2205A Student Center
Monday, Feb. 20th, 2017
Published on 02/16/2017
The ePHR (electronic Personal Health Record) is a self-service technology (SST) used in health care, which can serve as an electronic information source for patients, physician and the government. Based on the literature review, we found that there are some concerns and barriers during the ePHR implement in industry perspectives, physicians’ perspective, patients’ perspectives and technology perspectives. In the pilot study of ePHR implementation impact on physician workflow, we conduct a qualitative analysis using structured physician interviews, and a quantitative analysis for physician workflow observations. We try to create recommendations for ePHR implementation for a variety of physician practices, at the same time, discussed some other important ePHR implementation components: communication, training and measurement.
2205A Student Center
Monday, Feb. 13th, 2017
Published on 02/12/2017
Informatics Strategies for Risk Stratification in Population Health Management
Risk analysis and population health management can improve health outcomes, but improved risk stratification is needed to manage healthcare costs. Analysis of 157 publications on translational implementations of “risk stratification in population health management of chronic disease” showed a consensus that population health management and risk stratification can improve outcomes, but found uncertainty over best methods for risk prediction and controversy over the cost savings. The consensus of another 85 publications on the methodologies of “data mining for predictive healthcare analytics” was that clinically interpretable machine learning techniques are more appropriate than “black box” techniques for structured big data sources in healthcare, and the “area under the curve” of a prediction model’s sensitivity versus one-minus-specificity is a standard and reliable way to measure the model’s discrimination. This study used clinically interpretable machine-learning algorithms, combined with simple but powerful data analytic techniques such as cost analysis and data visualization, to evaluate and improve risk stratification for a managed patient population.
This study retrospectively observed 10,000 mid-Missouri Medicare and Medicaid patients between 2012 and 2014. Cost and utilization analyses, statistical clustering, contrast mining, and logistic regression were used to identify patients within a managed population at risk for higher healthcare costs, demonstrate longitudinal changes in risk stratification, and characterize detailed differences between high-risk and low-risk patients. The two highest risk stratification tiers comprised only 21% of patients but accounted for 43% of prospective charges. Patients in the most expensive sub-cluster of the most expensive risk tier were nearly twice as costly as high-risk patients on average. Combining contrast mining with logistic regression predicted the most expensive 5% of patients with 84% accuracy, as measured by area under the curve.
All the strategies used in this study, from the simplest to the most sophisticated, produced useful results. By predicting the small number of patients who will incur the majority of healthcare expenses in terms that are clinically interpretable, these methods can support population health managers in focusing preventive and longitudinal care more effectively. These models, and similar models developed by integrating diverse informatics strategies, could improve health outcomes, delivery, and costs.
2206A Student Center
Monday, Feb. 13th, 2017
Published on 02/10/2017
Auxins are a class of phytohormones in plants which have an active role in growth and development. The Auxin hormone control pathway in maize meristem is not well studied and has significant scope for in-depth exploration. Previous studies have not shown much novel information about how Auxin is regulated. Weighted Gene co-expression analysis takes results from differentially expressed genes and organizes them into clusters and modules showing possible interactions and co-regulation. These clusters usually highlight unique interactions which cannot be seen by most other methods. We present our ongoing work in building gene co-regulatory networks using certain gene knockouts in the maize meristem Auxin network.
2206A Student Center
Monday, Feb. 6th, 2017
Published on 02/03/2017
Health communication is the process that coordinates health services such as specimen transaction, oral interactions, medical records, and more. Healthcare workflows are based on communication established historically through the practice of healthcare or by the leadership in health institutions. However, during healthcare practices communication doesn’t flow according to plan; interpersonal miscommunication, technical glitches, information overload, etc. risk inefficient healthcare services. We hypothesize that health records contain information related to communication and we can retrieve it in order to address issues of communication. We present an informatics pipeline to retrieve health communication episodes from unstructured health data. The method uses Resource Description Framework (RDF), ontological modeling, and description logic inference to uncover and quantify implicit communication episodes. Retrieved communication has the potential to optimize and improve health communication structures especially, in data-intensive to precision medicine settings.
