Biology subjects

Kho, A. N.

Publications and source records attributed to Kho, A. N..

3 recordsLinked to original sources

bioRxiv2020

Multi-ancestry Genome- and Phenome-wide Association Studies of Diverticular Disease in Electronic Health Records with Natural Language Processing enriched phenotype algorithm

Background and aimsDiverticular disease is among the most prevalent conditions encountered by gastroenterologists, affecting [~]50% of Americans before the age of 60. Our aim was to identify genetic risk variants and clinical phenotypes associated with diverticular disease, utilizing the electronic health record (EHR) with Natural Language Processing (NLP). MethodsWe developed a NLP-enriched phenotype algorithm that incorporated colonoscopy or abdominal imaging reports to accurately identify patients with diverticulosis and diverticulitis from multicenter EHRs. We performed genome-wide association studies (GWAS) of diverticular disease in European, African and multi-ancestry participants, followed by phenome-wide association studies (PheWAS) of the risk variants to identify their potential comorbid/pleiotropic effects in the clinical phenome. For more in-depth investigation of associated clinical phenotypes, we also performed PheWAS with the previously reported 52 GWAS susceptibility variants for diverticular disease. ResultsAncestry-stratified GWAS analyses confirmed the well-established associations between ARHGAP15 loci with diverticular disease in European cohorts, and found similar positive effect sizes in African cohorts but with non-significant p-values. With overall intensified GWAS signals in diverticulitis patients compared to diverticulosis patients, we found substantial genetic correlations between diverticulosis and diverticulitis, up to 0.997 in European ancestry. PheWAS analyses identified associations between the diverticular disease GWAS variants and circulatory system, genitourinary, and neoplastic EHR phenotypes. ConclusionOur multiancestry GWAS-PheWAS study demonstrated an effective use of multidimensional EHR information in disease case/control classification with NLP for more comprehensive and scalable phenotyping, and implementation of an integrative analytical pipeline to facilitate etiological investigation of a disease from a clinical perspective.

bioinformatics↗

bioRxiv2019

A polygenic and phenotypic risk prediction for Polycystic Ovary Syndrome evaluated by Phenome-wide association studies

PurposeAs many as 75% of patients with Polycystic ovary syndrome (PCOS) are estimated to be unidentified in clinical practice. Utilizing polygenic risk prediction, we aim to identify the phenome-wide comorbidity patterns characteristic of PCOS to improve accurate diagnosis and preventive treatment.\n\nMethods and FindingsLeveraging the electronic health records (EHRs) of 124,852 individuals, we developed a PCOS risk prediction algorithm by combining polygenic risk scores (PRS) with PCOS component phenotypes into a polygenic and phenotypic risk score (PPRS). We evaluated its predictive capability across different ancestries and perform a PRS-based phenome-wide association study (PheWAS) to assess the phenomic expression of the heightened risk of PCOS. The integrated polygenic prediction improved the average performance (pseudo-R2) for PCOS detection by 0.228 (61.5-fold), 0.224 (58.8-fold), 0.211 (57.0-fold) over the null model across European, African, and multi-ancestry participants respectively. The subsequent PRS-powered PheWAS identified a high level of shared biology between PCOS and a range of metabolic and endocrine outcomes, especially with obesity and diabetes: morbid obesity, type 2 diabetes, hypercholesterolemia, disorders of lipid metabolism, hypertension and sleep apnea reaching phenome-wide significance.\n\nConclusionsOur study has expanded the methodological utility of PRS in patient stratification and risk prediction, especially in a multifactorial condition like PCOS, across different genetic origins. By utilizing the individual genome-phenome data available from the EHR, our approach also demonstrates that polygenic prediction by PRS can provide valuable opportunities to discover the pleiotropic phenomic network associated with PCOS pathogenesis.

bioinformatics↗

bioRxiv2019

Concordance of Race Documented in Electronic Health Records and Genetic Ancestry

ObjectiveGenetic screening is the gold standard for biogeographical ancestry (i.e. race), but this information is often unavailable to those developing research studies. We assessed agreement between census- and electronic health record (EHR)-derived demographic data with genetic ancestry to determine if these sources could support selection of diverse cohorts.\n\nMaterials and MethodsWe identified a population of 4,837 genotyped patients and determined concordance between genetic measures of ancestry against race derived from decennial nationwide census, electronic medical records, and self-report.\n\nResultsWe identified a 90% or greater concordance between the EHR-derived data and genetic ancestry. Census data had a high concordance (97%) with genetic and self-reported data for patients of European ancestry but low concordance for patients of African ancestry (64%).\n\nDiscussion and ConclusionsThe high concordance between EHR-derived race and genetic ancestry suggests that EHR-derived information could be an effective proxy for race when recruiting for diverse research cohorts.

bioinformatics↗