Biostatistics Commons^™

Establishing A Public Health Surveillance System For The Opioid Crisis: The Experience Of The Healing Communities Study, Bridget Freisthler, Daniel J. Feaster, Charles Knott, Marc Larochelle, John Mccarthy, Svetla Slavova, Sharon L. Walsh, Jennifer Villani

Biostatistics Faculty Publications

Introduction: Efforts to reduce opioid overdose deaths in the United States have been stymied by the lack of timely and standardized population-level data for local, state, and national levels. The U.S. has a strong national need for linking opioid and other drug overdose surveillance data to service utilization data for overdose prevention and treatment to inform resource allocation and response planning.

Methods: We provide insight on the challenges of identifying, obtaining, and harmonizing administrative outcome data across four states using the collective experience from the HEALing Communities Study to test a community-engaged, data-driven, population-level intervention to reduce opioid overdose deaths. …

Feasibility, Acceptability, And Preliminary Efficacy Of A Pilot Study To Integrate Buprenorphine Into A Harm-Reduction Drop-In-Center In Kampala, Uganda, Julia Dickson-Gomez, Sergey Tarima, Wamala Twaibu, Dan Katende, Latifah Kyeswa, Laura Glasman, Arthur Kiconco, Sarah Krechel, Bryan Johnston, Moses Ogwal, Brian Byamah Mutamba, Peter Mudiope, Stella Alamo, Rhoda Wanyenze, Geofrey Musinguzi

Biostatistics Faculty Publications

Illicit drug use has been increasing rapidly in Sub-Saharan Africa in the past decade. However, until recently HIV prevention has largely ignored people who inject drugs and medications to treat opioid use disorder (MOUD) were largely absent. This paper reports results of a pilot intervention that integrated buprenorphine into a harm-reduction drop-in-center for people with opioid use disorder (OUD) in Kampala, Uganda. We collected implementation outcomes and changes in self-reported drug use after buprenorphine initiation. We conducted qualitative interviews with a subset of 14 participants who had initiated buprenorphine. Sixty-two participants were screened for OUD, of whom 57 were eligible …

Artificial Intelligence In Biomedical Team Science: Perceptions, Practices, And Training Needs, Emily Slade, Kelsey N. Karnik, Caitline Phan, Megan E. Hall, Yana Feygin, Kristen J. Mcquerry

Biostatistics Faculty Publications

Introduction: Artificial intelligence (AI) is increasingly used in biomedical research, yet limited empirical work has described how researchers use AI tools on collaborative research teams and how they view their role within team-based research. This study examines researchers’ experience with and attitudes toward AI use in collaborative research environments.

Methods: A cross-sectional survey was administered to 178 investigators engaged in collaborative research at the University of Kentucky. Questions assessed AI use across research and communication tasks, team-related decision-making practices, perceived benefits and concerns, and preferences for training and frameworks.

Results: Thirty-nine participants responded (22%). AI use was heterogeneous: 26% had …

Enhancing Team Science By Training Collaborative Biostatisticians To Have A Strong Statistical Voice, Gina-Maria Pomann, Steven C. Grambow, Marissa C. Ashner, Bibhas Chakraborty, Nan Liu, Megan L. Neely, Sarah Peskoe, Lacey Rende, Emily Slade, Tracy Truong, Lexie Zidanyue Yang, Greg P. Samsa, Jesse D. Troy

Biostatistics Faculty Publications

Strong statistical voice is defined as the ability to advocate and negotiate for good and ethical statistical practices, including integrating and resolving differing scientific approaches. This skill is crucial for biostatisticians who work on biomedical research teams, as it ensures the integrity and accuracy of statistical analyses and fosters productive collaborations with non-statisticians. Despite its importance, new graduates often lack targeted training opportunities. This manuscript presents a scalable training approach through the development of online videos. Preliminary didactic materials focused on two key applications: providing written comments on manuscripts and engaging in study design discussions. To evaluate this training approach, …

Body Mass Index Has No Impact On Complications And Mortality For Patients With Stage Iv Pancreatic Ductal Adenocarcinoma, Ren Bryant, Hannah Darnell, Megan Hall, Kelsey N. Karnik, Kristen J. Mcquerry, Ruben R. Plentz

Biostatistics Faculty Publications

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of United States (USA) cancer death. Overweight and obesity developing into a growing global medical and socio-economic problem, affecting approximately 42% of adults in the USA population. The aim of our analysis was to evaluate the influence of overweight and obesity on complications and clinical outcome in patients with stage IV PDAC.

