Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology Project

老龄化研究的跨学科基础设施：罗切斯特流行病学项目

• 批准号: 10409783
• 负责人: Nathan K LeBrasseur
• 金额: $ 79.27万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10409783
• 关键词: Address; Age-Years; Aging; Agreement; Algorithms; Angiotensin Receptor; Area; Benchmarking; Biological; Biological Markers; Caring; Ceramides; Clinic; Clinical; Clinical Trials; Code; Data; Delirium; Diagnosis; Diagnostic Services; Disease; Disease Outcome; Drug Prescriptions; Drug Utilization; Elderly; Electronic Health Record; Enrollment; Epidemiologic Methods; Epidemiology; Future; Grant; Health; Healthcare; Infrastructure; Institution; Link; Manuals; Measures; Medical; Medical Informatics; Medical Records; Metformin; National Institute on Aging; Natural Language Processing; Observational Study; Outcome; Persons; Pharmaceutical Preparations; Phase; Phenotype; Polypharmacy; Population; Population Study; Proteins; Recommendation; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Review Committee; Structure; Syndrome; System; Techniques; Testing; Text; Time; United States Centers for Medicare and Medicaid Services; age related; aging population; biobank; cost effective; data infrastructure; design; electronic data; falls; healthspan; improved; interdisciplinary collaboration; medical attention; novel; novel marker; novel strategies; senescence; tool

PROJECT SUMMARY The National Institutes on Aging (NIA) has recommended strengthening research infrastructures to address future aging research questions (2016 Data Infrastructure Review Committee Report and PAR-16-367). In particular, they recommend: 1) integrating biological data into larger population-based studies; 2) increasing use of electronic health record (EHR) data and linking to medical care claims data; and 3) developing new approaches to collecting data to answer important scientific questions about mechanisms of aging. The Rochester Epidemiology Project (REP; NIA R01 AG034676) is a unique infrastructure for studies of aging, because the REP collects longitudinal EHR data on all health conditions that come to medical attention for a large, Midwestern population. Therefore, the REP allows investigators to study all age-related diseases and outcomes. However, the REP has three significant gaps. First, the REP does not include biospecimens. Second, the REP is missing health care delivered outside of the health care institutions that partner with the REP, and it does not include information on filled prescriptions. Third, a significant proportion of EHR data is difficult to access due to two factors: 1) the full text of the EHRs includes extensive clinical notes about aging outcomes and geriatric syndromes, but these notes are not routinely coded for billing, and can only be accessed through laborious manual review; and 2) the REP health care partners use three different EHR systems, making it difficult to apply electronic data extraction tools across all partners. To address these three gaps, we will develop an interdisciplinary collaboration across experts in aging research, epidemiologic methods, biobanking, and medical informatics to create a new, comprehensive research infrastructure (“Bio-REP”) to support aging research. In the R21 phase, we will develop a comprehensive research infrastructure that combines the REP data with Mayo Clinic Biobank biospecimens, medical claims data from the Centers for Medicare and Medicaid Services (CMS; Aim 1), and geriatric syndrome data that are included in the unstructured EHR clinical notes using Natural Language Processing techniques (NLP; Aim 2). In the R33 phase, we will deploy NLP algorithms developed in Aim 2 in the clinical notes from two additional EHR systems (Aim 3), and we will conduct two demonstration projects. First, we will measure associations between novel aging-related biomarkers and aging-related outcomes (Aim 4). Second, we will determine whether two common medications that are hypothesized to impact aging (metformin and angiotensin receptor blockers) modify associations between aging biomarkers and aging outcomes (Aim 5). The new, robust Bio-REP infrastructure will support a wide range of efficient, cost-effective observational studies to characterize associations between aging-related biomarkers and specific diseases, geriatric syndromes, and drug utilization. Such studies are urgently needed to design effective clinical trials to improve the health span of the aging population.