2206A Student Center
Monday, Jan. 30th, 2017
Published on 01/24/2017
With the advent of next-generation sequencing technologies, a considerable effort has been put into sequencing the epigenome of different species. The efforts such as “Encode” and “Roadmap” epigenomics projects provide an opportunity to compare epigenomes across species (especially between human and mouse). This study is an effort to understand how different histone modifications vary/co-appear between orthologus regions of the two species. In this work, we have also used various measures of orthologus similarity between each pair of orthologus genes and explore how histone modifications are conserved with respect to changes in these similarity measures. These measures of similarity include “gene ontology semantic similarity” (GOSemsim), “codon usage frequency similarity” (CUFS), Ka/Ks ratio and gene expression similarity. Our simulations indicate that evolutionary selection pressure of an orthologus pair (Ka/Ks ratio) is more strongly correlated with its histone modification than any other similarity measure.
2206A Student Center
Monday, Jan. 23rd, 2017
Published on 01/18/2017
Early childhood home visiting programs date back to the 1880s and deliver a vital public service of providing and connecting families with health, educational, and economic resources to support optimal development. Continuous quality improvement (CQI) consists of systematic and continuous actions that lead to measurable improvement in services for targeted groups. CQI initiatives (CQII) in home visiting programs have traditionally occurred within a local implementing agency (LIA), parent organization, or funding provision. LIA CQII are often lost to the benefit of external agencies facing similar challenges. We developed a web-based environment, the Gateway, to virtually connect and engage users within an environment aimed to balance CQII training and practice. The environment supports CQII activities which promote and support LIAs quality improvement initiatives while aligning stakeholders from seven Missouri home visiting LIAs. Gateway standardizes quality improvement training, collates overlapping resources, and supports knowledge translation, thus improving capacity for measurable change in organizational initiatives. Gateway allows LIA personnel to identify program activities in need of quality improvement, and guide the planning, implementation, and evaluation of CQII. Prior to site launch, pilot and usability testing was conducted to three defined groups with positive results and a combined System Usability Scale score of 71.63. After full launch, we examined performance relative to targets through the integration of data, dashboards, and reports. To our knowledge, a virtual environment aimed to create a culture of quality improvement and foster CQII for home visiting program LIAs has not been previously reported. Given broad focus on CQI priorities across disciplines, the Gateway offers endless potential with expansion of this site and deployment to programs and agencies beyond the build population.
2206A Student Center
Monday, Dec. 5th, 2016
Published on 11/30/2016
The Neosho madtom (Noturus placidus) is a small catfish, generally less than 3 inches in length, unique to the Neosho-Spring River system within the Arkansas River Basin. It was federally listed as threatened in 1990, largely due to habitat loss. As part of conservation efforts, we generated whole genome Illumina paired-end sequence data from ten Neosho madtom (average 39X coverage) originating from three geographically separated subpopulations to evaluate genetic diversity and population structure. One slender madtom (Noturus exilis) was also sequenced as an outgroup. Although over 1 million variants were found between Neosho and slender madtom, only 86,155 SNPs were variable across the Neosho madtoms sequenced, indicating overall low level genetic diversity. In addition, principal component analysis based on these genotypes indicated weak population structure, suggesting these subpopulations are genetically compatible for reintroduction among the locations. Using only 50X coverage of paired-end and mate pair data, we assembled the Neosho madtom genome into 68,147 scaffolds with a scaffold N50 of 120 kb, demonstrating the value in assembling a genome from a population that is closely related to a species of economic interest (i.e., channel catfish, Ictalurus punctatus) but has lower genetic diversity and is easier to assemble. Ongoing efforts aim to improve the assembly and develop demographic models and genomic resources to investigate the basic biology of why such a low-diversity species can subsist and to assist in future conservation efforts.
Steps in Transforming the Missouri Cancer Registry (MCR) from an Incidence Registry to a Survival Registry
CE706, Clinical Education & Support Building
Thursday, Nov. 17th, 2016
Published on 11/09/2016
The Problem: Breast cancer is the most common invasive cancer among women of all races and ethnicities in the United States (US). About 12 percent of women will be diagnosed with breast cancer in one stage of their lives in the US.
Significance: The Missouri Cancer Registry (MCR) needs to be transformed from an incidence registry to a survival registry to accurately measure the impact of Missouri public health programs. Using interactive mapping software reports of maps and statistics to improve data visualization and assess reports-user interface. Many studies have concluded the importance of estimation of cancer incidence, mortality and survival together.
Aims: To estimate breast cancer burden in Missouri during recent years in terms of breast cancer incidence, mortality and survival rates; to visualize these results; and to assess the usability of the Missouri Cancer Registry and Research Center’s (MCR-ARC’s) interactive maps and profile reports.
