Projects

Active projects:

Elective Induction of Labor and Pregnancy Outcomes (NICHD grant R01HD071986; PIs: Dublin and Getahun)

We are drawing on data from two large healthcare systems to create a large database examining pregnancy outcomes in over 6,000 women.  Our major goals are 1) To examine maternal and infant outcomes associated with elective induction of labor compared to expectant management at 38, 39 and 40 weeks of gestation; and 2) to examine how risks vary according to maternal race/ethnicity, parity, and obesity status. We will complete approximately 6500 chart reviews across the two sites. This project uses a two-phase study design to oversample the most informative women, those with both the exposure of interest and an outcome of interest.  Outcomes to be examined include cesarean delivery, infant admission to the neonatal intensive care unit, postpartum hemorrhage, chorioamnionitis, and low Apgar score.

 

Medication Exposure in Pregnancy Risk Evaluation Program

(FDA contract HHSF223200510012C-COA7; PI: Platt)

In this multisite collaborative project, 11 health plans worked together to develop a rich database on 1.2 million births to 900,000 women in the years 2001-2008.  These data will enable the ongoing study of medication use and outcomes in pregnancy. Specific components include: 1) maternal-infant record linkage; 2) linkage to infants' birth certificate data; 3) validation of data elements through medical chart abstractions; and 4) annual update of the datasets.

 

Efforts to Develop the Sentinel Initiative: A Protocol-based Assessment of Selected Medications and Death

(FDA contract HHSF223200910006I; PI: Platt; project lead:  Dr. Denise Boudreau, GHRI)

This project aims to assess the associations of antibiotics and antidepressants with sudden cardiac death.  We are working with data from the Mini-Sentinel Distributed Database, which includes information on over 120 million people in the US contributed by over 20 data partners.  This project will use cutting edge statistical methods and a very large dataset to assess the safety of several commonly used medications.

 

Medication and Dementia Risk in Older Adults (Branta Foundation, PI: Dublin)

We will study the association between 3 medication classes - opioid pain medications, benzodiazepines, and general anesthesia - and brain outcomes in older adults, including dementia, global cognitive trajectory, and neuropathology.

 

Completed projects:

Efforts to Develop the Sentinel Initiative: Using Supplemental Information for Improved Confounder Adjustment

(FDA contract HHSF223200910006I; PI: Platt)

Dr. Dublin led a workgroup that explored the value of innovative methods, specifically 2-phase study designs, for better understanding signals of medication risk that may emerge within the FDA’s Sentinel Initiative, a large scale program for conducting active surveillance of medication safety. The workgroup’s aims were: 1) To develop a 2-phase sampling design strategy for supplemental data collection (e.g. medical record review) to refine a signal detected in automated data; 2) To develop a framework to determine which confounders should be collected; and 3) To develop an alternative strategy through which supplemental information could be collected on an ongoing basis, before a signal is detected. 

 

Systemic Sulfonamide Use During Pregnancy and the Risk of Selected Congenital Abnormalities in the Offspring

(FDA contract HHSF223200510012C-COA7; PI: Platt)

The major goal of this project was to measure the association between exposure to sulfonamide antibiotics during the first trimester of pregnancy and congenital abnormalities in the offspring. Using data from the MEPREP databases, we assembled a cohort including 7,000 women exposed to sulfonamides in the first trimester, 7,000 exposed to other (nonteratogenic) antibiotics but not sulfonamides in the first trimester, and 7,000 with no first-trimester antibiotic exposure.  A large sample of charts was reviewed to validate potential birth defect outcomes.

                                                                                                       

Natural Language Processing to Identify Pneumonia from Radiology Reports

Group Health Research Institute Development Fund (PI: Dublin)                                       

In this project, we developed and validated Natural Language Processing tools to identify pneumonia cases from electronic radiology text reports.

 

Links

For more information on Dr. Dublin - go her homepage at the Group Health Research Institute

Research Interests

Dr. Dublin’s research interests include pharmacoepidemiology, pregnancy outcomes and perinatal epidemiology; aging; and cardiovascular epidemiology. Her work uses real-world health care data from Group Health and many other sources to better understand the safety and effectiveness of medications and other medical interventions.  She often focuses on the impact of interventions in vulnerable populations, particularly pregnant women and older adults. She also has interest and expertise in using novel statistical and epidemiologic methods to answer real-world questions, such as the use of two-phase study designs to reduce bias and Natural Language Processing  to extract information from electronic medical records (EMRs).  She is the Group Health site Principal Investigator for the Medication Exposures in Pregnancy Risk Evaluation Program (MEPREP), a multisite collaboration that has developed data sets including 1.2 million pregnancies across 11 health plans to examine medication safety in pregnant women.

Publications

Dublin S, Jackson MJ, Nelson JC, Weiss NS, Larson EB, Jackson LA. Statin use and risk of community acquired pneumonia in older people: population based case control study. BMJ 2009 Jun 16;338:b2137. doi: 10.1136/bmj.b2137. PMC2697311.

Dublin S, Walker RL, Jackson ML, Nelson JC, Weiss NS, Jackson LA. Use of proton pump inhibitors and histamine-type 2 receptor blockers and risk of pneumonia in older adults: a population-based case-control study. Pharmacoepidemiol Drug Saf 2010 Aug;19(8):792-802. PMC2938739.

Davis RL, Eastman D, McPhillips H, Raebel MA, Andrade SE, Smith D, Yood MU, Dublin S, Platt R.  Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy.  Pharmacoepidemiol Drug Saf 2011 Feb;20(2):138-45. doi: 10.1002/pds.2068. Epub 2010 Nov 15. PMC3232183.

