High-quality health care research depends on high-quality biostatistics: Without it, conducting scientifically sound studies would be like trying to assemble a puzzle without having all the right pieces. The Biostatistics Unit at Kaiser Permanente Washington Health Research Institute promotes the use of rigorous statistical methods that enhance the quality of research at Kaiser Permanente Washington and nationwide.
KPWHRI biostatisticians help lead several national consortia that are developing innovative methodological approaches to benefit public health, including the Food and Drug Administration (FDA)’s Sentinel Initiative. “We help the FDA overcome analytic challenges in using health care databases to conduct post-market safety surveillance, developing new methodological approaches that allow rapid safety surveillance of new medical products,” says Jennifer Nelson, PhD, director of biostatistics at KPWHRI.
Another such project is the National Institutes of Health (NIH)’s Health Care Systems Research Collaboratory, which supports several pragmatic clinical trials that take advantage of large health systems’ existing data resources to efficiently produce results that better reflect real-world care. Andrea Cook, PhD, and Jennifer Bobb, PhD, are developing new methods for these clinical trials that use data from electronic health records (EHRs) and other existing data systems. As Dr. Cook explains, “You need different methods and a whole new approach to trial design to test interventions that will work in a real-world setting.”
As a co-investigator on the Mental Health Research Network (MHRN), Susan Shortreed, PhD, helps design research ranging from comparative effectiveness and safety studies to predicting outcomes over time based on patient and provider characteristics and treatment choices. “Our long-term goal is to improve mental health care by using EHR data to identify which depression treatments will work best for which people,” she says.
KPWHRI biostatisticians also play an integral role in influential learning health system (LHS) research, which focuses on rapidly improving the delivery of health care using feedback from patients, community members, providers, and health system leadership. As an Agency for Healthcare Research and Quality (AHRQ)/Patient-Centered Outcomes Research Institute (PCORI)-funded LHS scholar, R. Yates Coley, PhD, provides risk prediction expertise to KPWHRI’s LHS Program, using data from a person’s health history, diseases, treatments, and other information to predict, in an automated manner, who is at higher risk for prostate cancer as well as who will respond well to treatment for depression.
With the use of EHR data for research rising, methodological rigor is more important than ever. That’s why Drs. Cook and Nelson joined with Patrick Heagerty, PhD, a KPWHRI affiliate investigator and professor of biostatistics at the University of Washington, to launch the Seattle Symposium on Health Care Data Analytics. Held in 2014, 2016, and 2018, this first-of-its-kind event brought together scientists from across the country to discuss the statistical challenges of using EHR data for health research and to explore new methods to overcome those challenges.
Through the symposium and the many ongoing projects at KPWHRI, our biostatisticians continue to improve the rigor with which scientists address important questions about public health and health services. “We have an incredibly strong group, including many very talented master’s-level statisticians who help apply and adapt statistical methods to real-world situations—an asset that is rare in most academic research settings,” Dr. Nelson says.
Lesser RP, Webber WRS, Miglioretti DL, Pillai JJ, Agarwal S, Mori S, Morrison PF, Castagnola S, Lawal A, Lesser HJ. Cognitive effort decreases beta, alpha, and theta coherence and ends afterdischarges in human brain. Clin Neurophysiol. 2019 Nov;130(11):2169-2181. doi: 10.1016/j.clinph.2019.07.007. Epub 2019 Jul 19. PubMed
Nelson JC, Ulloa-Pe'rez E, Bobb JF, Maro JC. Leveraging the entire cohort in drug safety monitoring: part 1: methods for sequential surveillance that use regression adjustment or weighting to control confounding in a multi-site, rare event, distributed data setting. J Clin Epidemiol. 2019 May 17. pii: S0895-4356(17)30857-0. doi: 10.1016/j.jclinepi.2019.04.012. [Epub ahead of print]. PubMed
Cruz M, Gillen DL, Bender M, Ombao H. Assessing health care interventions via an interrupted time series model: Study power and design considerations. Stat Med. 2019 May 10;38(10):1734-1752. doi: 10.1002/sim.8067. Epub 2019 Jan 7. PubMed
Bender M, Murphy EA, Cruz M, Ombao H. System and unit-level care quality outcomes after reorganizing frontline care delivery to integrate clinical nurse leaders: a quasi-experimental time series study. J Nurs Admin. 2019 49(6), p. 315-322.
Mosley JD, Feng Q, Wells QS, Van Driest SL, Shaffer CM, Edwards TL, Bastarache L, Wei WQ, Davis LK, McCarty CA, Thompson W, Chute CG, Jarvik GP, Gordon AS, Palmer MR, Crosslin DR, Larson EB, Carrell DS, Kullo IJ, Pacheco JA, Peissig PL, Brilliant MH, Linneman JG, Namjou B, Williams MS, Ritchie MD, Borthwick KM, Verma SS, Karnes JH, Weiss ST, Wang TJ, Stein CM, Denny JC, Roden DM. A study paradigm integrating prospective epidemiologic cohorts and electronic health records to identify disease biomarkers. Nat Commons, 2018 Aug 30;9(1):3522. doi: 10.1038/s41467-018-05624-4. PubMed
Jennifer F. Bobb, PhDAssociate Biostatistics Investigator |
Yates Coley, PhDAssociate Biostatistics Investigator |
Andrea J. Cook, PhDSenior Biostatistics Investigator |
Maricela Cruz, PhDAssistant Biostatistics Investigator |
Noorie Hyun, PhDAssociate Biostatistics Investigator |
Jennifer C. Nelson, PhDDirector, Biostatistics; Senior Investigator |
Pamela A. Shaw, PhD, MSSenior Biostatistics Investigator |
Susan M. Shortreed, PhDSenior Biostatistics Investigator |
Yu-Ru Su, PhDAssociate Biostatistics Investigator |
Brian D. Williamson, PhDAssistant Biostatistics Investigator |
Melissa L. Anderson, MSPrincipal Collaborative Biostatistician |
Laura E. Ichikawa, MSPrincipal Collaborative Biostatistician |
Abisola Idu, MS, MPHCollaborative Biostatistician |
Eric Johnson, MSSenior Collaborative Biostatistician |
Chloe Krakauer, PhDCollaborative Biostatistician |
Rod L. Walker, MSPrincipal Collaborative Biostatistician |
Robert D. Wellman, MSPrincipal Collaborative Biostatistician |
Onchee Yu, MSPrincipal Collaborative Biostatistician |
Weiwei Zhu, MSSenior Collaborative Biostatistician |
Annie Piccorelli, PhDSenior Collaborative Biostatistician |