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Discovering and Applying Knowledge in Clinical Databases

Award Number: R01LM006910
ORGANIZATION: NATIONAL LIBRARY OF MEDICINE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/01/2000
PERIOD OF PERFORMANCE END DATE: 02/28/2026

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Discovering and Applying Knowledge in Clinical Databases - PROJECT SUMMARY / ABSTRACT The long-term goal of our ongoing project, “Discovering and applying knowledge in clinical databases,” is to learn from data in the electronic health record (EHR) and to apply that knowledge to understand and improve health. The EHR, because of its broad capture of human health, greatly amplifies our ability to carry out observational research, opening the possibility of covering emerging problems, diverse populations, rare diseases, and chronic diseases in long-term longitudinal studies. Unfortunately, the strength of EHR data—its breadth and flexible nature—imposes additional challenges. We have found that the biggest challenge comes from the inaccuracy, incompleteness, complexity, and resulting bias inherent in the recording of the health care process. We previously showed that health care process bias exists to the extent, for example, that simple use of the data can create signals implying the opposite of what we know to be true. One of the most important factors is sparse, irregular sampling; we found that sampling bias can be reduced by reparameterizing time and that prediction techniques that can accommodate EHR-specific data and resist their biases like data assimilation can be used on EHR data to produce good estimates of glucose and HA1c. The previous cycle of this project produced 75 publications. We propose to develop methods to accommodate health care process bias, using both knowledge engineering and experience with health care process bias as well as advanced statistical techniques that employ dynamical models and latent variables. We hypothesize that heuristics and models combined with knowledge can improve our ability to generate inferences and learn phenotypes despite health care process bias. Our aims are as follows: (1) Taking a knowledge engineering approach, study the effect of preprocessing and analytic choices on reducing health care process bias, and using machine learning techniques, learn more about health care process bias. (2) Taking a more empirical approach, use dynamic latent factor modeling and variation inference to accommodate health care process bias, learning how a patient's health state and health processes affect censoring, exploiting information from many variables at once. (3) Use data assimilation and mechanistic models to learn otherwise unmeasurable physiologic phenotypes despite irregular, sparse sampling typical of electronic health records. (4) Use the developed models and generated phenotypes to answer clinical questions, and disseminate the results.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	23	2/19/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $554,492 )
2023	2023	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	23	2/8/2023	NON-COMPETING CONTINUATION	$554,492
														Subtotal = $554,492

Issue Date FY: 2022 ( Subtotal = $568,584 )
2022	2022	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	22	3/28/2022	NON-COMPETING CONTINUATION	$568,584
														Subtotal = $568,584

Issue Date FY: 2021 ( Subtotal = $605,827 )
2021	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	001	21	2/22/2021	SUPPLEMENT FOR EXPANSION	$35,380
2021	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	003	21	4/28/2021	SUPPLEMENT FOR EXPANSION	$1,863
2021	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	002	21	4/28/2021	NON-COMPETING CONTINUATION	$28,430
2021	2021	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	21	2/19/2021	NON-COMPETING CONTINUATION	$540,154
														Subtotal = $605,827

Issue Date FY: 2020 ( Subtotal = $619,921 )
2020	2020	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK, THE	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	002	20	8/28/2020	SUPPLEMENT FOR EXPANSION	$37,243
2020	2020	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	001	20	5/15/2020	NON-COMPETING CONTINUATION	$29,135
2020	2020	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	20	2/28/2020	NON-COMPETING CONTINUATION	$553,543
														Subtotal = $619,921

Issue Date FY: 2019 ( Subtotal = $596,772 )
2019	2019	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	001	19	2/15/2019	COMPETING CONTINUATION	$596,772
2019	2019	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	003	19	7/16/2019	COMPETING CONTINUATION	$871
2019	2017	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	002	18	7/16/2019	NON-COMPETING CONTINUATION	-$871
2019	2017	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	18	2/14/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $596,772

Issue Date FY: 2017 ( Subtotal = $437,796 )
2017	2017	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	003	18	9/14/2017	NON-COMPETING CONTINUATION	$437,795
2017	2016	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	002	17	1/9/2017	EXTENSION WITH OR WITHOUT FUNDS	$191,684
2017	2015	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	001	16	1/9/2017	NON-COMPETING CONTINUATION	-$191,684
2017	2013	TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK	630 W 168TH ST FL 4	NEW YORK	NY	10032	NEW YORK	USA	Medical Library Assistance	000	14	12/29/2016	COMPETING CONTINUATION	$1
														Subtotal = $437,796