Methods: We retrospectively reviewed electronic health records of patients diagnosed with stage IV PDAC (n=162) who followed with the University of Kentucky from January 2017–October 2024. Comparisons were based on the body mass index (BMI): low BMI …

Association Between Lifetime Interpersonal Violence And Post– Covid-19 Condition Among Women In Kentucky, 2020-2022, Ayşe Güler, Heather M. Bush, Katie Schill, Nurlan Kussainov, Ann L. Coker

Biostatistics Faculty Publications

Objective: The COVID-19 pandemic increased the risk of interpersonal violence. We investigated the association between lifetime interpersonal violence experience and risk of post–COVID-19 condition (the persistence of symptoms of COVID-19 and severity of health problems associated with COVID-19 that last a few weeks, months, or years) among women with lifetime interpersonal violence experience.   Methods: Women participants aged ≥18 years in Kentucky’s Wellness, Health & You—COVID-19 study completed online quantitative surveys about the impacts of the pandemic, developing COVID-19, and symptoms of post–COVID-19 condition. We conducted cross-sectional analyses estimating rate ratios of developing COVID-19 and symptoms of post–COVID-19 condition during the …

Comparison Of Machine Learning Models For Colon Cancer Survival: Predictive Modeling Approach, Reuben Adatorwovor, Motolani E. Ogunsanya, Bin Huang, Richard Charnigo, Olufunmilola Abraham

Biostatistics Faculty Publications

Background: Colon cancer is a leading cause of cancer-related deaths worldwide, with survival influenced by risk factors, treatment type, and patient characteristics. Traditional statistical models, such as Kaplan-Meier curves, have been widely used to estimate survival probabilities. However, these models often have difficulty handling complex interactions, covariates, and nonlinear relationships between risk factors. Recently, machine learning (ML) techniques have emerged as promising tools for improving survival prediction by handling large covariates and capturing complex patterns.

Objective: This study compares several ML models to accurately estimate colon cancer survival by leveraging data from the Kentucky Cancer Registry. By identifying key risk …

Disentangling The Inverse Relationship Between Cancer And Alzheimer’S Or Parkinson’S Disease: A Systematic Review On Mendelian Randomization Studies, Khine Zin Aung, Su Su Zin, Xian Wu, Zin W. Myint, Shama D. Karanth, Steven Estus, Christopher M. Norris, Peter T. Nelson, David W. Fardo, Erin L. Abner, Yuriko Katsumata

Biostatistics Faculty Publications

Introduction

Although studies have reported an inverse relationship between cancer and neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD), findings remain inconsistent. Observational studies are limited by survival bias and reverse causation. To better understand the relationship, we conducted a systematic review of Mendelian randomization (MR) studies examining both directions—assessing cancer as a risk factor for AD or PD, as well as AD or PD as exposures influencing cancer risk.

Methods

We systematically reviewed MR studies investigating the causal relation between cancer and either AD or PD. Cancer could be specified as either an exposure or an …

Incident Atherosclerotic Cardiovascular Disease Among Veterans By Gender Identity: A Cohort Study, Carl G. Streed Jr., Meredith S. Duncan, Kory R. Heier, T. Elizabeth Workman, Lauren B. Beach, Guneet K. Jasuja, Hill L. Wolfe, Landon D. Hughes, John R. O’Leary, Melissa Skanderson, Joseph L. Goulet

Biostatistics Faculty Publications

Background: Transgender and gender diverse (trans) populations are at elevated risk for atherosclerotic cardiovascular disease (ASCVD).

Objective: Measure the association of gender identity and gender-affirming hormone therapy (GAHT) with ASCVD outcomes.

Design: Cohort study.

Participants: Over 1 million veterans receiving care in the Veterans Health Administration.

