CHMPR Seminar

Medical Epistemology: A Gerontologist’s Perspective

Dr. John D. Sorkin, M.D., Ph.D.
University of Maryland School of Medicine

3:00pm Wednesday, 27 April 2016, ITE 325b

The randomized clinical trial is the gold standard method by which we test a hypothesis positing an association between an exposure and outcome. Unfortunately many hypotheses are not grist for a clinical trial. It would, for example not be ethically permissible to randomize people to smoking vs. non-smoking if we wanted to study the hypothesis that smoking is associated with increased incidence of lung cancer. Similarly it would not be ethical to randomize pregnant women to being infected or not infected with Zika virus to determine if maternal Zika infection is associated with microcephaly. Clinical trials are also not helpful in determining the relation between a putative exposure and a rare disease such as Pick’s disease (a rare type of frontotemporal dementia) as the number of subjects who would need to be studied is prohibitively large.

The movement over the last decade away from paper-based charts to the electronic medical record (EMR) and advances in the speed of computers allow us to process large volumes of data in near real-time, and herald the advent of clinical studies based on “big data”. The availability of big data requires us to rethink how we can establish an association between cause and effect because the big data we obtain from the EMR are not collected from randomized clinical trials, and as noted above a clinical trial cannot be used to study many diseases. Further making inferences based on the EMR can be difficult because data gleamed from the electronic medical record can be confounded by changes brought about by the aging process which include primary aging (i.e., the aging process itself), secondary aging (i.e., changes brought about by changes in lifestyle as we get older) and tertiary aging (i.e., disease). Fortunately epidemiologists have designed and used study designs other than the clinical trials for years to gain insight into the relation between exposure and disease. The aim of my talk is to review five study designs, cross-sectional, time-series and longitudinal, case-control and cohort study designs, that can be used to identify change, quantify the rate at which changes occurs with aging, and to separate biological aging from the effects of life style and disease. In addition to presenting the five study designs, I will review the strengths and weaknesses of the five study designs. It is my hope that thinking about five study designs will help you design analyses that make use of big data to examine questions relevant to public health and treatment of disease.

Dr. John Sorkin is a professor at the University of Maryland School of Medicine. His research examines the changes that occur with aging in carbohydrate and lipid metabolism, obesity, and body fat distribution. He is interested in measuring the changes and determining the relation of the changes to the development of diabetes, cardiovascular disease, death, morbidity, and mortality. These interests have lead him to try to identify the phenotypes associated with longevity and the genetics of longevity in collaboration with Drs. Shuldiner and Mitchell. Dr. Sorkin is Chief of Biostatistics and Informatics for the Division of Gerontology and is PI of the Statistics Core for the University of Maryland Claude D. Pepper Older Americans Independence Center and Baltimore VA Geriatrics Research, Education and Clinical Center.

Gaurav Luthria
B.S., Bioinformatics
Summa Cum Laude
Hometown: Laurel, Maryland
Plans: Ph.D. in Bioinformatics and Integrative Biology, Harvard

UMBC has opened the doors to so many new opportunities. Working on various research projects, participating in hackathons, and learning from my professors at UMBC has been invaluable in shaping my career aspirations.

During his years at UMBC, Gaurav Luthria has used bioinformatics to explore a variety of research fields. At an internship at the University of Pennsylvania School of Medicine he studied genetic relationships among ancestral African populations, and at the Health Sciences and Technology Division (a joint initiative between MIT and Harvard) he used social media data to study neurodevelopmental disorders. Here at UMBC, Luthria developed algorithms to elucidate the structure of RNA molecules.

As a Meyerhoff and MARC U*STAR scholar Luthria received key mentorship that helped him establish and achieve his goals. He was also inducted into the academic honor society Phi Beta Kappa and the Carson Scholars Hall of Fame, and he received a Barry Goldwater Scholarship honorable mention.

Luthria gave back to the UMBC community by serving as a chemistry tutor and genetics teaching assistant.

Images: Luthria presents research at the end of his freshman year; photo courtesy Gaurav Luthria. Portrait by Marlayna Demond ‘11 for UMBC.

Grace Choi
B.S., Mathematics and Statistics
Summa Cum Laude
Hometown: Ellicott City, Maryland
Plans: Ph.D. in Biostatistics, University of Pennsylvania

The support from faculty and availability of undergraduate research opportunities have helped me gain vital work experience and discern my passions and skills. The rigor of UMBC classes helped me grow academically and highlighted the importance of group studying.

Grace Choi is an outstanding example of the UMBC student drive to pursue academic excellence at its highest levels while also taking time to support communities and causes of personal resonance.

Graduating with a 4.0, Choi has been admitted into the Phi Beta Kappa National Honor Society and placed on the UMBC President’s Academic List. She has received numerous departmental awards, including the Outstanding Learning Assistant in Physics and Outstanding Graduating Senior in Statistics. She also received support from the UMBC Centennial Award Scholarship and Sinha Endowment for Excellence in Statistics.

 
Beyond the classroom, Choi has served as mission and advocacy chair for UMBC’s Relay for Life and was the secretary and large group coordinator for InterVarsity Christian Fellowship. This role involved leading discussions on topics such as faith, race, and social justice.

Images: Choi emceeing an InterVarsity large group meeting, an activity that helped her broaden her perspectives; photo courtesy Grace Choi. Portrait by Marlayna Demond ‘11 for UMBC.