Issue Date FY: 2016 ( Subtotal = $595,766 )
2016	2016	COLUMBIA UNIVERSITY	615 WEST 131ST ST, 4TH FLOOR	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	000	17	8/24/2016	EXTENSION WITH OR WITHOUT FUNDS	$437,795
2016	2016	COLUMBIA UNIVERSITY	615 WEST 131ST ST, 4TH FLOOR	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	001	17	8/30/2016	SUPPLEMENT FOR EXPANSION	$157,971
														Subtotal = $595,766

Issue Date FY: 2015 ( Subtotal = $424,661 )
2015	2015	COLUMBIA UNIVERSITY	615 WEST 131ST ST, 4TH FLOOR	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	000	16	8/6/2015	NON-COMPETING CONTINUATION	$424,661
														Subtotal = $424,661

Issue Date FY: 2014 ( Subtotal = $584,661 )
2014	2014	COLUMBIA UNIVERSITY	615 WEST 131ST ST, 4TH FLOOR	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	001	15	9/17/2014	SUPPLEMENT FOR EXPANSION	$160,000
2014	2014	COLUMBIA UNIVERSITY	615 WEST 131ST ST, 4TH FLOOR	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	000	15	8/16/2014	NON-COMPETING CONTINUATION	$424,661
														Subtotal = $584,661

Issue Date FY: 2013 ( Subtotal = $437,795 )
2013	2013	COLUMBIA UNIVERSITY	615 WEST 131ST ST, 4TH FLOOR	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	000	14	9/2/2013	COMPETING CONTINUATION	$437,795
														Subtotal = $437,795

Issue Date FY: 2012 ( Subtotal = $390,857 )
2012	2012	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW Memorial LIBRARY	NEW YORK-NEW YORK	NY	10027		USA	Medical Library Assistance	000	13	8/31/2012	NON-COMPETING CONTINUATION	$390,857
														Subtotal = $390,857

Issue Date FY: 2011 ( Subtotal = $385,238 )
2011	2011	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW Memorial LIBRARY	NEW YORK-NEW YORK	NY	10027		USA	Medical Library Assistance	000	12	8/16/2011	NON-COMPETING CONTINUATION	$385,238
														Subtotal = $385,238

Issue Date FY: 2010 ( Subtotal = $386,810 )
2010	2010	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW Memorial LIBRARY	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	000	11	9/1/2010	NON-COMPETING CONTINUATION	$386,810
														Subtotal = $386,810

Issue Date FY: 2009 ( Subtotal = $536,464 )
2009	2009	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW Memorial LIBRARY	NEW YORK	NY	10027	NEW YORK	USA	Trans-NIH Recovery Act Research Support	001	9	9/24/2009	SUPPLEMENT FOR EXPANSION	$152,617
2009	2009	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW Memorial LIBRARY	NEW YORK	NY	10027	NEW YORK	USA	Medical Library Assistance	002	10	9/23/2009	COMPETING CONTINUATION	$383,847
2009	2008	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW LIBRARY	NEW YORK-NEW YORK	NY	10027		USA	Medical Library Assistance	000	9	9/23/2009	NON-COMPETING CONTINUATION	$0
														Subtotal = $536,464

Issue Date FY: 2008 ( Subtotal = $338,600 )
2008	2008	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW LIBRARY	NEW YORK-NEW YORK	NY	10027		USA	Medical Library Assistance	000	9	9/10/2008	NON-COMPETING CONTINUATION	$338,600
														Subtotal = $338,600

Issue Date FY: 2007 ( Subtotal = $345,833 )
2007	2007	COLUMBIA UNIVERSITY, SCHOOL OF ARTS & SCIENCES	106 LOW LIBRARY	NEW YORK-NEW YORK	NY	10027		USA	Medical Library Assistance	000	8	9/6/2007	NON-COMPETING CONTINUATION	$345,833
														Subtotal = $345,833

Issue Date FY: 2006 ( Subtotal = $372,106 ) (Continued on the next page)
Grand Total All Awards = $10,558,021

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Discovering and Applying Knowledge in Clinical Databases

Award Number: R01LM006910

ORGANIZATION: NATIONAL LIBRARY OF MEDICINE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/01/2000

PERIOD OF PERFORMANCE END DATE: 02/28/2026

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