Studies recently approved to use KP Research Bank data
The 2019 novel coronavirus (SARS-CoV-2), which causes COVID-19, spread across the world causing a global pandemic. The virus’s high infection rate and the severity of symptoms in older adults and those with underlying conditions have resulted in unprecedented actions across the United States to slow its transmission. These include national emergency declarations and shelter-in-place orders that closed businesses and mandated social distancing. These measures have been successful in slowing the spread of COVID-19, but they have also caused enormous social and economic disruptions, including increases in unemployment and financial strain. The uncertainty associated with the COVID-19 pandemic and social distancing practices may also lead to anxiety and depression. Thus, it is important to understand the direct health effects of the pandemic, as well as its social and behavioral impact. This project aims to 1) characterize the health-impacts of COVID-19 in cancer survivors; 2) identify demographic, household, behavioral, and health history factors associated with severe COVID-19 outcomes in cancer survivors; and 3) evaluate the behavioral, social, and mental health impacts of the COVID-19 pandemic on cancer survivors.
Bloodstream infection (sepsis) is a common cause of death in North America and across the world, but little is known about genetic susceptibility to this infection. We are conducting a series of genetic studies in two separate populations, a Norwegian (https://www.ntnu.edu/) and an American population (KP Research Bank), totaling more than 150,000 people. We are examining millions of single point mutations in the DNA of these individuals, and seeing how they are associated with risk of contracting and dying from a bloodstream infection, along with some common causes of sepsis, such as lower respiratory tract infection, urinary tract infection, and skin infections. We will also look at the genetic risk of bloodstream infection among people with cancer or those undergoing prostate biopsies. If we observe similar patterns in the Norwegian and U.S. populations, we can be more confident that the findings are not by chance. The study is the largest to date on this topic. The knowledge generated from this project may help guide clinical decisions for both doctors and patients, and further personalize follow-up, diagnosis, and treatment in the future.
This project is examining the effects of statin medications — a treatment for elevated cholesterol and heart disease — on the development of Alzheimer’s disease and related dementias (ADRD), using data from our Research Bank participants from Kaiser Permanente Northern California. While some studies have found a reduced risk of dementia among statin users, results have been inconsistent. This study with a large and well-characterized database will provide a definitive assessment of the overall effect of statin treatment on dementia risk. By 2030, it’s expected there will be about 75 million people with dementia, making it among the most important public health problem in the world today. This study could provide evidence supporting a causal role for statins in preventing ADRD, influence clinical guidelines for statin use, and reduce the growing burden of ADRD. Given the widespread current use of statins, rigorous evidence of their cognitive effects across the population is essential. Even very small effects of statins could have large population effects.
When a patient first shows signs of severe mental illness (psychotic symptoms), it can be difficult to tell if the symptoms are due to depression, bipolar disorder, or schizophrenia. These similarities can lead to misdiagnosis, improper treatment, and delays in care. As such, there is a need for reliable biological markers that could help predict which patients will go on to develop depression, schizophrenia, bipolar disorder, or not have any further psychiatric symptoms. Such markers would lower patient suffering and potentially improve outcomes. This study is examining the role of mitochondria in individuals with a psychotic disturbance to predict what psychiatric diagnoses they will develop compared to people who are otherwise similar in age, gender, and general health status, but without serious mental illnesses. It is the first study to compare patients with psychotic disturbances who develop schizophrenia, bipolar disorder, and depression to patients who do not develop any severe mental illness. This study will provide preliminary evidence of potential biological markers to help differentiate and understand the underlying biology involved in these conditions.
Time and again, it has been shown that individuals with dementia have a reduced risk of cancer and individuals with cancer have a reduced risk of dementia. It is not clear, however, how the two conditions are related biologically. We propose to study how genetics might influence dementia and cancer in opposite directions. The results have the potential to yield pivotal insights into the underpinnings of the diseases and to inform possible prevention and therapeutic strategies. Such science could provide critical given the substantial effects of dementia and cancer on quality of life and mortality.
The prevalence of lung injury cases associated with e-cigarette or vaping products necessitates rigorous research to understand health outcomes associated with e-cigarette use. This study will examine health care utilization, cardiovascular disease, pulmonary health outcomes, and COVID-19 illness among three groups of KPRB participants: e-cigarette users, smokers who do not use e-cigarettes, and never-smokers. Results from this study will contribute to the scientific literature by describing the population of patients who use e-cigarettes and evaluating the health outcomes associated with e-cigarette use. Patients and KP members will benefit from these findings as their medical providers will be able to provide more information about risks associated with e-cigarette use.
Excess weight puts people at risk for certain cancers, and the number of people who get these cancers is going up, along with the obesity epidemic. Up to half of all women who develop cancer in the lining of the womb or uterus (endometrial cancer) carry excess weight. While Pap smears can find cervical cancer early, we currently do not have good ways to test for endometrial cancer or precancer so it can be found and treated early.
Using Kaiser Permanente’s electronic health record, scientists will look for endometrial precancer or cancer diagnoses and treatment and identify characteristics, such as obesity, that increase the risk of getting this disease. Scientists will use KP Research Bank survey data on lifestyle habits, such as exercise and diet, to see if these habits impact the risk of developing endometrial precancer or cancer. They will also be able to identify which women may benefit the most from endometrial cancer screening to help doctors detect and find changes (precancerous cells) in the lining of the womb or uterus that can be treated before they turn into cancer.
Low back pain and other lumbar spinal disorders cause people more disability than any other health condition. Lumbar spinal disorders are the third leading cause of health care costs. This is in large part caused by spine surgery, including surgery that doesn’t improve a person’s well-being. A major problem with spine care is that doctors don’t know which people with a lumbar spinal disorder are more likely to recover without surgery. The goal of this project is to develop precision medicine approaches that will help Kaiser Permanente members and their health care teams make informed decisions about non-surgical and surgical treatment for lumbar spine disorders. First, scientists will develop models using information from the Kaiser Permanente electronic health record and members’ genetic risk profiles to predict low back pain-related outcomes, including whether or not spine surgery would be a good option. Second, scientists will test the models they develop using separate groups of people to ensure the models are accurate. These findings may ultimately inform development of electronic tools that can be used to help patients and doctors make better decisions when deciding about treatment for lumbar spine disorders.
The coronavirus (COVID-19) caused a global pandemic. Older individuals and those with underlying medical conditions have especially been at a higher risk for hospitalization or death. Communities of color are experiencing disproportionately high death rates from COVID-19. However, most people experience cases that are mild or asymptomatic. Scientists believe that underlying genetic factors contribute to the severity of COVID-19 infection. The purpose of this study is to identify genes that are associated with severe cases of COVID-19 (that result in hospitalization and death) compared to mild cases and those without any symptoms at all.
We hope the results of this study will lead to an understanding of genetic factors associated with COVID-19, and potentially lead to effective treatments of COVID-19 infections.