Main Measures: Gender identity was identified via a validated natural language processing (NLP) algorithm. Incident ASCVD (acute myocardial infarction, ischemic stroke, or revascularization after the baseline date) was identified via International Classification of Diseases diagnosis codes among veterans without prevalent ASCVD. We calculated sample statistics stratified by gender identity and used Cox proportional hazard …

Communities That Heal Intervention And Mortality Including Polysubstance Overdose Deaths: A Randomized Clinical Trial, Bridget Freisthler, Rouba A. Chahine, Jennifer Villani, Redonna Chandler, Daniel J. Feaster, Svetla Slavova, Jolene Defiore-Hyrmer, Alexander Y. Walley, Sarah Kosakowski, Arnie Aldridge, Carolina Barbosa, Sabana Bhatta, Candace Brancato, Carly Bridden, Mia Christopher, Tom Clarke, James David, Lauren D'Costa, Irene Ewing, Soledad Fernandez, Erin Gibson, Louisa Gilbert, Megan E. Hall, Sarah Hargrove, Timothy Hunt, Elizabeth N. Kinnard, Lauren Larochelle, Aaron Macoubray, Shawn R. Nigam, Edward V. Nunes, Carrie B. Oser, Sharon Pagnano, Peter J. Rock, Pamela Salsberry, Aimee Shadwick, Thomas J. Stopka, Sylvia Tan, Jessica L. Taylor, Philip M. Westgate, Elwin Wu, Gary A. Zarkin, Sharon L. Walsh, Nabila El-Bassel, T. John Winhusen, Jeffrey H. Samet, Emmanuel A. Oga

Biostatistics Faculty Publications

IMPORTANCE: The HEALing Communities Study (HCS) evaluated the effectiveness of the Communities That HEAL (CTH) intervention in preventing fatal overdoses amidst the US opioid epidemic.

OBJECTIVE: To evaluate the impact of the CTH intervention on total drug overdose deaths and overdose deaths involving combinations of opioids with psychostimulants or benzodiazepines.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was a parallel-arm, multisite, community-randomized, open, and waitlisted controlled comparison trial of communities in 4 US states between 2020 and 2023. Eligible communities were those reporting high opioid overdose fatality rates in Kentucky, Massachusetts, New York, and Ohio. Covariate constrained randomization stratified …

A Guide To Successful Management Of Collaborative Partnerships In Quantitative Research: An Illustration Of The Science Of Team Science., Alyssa Platt, Tracy Truong, Mary Boulos, Nichole E Carlson, Manisha Desai, Monica M Elam, Emily Slade, Alexandra L Hanlon, Jillian H Hurst, Maren K Olsen, Laila M Poisson, Lacey Rende, Gina-Maria Pomann

Biostatistics Faculty Publications

Data-intensive research continues to expand with the goal of improving healthcare delivery, clinical decision-making, and patient outcomes. Quantitative scientists, such as biostatisticians, epidemiologists, and informaticists, are tasked with turning data into health knowledge. In academic health centres, quantitative scientists are critical to the missions of biomedical discovery and improvement of health. Many academic health centres have developed centralized Quantitative Science Units which foster dual goals of professional development of quantitative scientists and producing high quality, reproducible domain research. Such units then develop teams of quantitative scientists who can collaborate with researchers. However, existing literature does not provide guidance on how …

A Case Study On Variations In Network Structure And Cross- Sector Alignment In Two Local Systems Serving Pregnant And Parenting Women In Recovery, Liza M. Creel, Yana Feygin, Madeline Shipley, Deborah Winders Davis, Tiffany Cole Hall, Chaly Downs, Stephanie Hoskins, Natalie Pasquenza, Scott D. Duncan

Biostatistics Faculty Publications

Objective: To describe network structure and alignment across organizations in healthcare, public health, and social services sectors that serve pregnant and parenting women with substance use disorder (SUD) in an urban and a rural community.

Data Sources and Study Settings: Two community networks, one urban and one rural with each including a residential substance use treatment program, in Kentucky during 2021.

Study Design: Social network analysis measured system collaboration and cross-sector alignment between healthcare, public health, and social services organizations, applying the Framework for Aligning Sectors. To understand the alignment and structure of each network, we measured network density overall …

Higher First 30-Day Dose Of Buprenorphine For Opioid Use Disorder Treatment Is Associated With Decreased Mortality, Feitong Lei, Michelle R. Lofwall, Jana Mcanich, Reuben Adatorwovor, Emily Slade, Patricia R. Freeman, Daniela Moga, Nabarun Dasgupta, Sharon L. Walsh, Rachel Vickers-Smith, Svetla Slavova

Biostatistics Faculty Publications

Objective: Buprenorphine is a medication for opioid use disorder that reduces mortality. This study aims to investigate the less well-understood relationship between the dose in the early stages of treatment and the subsequent risk of death.

