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Post-Doc: The Epidemiology of Fabry Disease and Metabolic Acidosis in Manitoba - MB-004

Preferred Disciplines: Life Science, Epidemiology, Biostatistics
Project length: 16-24 months (4 units)
Desired start date: As soon as possible
Location: Winnipeg, MB
No. of Positions: 1
Preferences: University of Manitoba
Company: Chronic Disease Innovation Centre 

About Company:

CDIC is focused on chronic disease management and prevention. Our research is primarily about sophisticated data to predict risk and to model and evaluate improved processes and treatment. We endeavour to: improve health, health care and wellbeing of our patients, spur innovation that reduces healthcare costs, bring new healthcare product and technologies to market, provide local, national and international reach, and unite experts from healthcare, research, academic, medical device and business sectors. Researchers at the Seven Oaks Hospital Chronic Disease Innovation Centre are affiliated with the University of Manitoba; however, the CDIC is governed by a volunteer board appointed by Seven Oaks General Hospital Foundation. It is integrated with the operation of Seven Oaks Hospital and the Wellness Institute but as an independent non-profit organization.

Project Description:

Metabolic acidosis is common in patients with advanced chronic kidney disease (CKD), and is caused by a combination of increased dietary acid load, loss of bicarbonate, or diminished net acid excretion. It has been associated with many complications, including decreased cardiac function, faster progression to kidney failure, impaired immune response, and altered bone and muscle metabolism. Several large population-based studies have examined the association of metabolic acidosis and CKD progression. These studies have described a strong and consistent association with kidney failure, and more proximal kidney outcomes, but have not examined the risk of cardiovascular events, hospitalizations or overall health care resource utilization. Understanding the link between acidosis and these outcomes can further inform the utility of novel therapies to treat metabolic acidosis and highlight potential opportunities for intervention.

Fabry disease is a rare x-linked recessive disease caused by mutations in the gene for alpha galactosidase A (GLA). The incidence of Fabry disease is classically estimated to be between 1/40,000 and 1/120,000. However, newer lines of genetic evidence suggest that these rates underestimate the true incidence of the disease which may be as high as 1/3,000. This discordance between clinical and gene diagnosis frequencies suggests that the majority of Fabry disease remains undiagnosed. Due to the low frequency of Fabry Disease, screening all patients for the disease is impractical outside of screening studies. However, several clinical scenarios have been associated with a much higher incidence of Fabry disease. Being able to identify patients who meet the criteria of being at high risk for Fabry diseases can close the screening and treatment gap.

The intern will connect to the remote access terminal of the Manitoba Centre for Health Policy where they will access deidentified health records of Manitoba residents via Statistical Analysis Software (SAS). The intern will use SAS programming code to build a dataset where demographics, comorbidities, drug prescriptions, laboratory results and outcome and predictor variables are collected once inclusion and exclusion criteria are applied. Following that, they will use SAS programming code to complete their research objectives via various types of statistical models. The final deliverable of the project will be two manuscript style reports that will be suitable for publication in a medical journal complete with background, methods, results, discussion and conclusion complete with references, appendices, tables and figures.

Research Objectives/Sub-Objectives:

  • To identify patients in Manitoba who are at high risk of Fabry disease but currently undiagnosed.
  • To identify physicians in Manitoba who care for patients at at high risk of Fabry disease in order to facilitate approaching their patients for disease screening.
  • To describe the incidence and prevalence of metabolic acidosis in Manitoba.
  • To develop a profile of patients with metabolic acidosis in Manitoba.
  • To analyze factors associated with metabolic acidosis and its treatment.
  • To assess adverse outcomes associated with metabolic acidosis.

Methodology:

We will conduct a retrospective cohort study of individuals with metabolic acidosis and Fabry disease in Manitoba, Canada using data from the Manitoba Centre for Health Policy (MCHP) which houses databases that include information on medical services (physician claims), hospitalizations, laboratory results, and outpatient drug prescriptions which can be linked using de-identified personal health identifiers (PHINs).

Outcomes, predictors and covariates will be ascertained using validated algorithms via the International Classification of Disease codes (versions 9 and 10) and Anatomical Therapeutic Chemical codes. Statistical analyses will include descriptive statistics, logistic regression, Cox proportional hazards regression, and negative binomioal regression.

Expertise and Skills Needed:

The successful candidate will have expertise in epidemiology and biostatistics, and possess skills in statistical software coding and database management. They will gain expertise in healthcare terminology and applied clinical research and acquire skills in literature reviews and scientific writing.

For more info or to apply to this applied research position, please check your eligibility and find more information about open projects.

Interested students need to get the approval from their supervisor and send their CV along with a link to their supervisor’s university webpage by applying through the webform.

Post Date: 
02/26/2019

Program: 
Elevate

 

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