and visual impairment), inconvenience to visit (inability to transport), lack of insurance (cannot afford healthcare), insufficient understanding about the disease (unsuccessful communication with the clinicians), lack of social support (difficulty to comply with treatment), etc. Some of these reasons might be related to healthcare inequity and disparity associated with factors such as age, ethnicity, education level, and/or income level.

By identifying the factors associated with decreased access and utility of ophthalmic care in glaucoma patients, we can better understand the potentially existing inequity or disparity in glaucoma care, the influence of glaucoma on the patients' daily lives, key factors leading to better or poorer treatment compliance/outcome, and ways to identify patients at risk of poor access and utility of ophthalmic care needing further attention and outreach.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

  • Jo-Hsuan Wu - Research Fellow, University of California, San Diego

Collaborators:

  • Sally Baxter - Research Fellow, University of California, San Diego

V6 Duplicate of Cannabis-glaucoma study

Background: 1. With recent changes in legal regulation, the prevalence of cannabis use is increasing in the US 2. Cannabis has previously shown potential IOP-reducing and neuroprotective effects in some prior studies 3. Although only anecdote evidence is available, glaucoma…

Scientific Questions Being Studied

Background:
1. With recent changes in legal regulation, the prevalence of cannabis use is increasing in the US
2. Cannabis has previously shown potential IOP-reducing and neuroprotective effects in some prior studies
3. Although only anecdote evidence is available, glaucoma patients may be increasingly using cannabis as a therapeutical option

Relevance:
There is a huge knowledge gap on the public health impact and risk benefit of cannabis use in glaucoma patients. To fill this gap, it is important to understand the epidemiology of cannabis use among patients with glaucoma, as well as the potential benefit and risk of such behavior.

Aims:
1. To estimate the prevalence and frequency of cannabis use in patients with glaucoma
2. To characterize the social and demographic factors associated with cannabis use in these patients
3. To evaluate the differences in the prevalence of cannabis use disorder in glaucoma patients compared to healthy individuals

Project Purpose(s)

  • Disease Focused Research (glaucoma)

Scientific Approaches

We will define the cohort of glaucoma patients based on diagnosis codes. Data from the All of Us Lifestyle Survey will be used to characterize cannabis exposure.
1. We will ascertain the overall prevalence of cannabis use and then perform descriptive analyses to understand the variations of marijuana use by age, race, ethnicity, gender, and geographic region.
2. Data will be extracted for additional variables such as income, education, insurance, access to eye doctors, and access to general medical care based on responses to the All of Us Basics Survey and the Healthcare Access and Utilization Survey. We will then perform analyses to understand which variables are significantly associated with cannabis use.
3. We will query the EHR data for diagnosis codes related to marijuana use disorders and manifestations of adverse effects. We will compare the prevalence of marijuana use disorder between patients with glaucoma and healthy controls.

Anticipated Findings

1. We anticipated a higher prevalence and frequency of cannabis use in glaucoma patients as compared to healthy individual.
2. We also anticipated several socioeconomic factors to be associated with increased cannabis use in this cohort, such as increased age, certain race, certain geographic region with greater accessibility to cannabis products, lower access to medical care and eye care, etc.
3. The prevalence of marijuana use disorders and manifestations of adverse effects should be slightly higher or similar to that in healthy cohort.

This study will help fill the knowledge gap on the public health impact and risk benefit of cannabis use in glaucoma patients.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

  • Jo-Hsuan Wu - Research Fellow, University of California, San Diego

Collaborators:

  • Sally Baxter - Research Fellow, University of California, San Diego
  • Bharanidharan Radha Saseendrakumar - Project Personnel, University of California, San Diego
  • Alireza Kamalipour - Research Fellow, University of California, San Diego

Cannabis-glaucoma study

Background: 1. With recent changes in legal regulation, the prevalence of cannabis use is increasing in the US 2. Cannabis has previously shown potential IOP-reducing and neuroprotective effects in some prior studies 3. Although only anecdote evidence is available, glaucoma…

Scientific Questions Being Studied

Background:
1. With recent changes in legal regulation, the prevalence of cannabis use is increasing in the US
2. Cannabis has previously shown potential IOP-reducing and neuroprotective effects in some prior studies
3. Although only anecdote evidence is available, glaucoma patients may be increasingly using cannabis as a therapeutical option

Relevance:
There is a huge knowledge gap on the public health impact and risk benefit of cannabis use in glaucoma patients. To fill this gap, it is important to understand the epidemiology of cannabis use among patients with glaucoma, as well as the potential benefit and risk of such behavior.