Methods: We used Kentucky prescription monitoring data to identify adult Kentucky residents initiating transmucosal buprenorphine medication for opioid use disorder (January 2017 to November 2019). Average daily buprenorphine dose for days covered in the first 30 days of treatment was categorized as ≤8 mg, >8 to ≤16 mg, and >16 mg. Patients were followed for 365 days after the first 30 days of buprenorphine …

A Case Report On A Women’S Residential Substance Use Program In A Rural And Urban Setting, Deborah Winders Davis, Yana Feygin, Madeline Shipley, Tiffany Cole Hall, Chaly Downs, Stephanie Hoskins, Natalie Pasquenza, Scott D. Duncan, Liza M. Creel

Biostatistics Faculty Publications

Purpose To describe program characteristics and outcomes of a residential substance use recovery program serving pregnant and parenting women in a rural and urban location.

Description This assessment of administrative records from April 1, 2020 through March 31, 2022, included women in a rural (n = 140) and urban (n = 321) county in Kentucky.

Assessment This retrospective case study used descriptive and non-parametric analyses to assess the population and examine differences between locations, race, and ethnicity for women served. Logistic regression tested predictors of goal achievement by community. Of 461 women served, 65 (14.1%) delivered a baby while in …

Health Care For People Who Are Incarcerated: Teaching Third-Year Medical Students About Rights, Challenges, And Avenues Of Advocacy, Anna-Maria South, Kelsey N. Karnik, Sara Hieneman, Anthony A. Mangino, Michelle R. Lofwall

Biostatistics Faculty Publications

Introduction: Incarcerated patients are a vulnerable patient population with unique barriers to health care that physicians in every specialty encounter. Current medical school curricula lack universal education on health care for incarcerated people.

Methods: We developed an interactive workshop to provide third-year medical students at the University of Kentucky with information about delivering care outside of dedicated carceral settings to individuals who are incarcerated. The workshop included education on the demographic characteristics and medical conditions present in these populations along with understanding incarcerated persons’ rights to health care and how to interact with them and the associated jail/prison workforce often …

Stigma And Efficacy Beliefs Regarding Opioid Use Disorder Treatment And Naloxone In Communities Participating In The Healing Communities Study Intervention, Nicky Lewis, Barry Eggleston, Redonna K. Chandler, Dawn Goddard-Eckrich, Jamie E. Luster, Dacia Beard, Emma Rodgers, Rouba A. Chahine, Philip M. Westgate, Shoshana N. Benjamin, Janae Holloway, Thomas Clarke, R. Craig Lefebvre, Michael D. Stein, Donald W. Helme, Jennifer Reynolds, Sharon L. Walsh, Darcy Freedman, Nabila El-Bassel, Kara Stephens, Anita Silwal, Michelle R. Lofwall, Janet E. Childerhose, Hilary L. Surratt, Brooke N. Crockett, Amy L. Farmer, James L. David, Laura Fanucchi, Judy Harness, Ben Wilburn, Kelli Bursey, Kristin Mattson, Sarah Mann, Rebecca D. Jackson, Aimee Shadwick, Katherine Calver, Deborah Chassler, Jennifer Kimball, Nancy Regan, Jeffrey H. Samet, Rachel Sword-Cruz, Michael D. Slater

Biostatistics Faculty Publications

Background The HEALing Communities Study (HCS) included health campaigns as part of a community-engaged intervention to reduce opioid-related overdose deaths in 67 highly impacted communities across Kentucky, Massachusetts, New York, and Ohio. Five campaigns were developed with community input to provide information on opioid use disorder (OUD) and overdose prevention, reduce stigma, and build demand for evidence-based practices (EBPs). An evaluation examined the recognition of campaign messages about naloxone and whether stigma and efficacy beliefs regarding OUD treatment and naloxone changed in HCS intervention communities.