Incidence: An observational epidemiological study by doing secondary analysis of all registered female breast cancer cases in the MCR database from 2008 to 2012. Incidence rates by race, age, county, and senatorial district will be measured as well as percent of cases diagnosed at late stage and grade. These statistics will be presented using InstantAtlas.
Mortality: Mortality counts and rates will be from the NCHS Mortality database 2008–2012 via the SEER Program. The mortality rates will be measured by age, race, and Senate District Groups of Counties (SDGCs). The rates will be visualized using InstantAtlas.
Survival: An observational longitudinal epidemiological study by doing secondary analysis of all registered female breast cancer cases in the MCR database from 2004 to 2010 after matching registry breast cancer cases with unknown vital status and/or cause of death following linkage with Missouri Department of Health and Senior Services’ (DHSS) death files with the Social Security Death Index (SSDI) and the National Center for Health Statistics’ (NCHS’s) National Death Index (NDI) database. Survival rates will be measured by age, race, stage at diagnosis, grade at diagnosis, county, and by senate district. The results will be presented using InstantAtlas.
Usability: The investigators will conduct a scoping review to explore perceptions of public health professionals about the use of geographic information tools in public health. Also, the investigators will conduct a pilot study to measure the usability of the MCR-ARC’s published InstantAtlas reports using a sample of health professionals.
Expected outcomes: The results will be very informative for Missouri decision makers and public health leaders. InstantAtlas reports will enhance the communication between collaborators from different fields related to breast cancer and to disseminate female breast cancer data and inform health professionals and the public.
Keywords: Breast cancer, incidence, mortality, survival, MCR, MCR-ARC, NDI, SSDI, Usability
De novo assembly and comparison of whole genome consensus sequences for nine breeds of beef cattle
S119 Animal Science Resource Center
Tuesday, Nov. 15th, 2016
Published on 11/09/2016
With the recent rise in re-sequencing efforts fueled by next-generation short read sequencing technologies, we have lost sight of the overarching goal of trying to understand what functions a genetic variant has at the molecular level, which is one of the main reasons we started sequencing genomes to begin with. Instead, immense focus has been placed on identifying SNPs that are associated with important phenotypes. These association studies have undoubtedly allowed forward progression of the industry through genetics through providing variants that can be assayed and selected for or against. However, the main limitation of these studies is they very rarely identify causal mutations, instead a SNP linked to the causal mutation is identified. To further enhance the genetic merit of beef cattle in the United States and improve efficiency and profitability of beef production, we need to elucidate and understand the panoply of genetic variation that exists across our most productive beef cattle breeds. The utilization of this knowledge will further genetic progress in animal health and production by improving the detection of causal variants underlying economically important phenotypes. Further, the assembly of whole genome sequences to commence the discovery of these variants will provide a novel resource to the bovine genomic community, which is currently restricted by the inadequacy of whole genome reference sequences with which to compare re-sequenced animals. These efforts are guaranteed to greatly expand our current knowledge of genetic variation and improve association studies to assist in determining causal variants and providing more valuable and accurate genomic predictions for beef cattle breeders.
2206A Student Center
Monday, Nov. 14th, 2016
Published on 11/08/2016
Polyploidy is an important mechanism in plant evolution. We are interested in studying how selective pressures change after a lineage experiences whole genome duplication (WGD) or triplication (WGT). Alpha duplication is the most recent WGD event in Arabidopsis. Then a WGT event occurred in genus Brassica when they diverged from Arabidopsis thaliana. We examined selection at both the population and the species level, by calculating the ratio of non-synonymous to synonymous polymorphisms (pN/pS) and computing Ka/Ks between species. In both lineages of Arabidopsis and Brassica, pN/pS values are larger than Ka/Ks, in accord with the expectation that most populations include individuals possessing mildly deleterious mutations that will eventually be removed by purifying selection. Naïve models of evolution after gene duplication would suggest that duplicates should experience some period of relaxed purifying selection as a result of the genetic redundancy. However, we found that alpha duplicates are actually under stronger constraint compared to other genes. Similarly, triplicated Brassica rapa genes have smaller pN/pS and Ka/Ks when compared to single copy genes. This indicates that the special classes of genes surviving after polyploidy are still under relatively strong selective pressure. Next, we mapped pN/pS and Ka/Ks onto the Arabidopsis thaliana metabolic network and looked for correlations between selection and network statistics. We found pN/pS and Ka/Ks are more variable for nodes with lower degree, while nodes with higher degree are more likely to have smaller pN/pS and Ka/Ks. These results suggest that more “important” nodes in network are generally more constrained selectively.