Aims:
1. To estimate the prevalence and frequency of cannabis use in patients with glaucoma
2. To characterize the social and demographic factors associated with cannabis use in these patients
3. To evaluate the differences in the prevalence of cannabis use disorder in glaucoma patients compared to healthy individuals

Project Purpose(s)

  • Disease Focused Research (glaucoma)

Scientific Approaches

We will define the cohort of glaucoma patients based on diagnosis codes. Data from the All of Us Lifestyle Survey will be used to characterize cannabis exposure.
1. We will ascertain the overall prevalence of cannabis use and then perform descriptive analyses to understand the variations of marijuana use by age, race, ethnicity, gender, and geographic region.
2. Data will be extracted for additional variables such as income, education, insurance, access to eye doctors, and access to general medical care based on responses to the All of Us Basics Survey and the Healthcare Access and Utilization Survey. We will then perform analyses to understand which variables are significantly associated with cannabis use.
3. We will query the EHR data for diagnosis codes related to marijuana use disorders and manifestations of adverse effects. We will compare the prevalence of marijuana use disorder between patients with glaucoma and healthy controls.

Anticipated Findings

1. We anticipated a higher prevalence and frequency of cannabis use in glaucoma patients as compared to healthy individual.
2. We also anticipated several socioeconomic factors to be associated with increased cannabis use in this cohort, such as increased age, certain race, certain geographic region with greater accessibility to cannabis products, lower access to medical care and eye care, etc.
3. The prevalence of marijuana use disorders and manifestations of adverse effects should be slightly higher or similar to that in healthy cohort.

This study will help fill the knowledge gap on the public health impact and risk benefit of cannabis use in glaucoma patients.

Demographic Categories of Interest

This study will not center on underrepresented populations.

Data Set Used

Registered Tier

Research Team

Owner:

  • Jo-Hsuan Wu - Research Fellow, University of California, San Diego

Collaborators:

  • Sally Baxter - Research Fellow, University of California, San Diego
  • Bharanidharan Radha Saseendrakumar - Project Personnel, University of California, San Diego

Metformin and Glaucoma v6

There remain limited treatment options for glaucoma outside lowering intraocular pressure, which is not effective in all patients. Metformin, an antihyperglycemic drug used for the management of diabetes, is being increasingly explored for its neuroprotective effects in the eye. We…

Scientific Questions Being Studied

There remain limited treatment options for glaucoma outside lowering intraocular pressure, which is not effective in all patients. Metformin, an antihyperglycemic drug used for the management of diabetes, is being increasingly explored for its neuroprotective effects in the eye. We would like to investigate the relationship between metformin use and primary open-angle glaucoma incidence and progression using All of Us Data, given the limited studies focusing on this topic.

Project Purpose(s)

  • Drug Development

Scientific Approaches

We will build a cohort of patients with diabetes aged 40 and older, with no prior glaucoma diagnosis at baseline to assess glaucoma incidence. We will build a cohort of patients with diabetes aged 40 and older with an existing diagnosis of glaucoma to assess glaucoma progression. Then we will develop concept sets and extract data on outcomes (i.e. diagnosis of glaucoma, glaucoma progression represented by need for glaucoma surgery), as well as predictors including clinical data and social data. Analyses will be performed in R notebooks within the All of Us Workbench environment.

Anticipated Findings

We anticipate that metformin use will be associated with a reduced risk of developing primary open-angle glaucoma and reduced risk of progression to glaucoma surgery.

Demographic Categories of Interest

  • Race / Ethnicity
  • Age
  • Geography
  • Disability Status
  • Access to Care
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

Metformin and Glaucoma

There remain limited treatment options for glaucoma outside lowering intraocular pressure, which is not effective in all patients. Metformin, an antihyperglycemic drug used for the management of diabetes, is being increasingly explored for its neuroprotective effects in the eye. We…

Scientific Questions Being Studied

There remain limited treatment options for glaucoma outside lowering intraocular pressure, which is not effective in all patients. Metformin, an antihyperglycemic drug used for the management of diabetes, is being increasingly explored for its neuroprotective effects in the eye. We would like to investigate the relationship between metformin use and primary open-angle glaucoma incidence and progression using All of Us Data, given the limited studies focusing on this topic.

Project Purpose(s)

  • Drug Development

Scientific Approaches

We will build a cohort of patients with diabetes aged 40 and older, with no prior glaucoma diagnosis at baseline to assess glaucoma incidence. We will build a cohort of patients with diabetes aged 40 and older with an existing diagnosis of glaucoma to assess glaucoma progression. Then we will develop concept sets and extract data on outcomes (i.e. diagnosis of glaucoma, glaucoma progression represented by need for glaucoma surgery), as well as predictors including clinical data and social data. Analyses will be performed in R notebooks within the All of Us Workbench environment.

Anticipated Findings

We anticipate that metformin use will be associated with a reduced risk of developing primary open-angle glaucoma and reduced risk of progression to glaucoma surgery.

Demographic Categories of Interest

  • Race / Ethnicity
  • Age
  • Geography
  • Disability Status
  • Access to Care
  • Education Level
  • Income Level

Data Set Used

Registered Tier

Research Team

Owner:

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