AMPATH Data Analysis Team Creating New Research Collaborations
AMPATH’s Data Analysis Team (ADAT) provides statistical and data management expertise in Kenya and is changing the typical structure of global health research collaborations.
ADAT is co-directed by Ann Mwangi, PhD, associate professor of biostatistics at Moi University, and Joseph Hogan, PhD, professor of biostatistics at Brown University and grew with support from AMPATH partners and funding from a D43 training grant from the Fogarty International Center at the National Institutes of Health.
“There's often been an imbalance in the way technical statistics and data science work is carried out in global health collaborations, with most of the work being done by North American or possibly European partners,” said Dr. Hogan. “So many AMPATH studies collected data in Kenya or used data from the AMPATH Medical Records System (AMRS), but then all the analyses were done in other institutions. ADAT is shifting that center of gravity. Through a lot of investment by IU and the Regenstrief Institute and the NIH training grant, we've been able to build a statistical data science infrastructure on-site in Eldoret to support a lot of the work that goes on there,” he continued.
The grant, now in its seventh year, provides funding for Kenyan scholars to receive master's level training in biostatistics at Brown, as well as funding to conduct annual workshops for African statisticians and build curriculum capacity in biostatistics at Moi University.
The ADAT team includes a lead scientific programmer and statistician, two staff-level biostatisticians, two data analysts, and three data managers, with additional support from faculty at other AMPATH Consortium institutions. Four members of the team have received master’s degrees in biostatistics from Brown.
MEET SOME MEMBERS OF THE ADAT TEAM
“The ADAT team provides support for several NIH-funded research studies in Kenya, which represents the majority of funding for ADAT,” said Dr. Mwangi, who received her PhD at Brown. “ADAT provides a range of critical data management and analysis services at all stages of proposal design, project implementation, and analysis of results and manuscript writing for investigators at AMPATH. In the past it might not occur to someone who's new to AMPATH that this expertise exists in Kenya, but once they know they are usually very receptive to using the ADAT team. We hope to see utilization of ADAT continue to increase,” she added.
Dr. Hogan acknowledged that it can sometimes be a little less efficient to work with an analyst that's overseas, but that this is part of working in a global collaboration. He said that the ADAT team is also open to a hybrid approach of working with statisticians at other institutions. “I like to tell people I've never seen a review panel complain about too much being budgeted for statistics in a research proposal. It's usually the opposite,” said Dr. Hogan. Projects requiring data management and analysis support are connected with ADAT during the AMPATH Research Program’s internal proposal review process, and investigators and ADAT co-directors work together to determine the level of ADAT support that is required for a project.
“ADAT also helps Kenyan investigators lead their own projects and tap into statistical expertise that's on their own campus,” said Dr. Mwangi. Traditionally, statistical expertise at universities in Kenya, including Moi University, has been built around agricultural research. Part of the D43 training grant provides training related on the specific tools used in biomedical research for faculty members that have statistical expertise. Another part is aimed at developing new faculty and curriculum related to biostatistics. In the previous grant period, Moi faculty visited Brown for a semester to get ideas on how they could modify their own classes. This led to two new courses and a review of the proposal for a master's degree curriculum in biostatistics at Moi University.
“By continuing to expand this training and reorienting existing expertise, Moi University will ultimately be in a position to train Kenyan biostatisticians rather than them going to Brown or somewhere else in the US or Europe,” said Dr. Mwangi.
Another key element facilitating the growth of AMPATH biostatistics and research is the availability of information from the AMRS. The medical records system provides a longitudinal cohort of several hundred thousand people diagnosed with HIV in western Kenya and is a resource of information about clinical care and monitoring and evaluation of outcomes. The ADAT team can download and process a research grade version of information in the AMRS and it provides an invaluable resource for understanding outcomes of HIV treatments and interventions. “The knowledge gained from that database has had widespread impact for both the patients living with HIV around the world and for those seeking to understand what works and what doesn't,” said Dr. Mwangi.
The ADAT team and biostatistics capacity developing at Moi University was a key factor in the recent R01 award that the AMPATH team lead by Drs. Mwangi and Hogan recently received from the NIH in addition to renewal of the D43 training grant. The R01 grant is designed to develop machine learning algorithms to predict which patients are at risk of dropping out of HIV care and which are at risk of treatment failure. “We would not have received this grant if we didn't have the infrastructure on the ground in Kenya that we have now,” said Dr. Hogan. “It would not have been credible for us to go to NIH and say ‘We're just going to take all of the data from Kenya, analyze it and package algorithms at Brown or Regenstrief and then send them back.’ Instead this is a multinational team and a lot of the technical heavy lifting is going to be done in Kenya. I think that the review committee found that to be very appealing and it convinced them that we're in a strong position to actually get this work done and have it make an impact,” he continued.
Dr. Hogan added that the AMPATH partnership is unique in its ability to facilitate multi-institutional collaboration. “The level of trust and collaborative spirit, to me is just really inspiring. Allowing different institutions to lead different parts of the overall research program is a stroke of genius. It's basically a perfect example of the sum of the whole being greater than the sum of the parts. I have great admiration for the leaders and the senior investigators in AMPATH both in Kenya and in North America. They're exactly the kind of people I envisioned spending my career working with and they are terrific,” he concluded.