项目总结 国家老龄问题研究所(NIA)建议加强研究基础设施，以解决 未来老龄化研究问题(2016年数据基础设施审查委员会报告和PAR-16-367)。在……里面 具体地说，他们建议：1)将生物学数据整合到更大的基于人群的研究中；2)增加 使用电子健康记录(EHR)数据并链接到医疗保健索赔数据；以及3)开发新的 收集数据以回答有关衰老机制的重要科学问题的方法。 罗切斯特流行病学项目(REP；NIA R01 AG034676)是研究衰老的独特基础设施， 因为代表收集了所有健康状况的纵向EHR数据，这些健康状况在 中西部人口众多。因此，该代表允许调查人员研究所有与年龄相关的疾病和 结果。然而，这位代表有三个显著的差距。首先，该代表不包括生物制品。 其次，代表缺少在医疗机构之外提供的医疗服务，这些机构与 Rep，它不包括有关已填写处方的信息。第三，相当大比例的电子病历数据是 由于两个因素难以获取：1)EHR的全文包括大量关于衰老的临床笔记 结果和老年综合征，但这些笔记不是常规的账单编码，只能 通过繁重的手动审查访问；以及2)代表医疗保健合作伙伴使用三种不同的EHR 因此，很难在所有合作伙伴之间应用电子数据提取工具。 为了解决这三个差距，我们将在老龄领域的专家之间开展跨学科合作 研究、流行病学方法、生物库和医学信息学，以创建一个新的、全面的 支持老龄化研究的研究基础设施(“生物代表”)。在R21阶段，我们将开发一种 将REP数据与Mayo Clinic Biobank Biopecimens相结合的全面研究基础设施， 医疗保险和医疗补助服务中心(CMS；AIM 1)的医疗索赔数据，以及老年病 使用自然语言处理的非结构化EHR临床笔记中包含的证候数据 技术(NLP；目标2)。在R33阶段，我们将在临床上部署在Aim 2中开发的NLP算法 来自另外两个电子健康记录系统(目标3)的说明，我们将进行两个示范项目。首先，我们将 衡量新的衰老相关生物标记物和衰老相关结果之间的关联(目标4)。第二, 我们将确定假设影响衰老的两种常见药物(二甲双胍和 血管紧张素受体阻滞剂)改变衰老生物标志物和衰老结果之间的关联(目标5)。 新的、强大的Bio-Rep基础设施将支持广泛的高效、经济实惠的观测 研究与衰老相关的生物标记物与特定疾病、老年人 症状和用药情况。迫切需要这样的研究来设计有效的临床试验来改善 老龄化人口的健康跨度。

项目成果

Risk of hospitalization in synucleinopathies and impact of psychosis.

突触核蛋白病住院的风险和精神病的影响。

• DOI: 10.3389/fnagi.2023.1274821
• 发表时间: 2023
• 期刊: Frontiers in aging neuroscience
• 影响因子: 4.8

Association of Perinatal Factors With Severe Obesity and Dyslipidemia in Adulthood.

• DOI: 10.1177/21501327211058982
• 发表时间: 2022-01
• 期刊: Journal of primary care & community health
• 影响因子: 3.6
• 作者: Tadese K;Ernst V;Weaver AL;Thacher TD;Rajjo T;Kumar S;Kaufman T;Wi CI;Lynch BA
• 通讯作者: Lynch BA

Integrating Environmental Data with Medical Data in a Records-Linkage System to Explore Groundwater Nitrogen Levels and Child Health Outcomes.

• DOI: 10.3390/ijerph20065116
• 发表时间: 2023-03-14
• 期刊: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• 作者: Prissel, Christine M;Grossardt, Brandon R;Klinger, Gregory S;St Sauver, Jennifer L;Rocca, Walter A
• 通讯作者: Rocca, Walter A

Lifetime Prevalence of Psychiatric Disorders in Adolescents with Unexplained Weight Loss, Underweight, or Poor Appetite.

不明原因体重减轻、体重不足或食欲不振的青少年精神疾病的终生患病率。

• DOI: 10.1097/dbp.0000000000001173
• 发表时间: 2023
• 期刊: Journal of developmental and behavioral pediatrics : JDBP
• 作者: Witte,MicaelaA;HarbeckWeber,Cynthia;Lebow,Jocelyn;LeMahieu,Allison;Geske,Jennifer;Witte,Nathaniel;Whiteside,Stephen;Loth,Katie;Sim,Leslie
• 通讯作者: Sim,Leslie

The impact of obstructive sleep apnea screening guidelines in a population-based, midwestern cohort of children with Down Syndrome.

阻塞性睡眠呼吸暂停筛查指南对中西部唐氏综合症儿童人群的影响。

• DOI: 10.1016/j.ijporl.2023.111546
• 发表时间: 2023
• 期刊: International journal of pediatric otorhinolaryngology
• 影响因子: 1.5
• 作者: Matarese,ChristineA;Patel,Nisha;Lloyd,RobinM;Sorensen,Channing;Morgenthaler,TimothyI;Baughn,JulieM
• 通讯作者: Baughn,JulieM