Dublin S, Walker RL, Jackson ML, Nelson JC, Weiss NS, Von Korff M, Jackson LA. Use of opioids or benzodiazepines and risk of pneumonia in older adults: a population-based case-control study. J Am Geriatr Soc 2011 Oct;59(10):1899-907. doi: 10.1111/j.1532-5415.2011.03586.x. Epub 2011 Sept 13. PMC3223721.

Andrade SE, Davis RL, Cheetham TC, Cooper WO, Li DK, Amini T, Beaton SJ, Dublin S, Hammad TA, Pawloski PA, Raebel MA, Smith DH, Staffa JA, Toh S, Dashevski I, Haffenreffer K, Lane K, Platt R, Scott PE. Medication exposure in pregnancy risk evaluation program. Matern Child Health J 2011 Oct;16(7):1349-54. PMC3361624.

Habel LA, Cooper WO, Sox CM, Chan KA, Fireman BH, Arbogast PG, Cheetham TC, Quinn VP, Dublin S, Boudreau DM, Andrade SE, Pawloski PA, Raebel MA, Smith DH, Achacoso N, Uratsu C, Go AS, Sidney S, Nguyen-Huynh N, Ray WA, Selby JV. ADHD Medications and Risk of Serious Cardiovascular Events In Young and Middle-Aged Adults. JAMA 2011 Dec 28;306(24):2673-83. Epub 2011 Dec 12. PMC3350308.

Bobo WV, Davis RL, Toh SD, Li D-K, Andrade SE, Cheetham TC, Pawloski PA, Dublin S, Pinheiro S, Hammad T, Scott PE, Epstein RA, Arbogast PG, Morrow JA, Dudley JA, Lawrence JM, Avalos LA, Cooper WO. Trends in the use of antiepileptic drugs among pregnant women in the US, 2001-2007: a Medication Exposure in Pregnancy Risk Evaluation Program study. Paediatr Perinat Epidemiol. 2012 Nov;26(6):578-588. doi: 10.1111/ppe.12004. PMC3481178.

Lawrence JM, Andrade SE, Avalos LA, Beaton SJ, Chiu VY, Davis RL, Dublin S, Pawloski PA, Raebel MA, Smith DH, Toh S, Wang JQ, Kaplan S, Amini T, Hampp C, Hammad TA, Scott PE, Cheetham TC; for the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) Study Group. Prevalence, trends and patterns of use of antidiabetic medications among pregnant women, 2001-2007. Obstet Gynecol 2013; 121:106-114. PMC3811068

Avery TR, Kulldorff M, Vilk Y, Lingling L, Cheetham TC, Dublin S, Davis RL, Liu L, Herrinton L, Brown JS. Near real-time adverse drug reaction surveillance within population-based health networks: methodology considerations for data accrual. Pharmacoepidemiol Drug Saf 2013;22(5):488-95. doi: 10.1002/pds.3412. Epub 2013 Feb 12. PMC3644310.

Toh S, Li Q, Cheetham TC, Cooper WO, Davis RL, Dublin S, Hammad TA, Li D-K, Pawloski PA, Pinheiro SP, Raebel MA, Smith DH, Bobo WV, Lawrence JM, Dashevsky I, Haffenreffer K, Avalos LA, Andrade SE. Prevalence and trends in the use of antipsychotic drugs during pregnancy in the US: a population-based study of 585,615 deliveries. Arch Women’s Mental Health 2013;16(2):149-57. doi: 10.1007/s00737-013-0330-6. Epub 2013 Feb 7. PMC3715880.

Dublin S, Baldwin E, Walker RL, Christensen LM, Haug PJ, Jackson ML, Nelson JC, Ferraro J, Carrell D, Chapman WW. Natural Language Processing to identify pneumonia from radiology reports. Pharmacoepidemiol Drug Saf, 2013 Aug;22(8):834-841. doi: 10.1002/pds.3418. Epub 2013 Apr 1. PMC3811072.

Johnson KE, Beaton SJ, Andrade SE, Cheetham TC, Scott PE, Hammad TA, Dashevsky I, Cooper WO, Davis RL, Pawloski PA, Raebel MA, Smith DH, Toh S, Li D-K, Haffenreffer K, Dublin S.  Methods of linking mothers and infants using health plan data for studies of pregnancy outcomes.  Pharmacoepidemiol Drug Saf 2013 Jul;22(7):776-786.. doi: 10.1002/pds.3443. Epub 2013 Apr 18. PMC3707923.

Dublin S, Anderson ML, Heckbert SR, Hubbard RA, Sonnen JA, Crane PK, Montine TJ, Larson EB.  Neuropathologic changes associated with atrial fibrillation in a population-based autopsy cohort.  J Gerontol A Biol Sci Med Sci, 2014 May; 69(5)609-15. doi: 10.1093/gerona/glt141. Epub 2013 Sep 28.  PMCID:PMC3991149

Darney BG, Snowden JM, Cheng YW, Jacob L, Nicholson JM, Kaimal A, Dublin S, Getahun D, Caughey AB.  Elective induction of labor at term compared to expectant management: Maternal and neonatal outcomes. Obstet Gynecol 2013;122(4):761-9. doi: 10.1097/AOG.0b013e3182a6a4d0. PMC3905733.

Dublin S, Johnson KE, Walker RL, Getahun D, Andrade SE, Avalos LA, Beaton SJ, Davis RL, Herrinton LJ, Pawloski PA, Raebel MA, Smith DH, Toh S, Caughey AB.  Trends in elective labor induction at 6 US health plans, 2001-2007. J Women’s Health, in press.

In The News

Can These Daily Meds Give You Dementia?
msn, 03/02/2015

Certain Over-the-Counter Drugs Linked to Dementia
JAMA Internal Medicine, 01/26/2015