Methods Data were collected through surveys offered on Facebook/Instagram to members of communities participating in …

Expectile Neural Networks For Genetic Data Analysis Of Complex Diseases, Jinghang Lin, Xiaoran Tong, Chenxi Li, Qing Lu

Biostatistics Faculty Publications

The genetic etiologies of common diseases are highly complex and heterogeneous. Classic methods, such as linear regression, have successfully identified numerous variants associated with complex diseases. Nonetheless, for most diseases, the identified variants only account for a small proportion of heritability. Challenges remain to discover additional variants contributing to complex diseases. Expectile regression is a generalization of linear regression and provides complete information on the conditional distribution of a phenotype of interest. While expectile regression has many nice properties, it has rarely been used in genetic research. In this paper, we develop an expectile neural network (ENN) method for genetic …

The Efficacy Of Plant-Based Dietary Program In Patients With Diabetes: A Pilot Study, Reuben Adatorwovor, Nisha Sharma, Dakota Mccoy, Sharon Wasserstrom, Matthew Robinson, Jacquelyn Nyenhuis, Sowmya Suryanarayanan

Biostatistics Faculty Publications

Dietary choices play a key role in insulin sensitivity among diabetes patients. An 8-week pilot study was conducted to evaluate whether a mostly plant-based dietary program will lead to improvement in biochemical markers in adults with diabetes. The dietary program included educational presentations, weekly cooking demonstrations and small group discussions. A sample of thirty-two adults with diabetes (types 1 and 2) were recruited and seventeen (53%) completed the study. Matched-pair tests and Fishers exact tests were used to compare the changes in means and proportion of the participants’ responses. There were changes in HbA1c, lipids, CRP (mg/L), cholesterol (mg/dL), HDL …

Ovarian Cancer Epidemiology, Healthcare Access And Disparities (Orchid): Methodology For A Population-Based Study Of Black, Hispanic And White Patients With Ovarian Cancer, Tomi Akinyemiju, April Deveaux, Lauren Wilson, Anjali Gupta, Ashwini Joshi, Malcolm Bevel, Chioma Omeogu, Onyinye Ohamadike, Bin Huang, Maria Pisu, Margaret Liang, Molly Mcfatrich, Erin Daniell, Laura Jane Fish, Kevin Ward, Maria Schymura, Andrew Berchuck, Arnold L. Potosky

Biostatistics Faculty Publications

INTRODUCTION: Less than 40% of patients with ovarian cancer (OC) in the USA receive stage-appropriate guideline-adherent surgery and chemotherapy. Black patients with cancer report greater depression, pain and fatigue than white patients. Lack of access to healthcare likely contributes to low treatment rates and racial differences in outcomes. The Ovarian Cancer Epidemiology, Healthcare Access and Disparities study aims to characterise healthcare access (HCA) across five specific dimensions-Availability, Affordability, Accessibility, Accommodation and Acceptability-among black, Hispanic and white patients with OC, evaluate the impact of HCA on quality of treatment, supportive care and survival, and explore biological mechanisms that may contribute to …

Analysis Of Genes (Tmem106b, Grn, Abcc9, Kcnmb2, And Apoe) Implicated In Risk For Late-Nc And Hippocampal Sclerosis Provides Pathogenetic Insights: A Retrospective Genetic Association Study, Adam J. Dugan, Peter T. Nelson, Yuriko Katsumata, Lincoln M. P. Shade, Kevin L. Boehme, Merilee A. Teylan, Matthew D. Cykowski, Shubhabrata Mukherjee, John S. K. Kauwe, Timothy J. Hohman, Julie A. Schneider, Alzheimer’S Disease Genetics Consortium, David W. Fardo

Biostatistics Faculty Publications

Limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is the most prevalent subtype of TDP-43 proteinopathy, affecting up to 1/3rd of aged persons. LATE-NC often co-occurs with hippocampal sclerosis (HS) pathology. It is currently unknown why some individuals with LATE-NC develop HS while others do not, but genetics may play a role. Previous studies found associations between LATE-NC phenotypes and specific genes: TMEM106B, GRN, ABCC9, KCNMB2, and APOE. Data from research participants with genomic and autopsy measures from the National Alzheimer’s Coordinating Center (NACC; n = 631 subjects included) and the Religious Orders Study and Memory …

Hiv Infection And The Risk Of World Health Organization-Defined Sudden Cardiac Death, Matthew S. Freiberg, Meredith S. Duncan, Charles Alcorn, Chung-Chou H. Chang, Suman Kundu, Asri Mumpuni, Emily K. Smith, Sarah Loch, Annie Bedigian, Eric Vittinghoff, Kaku So-Armah, Priscilla Y. Hsue, Amy C. Justice, Zian H. Tseng

Biostatistics Faculty Publications

Background

People living with HIV have higher sudden cardiac death (SCD) rates compared with the general population. Whether HIV infection is an independent SCD risk factor is unclear.

