The Truven Health Blog

The latest healthcare topics from a trusted, proven, and unbiased source.


Genomic Data for Oncology Research Available in Literature

By Truven Staff

Kathleen Foley imageData. Most of us in research are data-hungry and data-greedy. When we can’t get our hands on a certain piece of data our eyes start roaming, looking for the nearest match, like a teenage boy ravaging the fridge for the tenth time in a day. We will grab anything that resembles data, although we typically crave the hardcore, quantifiable, number-crunching data we’re used to, especially in cancer research. It’s funny, though, how in our hunger-driven craze, we can be blind to obvious sources of data.

Today, oncology researchers are all scrambling for genomic data. It’s the single most common data question I get from researchers. But genomic data are not yet available in most secondary data sources, such as administrative claims data or HIPAA-compliant electronic medical records. How then can we begin to explore the role of genomic information in cancer research? As Talia Foster points out in her opinion brief, Oncology Literature Reviews Reach a Tipping Point in Genomic Assessment, the literature is a readily available source that is prime for exploration.

The literature is a versatile source of information on genomic markers in cancer. It can be analyzed both qualitatively, as well as quantitatively, and as Ms. Foster points out, it can address a variety of questions. Rather than wait for our typical sources of cancer data to fully incorporate genomic data, we can access the genomic literature today. By leveraging this powerful and rich source of data, we can not only begin to address many of the questions about the role of genomic assessment in diagnosis, prognosis and treatment response, the prevalence of various mutations and real world use of targeted agents, but we can also begin to plan new research studies that will help us in our search to get the right treatments, to the right patients, at the right time. Are you looking for genomic data? Perhaps the time is right for you to think about the literature for your next data venture.

Kathleen Foley
Senior Director, Strategic Consulting (Life Sciences)

Impact of FDA Safety Warning on Dispensed Zolpidem Dose for Women

By Truven Staff
Debra Irwin imageThe television show 60 Minutes recently aired a segment about gender differences in rates of drug metabolism. The program discussed a recent FDA safety warning and a recommended drug label change for Zolpidem, one of the most popular insomnia medications on the market. The safety warning was based on new data that showed women metabolize Zolpidem more slowly than men. Hence, women would require a lower dose of Zolpidem in order to avoid next morning impairment. After viewing this episode, my colleague and I became interested in the impact that the FDA safety warning had on Zolpidem dispensing patterns.

We examined the dose dispensed to new Zolpidem users before and after the FDA safety warning was issued. Women who were new users of Zolpidem were significantly more likely to receive low-dose Zolpidem after the safety warning compared to women who were new users of Zolpidem in the time period before the safety warning. However, the overall proportion of women receiving low-dose Zolpidem after the safety warning remained quite low.

Our findings may have significant public health implications for women using Zolpidem. An alarmingly high proportion of women who were new Zolpidem users were dispensed high-dose Zolpidem, despite the FDA safety warning. These findings highlight the importance of the extensive communication efforts required to effectively disseminate information concerning drug label changes to healthcare providers and patients.

Read more in our new issues brief, When Gender Matters: Impact of an FDA Safety Warning on Prescribed Zolpidem Dose.

Debra Irwin
Research Leader

Oncology Treatments and Care Benefit from Big Data

By Truven Staff
Kathleen Foley imageAn article in HealthCare IT News on March 21 discusses the latest use of IBM’s Watson computer for tackling the synthesis of complex information required to personalize cancer treatments to individual patients.   Drawing upon the medical literature, drug databases and patient genomic data, Watson will identify possible treatments for specific patients – tailored to their own genetic mutations. The application of Watson’s brain power to cull through an enormous amount of information is truly a step forward in the world of fighting cancer. The human brain can only synthesize small amounts of data at any given time, so having a computer help with the sifting and sorting is of tremendous value.

