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Making Sense of Making Sense of Longitudinal Data Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn Fellow WSPCHS 2014 – Brazil
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Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Dec 15, 2015

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Page 1: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Making Sense of Longitudinal Making Sense of Longitudinal Data Data

Changes in ventricular function in babies with a functional single

ventricle

Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn Fellow

WSPCHS 2014 – Brazil

Page 2: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

No Disclosures No Disclosures

Wilder TJ, McCrindle BW, Hickey EJ, DeCampli WM, Williams WG, Caldarone CA, Blackstone EH

Page 3: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Rajeswaran and Blackstone

Page 4: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

4

8

12

16

20

0 2 4 6 8 10 12

AF

Pre

vale

nce

(%

)

Months

CABG

No

Yes

Atrial FibrillationAtrial Fibrillation

Rajeswaran and Blackstone

Page 5: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

ObjectivesObjectives

Describe longitudinal data and a new method for analysis

Illustrate how a new method maximizes the information we can generate from longitudinal data– Clinical example of critical LVOTO

Page 6: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Joint work of the Cleveland Clinic Clinical Investigations team under the direction of Drs. Eugene Blackstone, Rajeswaran Jeevanantham (HVI/QHS: biostatistics)

Page 7: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Longitudinal DataLongitudinal Data

Rajeswaran and Blackstone Years after birth

Ventricular dysfunction

Page 8: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Transfusion after SurgeryTransfusion after Surgery

Rajeswaran and Blackstone

Page 9: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Pain ScorePain Score

Rajeswaran and Blackstone

Page 10: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

RV Function: 3882 echoes from 427 children with single RV

% O

f ec

ho

es in

eac

h s

tate

RV Dysfunction None Mild Moderate Severe

Years after birth

Mean age of SCPC = 7 mo.

Page 11: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Analytic StrategyAnalytic Strategy

Page 12: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

% R

V D

ysfu

nct

ion

Years after birth

Data Exploration:Patten-Specific Profile

RV Dysfunction None/Mild Moderate/ Severe

Page 13: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Data Analysis: Temporal Trends

Early Phase

Years after birth

% P

rob

abili

ty

Late Phase Raw Data

Page 14: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Data Analysis: Temporal Trends

Years after birth

Late Phase

Early Phase

% P

rob

abili

ty

Page 15: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Data Analysis:Risk Stratification

Probability of RV dysfunction: Norwood

Probability of RV dysfunction: Hybrid

Years after birth

% P

rob

abili

ty

Page 16: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Areas of InterestAreas of Interest

What is the rate of ventricular failure, and what factors influence that rate at various phases?

Comparing children with Right vs. Left single ventricle physiology: LVOTO vs. TA–What are the differences in VF?–What are the differences AVVR?

Page 17: Making Sense of Longitudinal Data Changes in ventricular function in babies with a functional single ventricle Travis Wilder, M.D. CHSS Data Center Kirklin-Ashburn.

Thank YouThank You