Methods and Results

This study evaluated participants from the Veterans Aging Cohort Study, an observational, longitudinal cohort of veterans with and without HIV infection matched 1:2 on age, sex, race/ethnicity, and clinical site. Baseline for this study was a participant's first clinical visit on or after April 1, 2003. Participants were followed through December 31, 2014. Using Cox proportional hazards regression, we assessed whether HIV infection, CD4 cell counts, and/or HIV viral …

Associations Of Circulating Dimethylarginines With The Metabolic Syndrome In The Framingham Offspring Study, Ibrahim Musa Yola, Carlee Moser, Meredith S. Duncan, Edzard Schwedhelm, Dorothee Atzler, Renke Maas, Juliane Hannemann, Rainer H. Böger, Ramachandran S. Vasan, Vanessa Xanthakis

Biostatistics Faculty Publications

BACKGROUND: Circulating levels of the endogenous inhibitor of nitric oxide synthase, asymmetric dimethylarginine (ADMA), are positively associated with the prevalence of metabolic syndrome (MetS) in cross-sectional investigations. It is unclear if circulating ADMA and other methylarginines are associated with incident MetS prospectively.

METHODS: We related circulating ADMA, symmetric dimethylarginine (SDMA), L-arginine (ARG) concentrations (measured with a validated tandem mass spectrometry assay) and the ARG/ADMA ratio to MetS and its components in 2914 (cross-sectional analysis, logistic regression; mean age 58 years, 55% women) and 1656 (prospective analysis, Cox regression; mean age 56 years, 59% women) individuals from the Framingham Offspring Study …

Effect Sizes And Intra-Cluster Correlation Coefficients Measured From The Green Dot High School Study For Guiding Sample Size Calculations When Designing Future Violence Prevention Cluster Randomized Trials In School Settings, Md. Tofial Azam, Heather M. Bush, Ann L. Coker, Philip M. Westgate

Biostatistics Faculty Publications

Purpose: Cluster randomized controlled trials (cRCTs) are popular in school-based research designs where schools are randomized to different trial arms. To help guide future study planning, we provide information on anticipated effect sizes and intra-cluster correlation coefficients (ICCs), as well as school sizes, for dating violence (DV) and interpersonal violence outcomes based on data from a cRCT which evaluated the bystander-based violence intervention ‘Green Dot’.

Methods: We utilized data from 25 schools from the Green Dot High School study. Effect size and ICC values corresponding to dating and interpersonal violence outcomes are obtained from linear mixed effect models. We …

Analysis Of Genetic Variants Associated With Levels Of Immune Modulating Proteins For Impact On Alzheimer’S Disease Risk Reveal A Potential Role For Siglec14, Benjamin C. Shaw, Yuriko Katsumata, James F. Simpson, David W. Fardo, Steven Estus

Biostatistics Faculty Publications

Genome-wide association studies (GWAS) have identified immune-related genes as risk factors for Alzheimer’s disease (AD), including TREM2 and CD33, frequently passing a stringent false-discovery rate. These genes either encode or signal through immunomodulatory tyrosine-phosphorylated inhibitory motifs (ITIMs) or activation motifs (ITAMs) and govern processes critical to AD pathology, such as inflammation and amyloid phagocytosis. To investigate whether additional ITIM and ITAM-containing family members may contribute to AD risk and be overlooked due to the stringent multiple testing in GWAS, we combined protein quantitative trait loci (pQTL) data from a recent plasma proteomics study with AD associations in a recent …

Age And Sex Are Associated With The Plasma Lipidome: Findings From The Goldn Study, Emily Slade, Marguerite R. Irvin, Kevin Xie, Donna K. Arnett, Steven A. Claas, Tobias Kind, David W. Fardo, Gregory A. Graf

Biostatistics Faculty Publications

Background
Developing an understanding of the biochemistry of aging in both sexes is critical for managing disease throughout the lifespan. Lipidomic associations with age and sex have been reported, but prior studies are limited by measurements in serum rather than plasma or by participants taking lipid-lowering medications.