And so far, the reaction appears appropriately modest. Watson may be able to detect and identify, but Watson can’t interpret and place treatments into context the way doctors can. Watson is an aide that will hopefully free up human time for the things that human’s do best, such as interpret, understand, recommend, listen to and take into account patient emotions and family needs.

At Truven Health, our approach to big data is much the same. We use technology to simplify, organize and identify patterns of care, drivers of cost, or patient sub-groups. We draw upon many components of big data, from medical claims to hospital discharges, work productivity and oncology EMRs as well as the literature, to identify patient-level value in cancer treatments. And like our medical counterparts, we leave the heavy thinking, the place where intuition drives solutions and identifies new paths forward, to our researchers. Good technology in the hands of humans striving to treat and cure cancer is good for everyone!

Kathleen Foley
Senior Director, Strategic Consulting (Life Sciences)

Access to Pediatric Healthcare Stands to Raise Parental Awareness about Human Papillomavirus (HPV) Vaccines

By Truven Staff
Whitney Witt imageA recent article that my colleagues and I published in the journal Sexually Transmitted Diseases, stated that improving access to pediatric check-ups may increase parental awareness of human papillomavirus (HPV) vaccines. The article was based on research that was funded by the Agency for Healthcare Research and Quality (AHRQ). We identified that parents of children who had a well-child checkup in the last 12 months were significantly more likely to have heard of HPV vaccines. These findings highlight the idea that pediatricians and family healthcare providers may serve as an important lifeline for HPV vaccine-related information for parents.

Our findings also have significant implications for child health insurance policy, as this study reports that children’s access to health insurance may be critical in ensuring that parents learn about HPV vaccines in the health care setting. The association between a child's lack of insurance and lower parental awareness may be a result of decreased access to preventive care.

We need to arm parents with important information about these vaccines and the implications for their child’s health, so that they have all the necessary information to make an informed decision about whether or not they want to vaccinate their child. Improving access to preventive pediatric healthcare may offer a critical opportunity to increase parental awareness of the HPV vaccines.

Read more in our press release.

Whitney Witt, PhD, MPH
Director, Behavioral Health and Quality Research

HPV is a sexually transmitted disease that infects about 14 million people aged 15 to 59 years annually in the United States, with approximately seven million HPV infections among individuals aged 15 to 24 years. HPV infections cause genital warts and a variety of cancers, including cervical cancer. Although current guidelines recommend standard administration of HPV vaccines for boys and girls at ages 11 to 12 years, less than 34% of adolescent girls in the U.S. aged 13 to 17 years completed all three doses of HPV vaccines in 2012.

Using Big Data in the Best Interest of the Patient

By Truven Staff
Kathleen Foley imageThe recent USA Today article, ‘Analysis of huge data sets will reshape health care’ highlighted many of the ways in which ‘big data’ are being used to improve healthcare in the United States. The linkage of data across hospitals, insurance claims, electronic medical record systems, and genomics databases are helping to identify more efficient treatments and high-cost patients, and determine best practices for treating patients with particular conditions.

Despite these benefits and many others, the creation of ‘big data’ assets is fraught with difficulties that may be limiting the true potential of existing data. In addition to privacy concerns and constraints which limit what types of data can be linked and by whom, there are issues around ownership and access to big data. Who should pay for the creation of these large data assets, and once created, who should have access? The answers are not straightforward and require the development of trust and a shared vision across many stakeholders.

Truven Health is actively involved in the development of data infrastructures to both create big data and facilitate analyses while guiding appropriate interpretation. One of the first areas of focus is the creation of cancer data assets. To facilitate research that will truly answer important questions for patients, providers, and payers, we are exploring all avenues for linking various data from claims data to EMRs to cancer registries. Only by combining data sources can we finally begin to address questions that will get the right treatment to the right patient at the right time. It isn’t just about generating big data, it’s also about knowing how to use it to generate knowledge that is a game changer.

Kathleen Foley
Senior Director, Strategic Consulting (Life Sciences)