The National Institute of Nursing Research (NINR) has awarded a five-year grant to Lisa Barcellos, professor of epidemiology at the UC Berkeley School of Public Health and director of the Center of Computational Biology in the College of Engineering. The award will fund her research on a big data approach to understanding what contributes to clinical outcomes in multiple sclerosis (MS).
Multiple sclerosis is a mysterious and often debilitating disease of the central nervous system that disrupts communication between the brain and the body. The cause of the disease is still largely unknown, and its severity and progression are not easily predicted.
For that reason, decreased cognitive function related to MS is significantly underdiagnosed, though it may occur in 60 percent of individuals with MS. “Systematic, validated, and longitudinal measures of cognitive status, physical disability, and disease progression for MS patients are not routinely obtained by treating physicians,” says Barcellos. “Therefore, rigorous, well-powered studies to identify factors that predict these important clinical outcomes have not been previously possible.”
Without high quality clinical outcomes data, broad-based, population metrics for cognitive function in MS do not exist. Barcellos and the rest of her research team aim to fill that gap.
The team has recently developed and validated an assisted, web-based tool to collect data on clinical outcomes of MS-validated cognitive function, physical disability, and progressive disease measures that are typically omitted from the electronic health record. They then plan to study MS outcomes in a multi-ethnic sample of 3,000 MS cases from the Kaiser Permanente Northern California Health Plan Membership, integrate outcomes data collected through their web tool with electronic health record data, and utilize machine learning models to predict outcomes.
In the end, the team plans to develop easy-to-read electronic reports for neurologists that include longitudinal histories of outcome measures that could enhance patient care in the clinic.
The NINR grant will disburse each year, totaling $2,903,800. For the first year, NINR is awarding $564,000. Barcellos believes that this award demonstrates a strong commitment to accelerating progress in understanding and improving clinical outcomes in MS.
“More work is needed to predict MS patient trajectories, to inform intervention, prevention and treatment strategies, and facilitate effective long-term management of MS,” she says. “This is important progress towards the full realization of precision medicine in MS.”
The research team includes Dr. Catherine Schaefer, research scientist at Kaiser Permanente Division of Research and co-founder (with Dr. Barcellos) of the Kaiser Permanente Northern California MS Research Program; Drs. Nandini Bakshi and Jackie Marcus, Kaiser Permanente physicians and neurologists; Mark van der Laan, professor of biostatistics, UC Berkeley School of Public Health; Emmanuelle Waubant, professor of neurology and pediatrics, UC San Francisco; and Ralph Benedict, professor and neuropsychologist, State University of New York at Buffalo.
By Austin Price