Methods
Our study included lipidomic data from 980 participants aged 18–87 years old from the Genetics of Lipid-Lowering Drugs and Diet Network (GOLDN). Participants were off lipid-lowering medications for at least 4 weeks, and signal intensities of 413 known lipid species were measured in plasma. We examined linear age and sex associations with …

Real World Clinicopathologic Observations Of Patients With Metastatic Solid Tumors Receiving Immune Checkpoint Inhibitor Therapy: Analysis From Kentucky Cancer Registry, Aasems Jacob, Jianrong Wu, Jill M. Kolesar, Eric B. Durbin, Aju Mathew, Susanne Arnold, Aman Chauhan

Biostatistics Faculty Publications

The state of Kentucky has the highest cancer incidence and mortality in the United States. High‐risk populations such as this are often underrepresented in clinical trials. The study aims to do a comprehensive analysis of molecular landscape of metastatic cancers among these patients with detailed evaluation of factors affecting response and outcomes to immune checkpoint inhibitor (ICI) therapy. We performed a retrospective analysis of metastatic solid tumor patients who received ICI and underwent molecular profiling at our institution.

Sixty nine patients with metastatic solid tumors who received ICI were included in the study. Prevalence of smoking and secondhand tobacco exposure …

Measurement Matters: Changing Penalty Calculations Under The Hospital Acquired Condition Reduction Program (Hacrp) Cost Hospitals Millions, Olga A. Vsevolozhskaya, Karina C. Manz, Pierre M. Zephyr, Teresa M. Waters

Biostatistics Faculty Publications

BACKGROUND: Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Program (HACRP). While early evaluations of the HACRP program reported cumulative reductions in hospital-acquired conditions, more recent studies have not found a clear association between receipt of the HACRP penalty and hospital quality of care. We posit that some of this disconnect may be driven by frequent scoring updates. The sensitivity of the HACRP penalties to updates in the program's scoring methodology has not been independently evaluated.

METHODS: We used …

Distinct Clinicopathologic Clusters Of Persons With Tdp-43 Proteinopathy, Yuriko Katsumata, Erin L. Abner, Shama Karanth, Merilee A. Teylan, Charles N. Mock, Matthew D. Cykowski, Edward B. Lee, Kevin L. Boehme, Shubhabrata Mukherjee, John S. K. Kauwe, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Peter T. Nelson

Biostatistics Faculty Publications

To better understand clinical and neuropathological features of TDP-43 proteinopathies, data were analyzed from autopsied research volunteers who were followed in the National Alzheimer’s Coordinating Center (NACC) data set. All subjects (n = 495) had autopsy-proven TDP-43 proteinopathy as an inclusion criterion. Subjects underwent comprehensive longitudinal clinical evaluations yearly for 6.9 years before death on average. We tested whether an unsupervised clustering algorithm could detect coherent groups of TDP-43 immunopositive cases based on age at death and extensive neuropathologic data. Although many of the brains had mixed pathologies, four discernible clusters were identified. Key differentiating features were age at …

Dot: Gene-Set Analysis By Combining Decorrelated Association Statistics, Olga A. Vsevolozhskaya, Min Shi, Fengjiao Hu, Dmitri V. Zaykin

Biostatistics Faculty Publications

Historically, the majority of statistical association methods have been designed assuming availability of SNP-level information. However, modern genetic and sequencing data present new challenges to access and sharing of genotype-phenotype datasets, including cost of management, difficulties in consolidation of records across research groups, etc. These issues make methods based on SNP-level summary statistics particularly appealing. The most common form of combining statistics is a sum of SNP-level squared scores, possibly weighted, as in burden tests for rare variants. The overall significance of the resulting statistic is evaluated using its distribution under the null hypothesis. Here, we demonstrate that this basic …

Epidemiologic Evaluation Of Nhanes For Environmental Factors And Periodontal Disease, P. Emecen-Huja, H. -F. Li, J. L. Ebersole, J. Lambert, Heather M. Bush

Biostatistics Faculty Publications

Periodontitis is a chronic inflammation that destroys periodontal tissues caused by the accumulation of bacterial biofilms that can be affected by environmental factors. This report describes an association study to evaluate the relationship of environmental factors to the expression of periodontitis using the National Health and Nutrition Examination Study (NHANES) from 1999–2004. A wide range of environmental variables (156) were assessed in patients categorized for periodontitis (n = 8884). Multiple statistical approaches were used to explore this dataset and identify environmental variable patterns that enhanced or lowered the prevalence of periodontitis. Our findings indicate an array of environmental variables were …