A Unique Summer Experience Without Traditional Course Work:

Balancing an Internship and Additional Research

Janelle Noel, M.S.KUMC Biostatistics Ph.D. Graduate Student

Outline• Process of Obtaining an Internship• The Internship

– Life as an Intern• Daily Schedule• Expectations

– Projects

• GRA Project• Work-School-Life Balance • Most Valuable Lessons Learned

Process of Obtaining an Internship

Process of Obtaining an Internship: Where should you look for an internship?

• Watch for emails that go out from the department

• American Statistical Association’s webpage– www.amstat.org

Process of Obtaining an Internship: Where should you look for an internship?

Process of Obtaining an Internship: Where should you look for an internship?

• Watch for emails that go out from the department

• American Statistical Association’s webpage– www.amstat.org

• Indeed, LinkedIn, and/or Career Builder

Process of Obtaining an Internship: Where should you look for an internship?

Process of Obtaining an Internship: Where should you look for an internship?

• Watch for emails that go out from the department• American Statistical Association’s webpage

– www.amstat.org

• Indeed, LinkedIn, and/or Career Builder• Look at websites from specific company

– Research Triangle companies– Pharmaceutical companies: Novartis, Eli Lilly, Bayer,

etc.– Hospital networks and other medical associations

Process of Obtaining an Internship: When should you look for an internship?

• Don’t wait!• Announcements for summer internships come

out as soon as November – Application deadlines are usually in late December

or early January

Process of Obtaining an Internship: What should you have prepared?

• Cover letter– General – Specific for each company

• Résumé/ Curriculum vitae (C.V.)• Personal statement• Questions for future employer/company• Answers to common interview questions

Process of Obtaining an Internship: Once accepted, what steps do you need to take to

make it a reality?Step 1: Tell the necessary people

Step 2: Get a game plan!– Where will you live?– How will you get there?– Determine finances/budget– Create a timeline

Step 3: Organize your materials

Step 4: Continue to have open communication with your future boss/company until your start date

PRIMARY RESEARCH TEAM

HOME

The Internship

The Internship• The Children’s Hospital Association

(CHA)– Legacy companies

1. Children Health Corporation of America (CHCA)

2. National Association of Children’s Hospitals and Related Institutions (NACHRI)

Two Campuses:1. Overland Park, KS

2. Washington, D.C.

CEO: Mark Wietecha, M.S., M.B.A

Mission Statements: “We are committed to improving access to quality care, reducing costs and keeping the unique needs of children at the forefront of health care reform implementation.”

The InternshipTitle: Analyst Intern

Company Branch: Statistical Solutions

Research Team:

Matt Hall, Ph. D.(Principal Biostatistician)

Troy Richardson, Ph. D.(Biostatistician)

Jay Berry, M.D., M.P.H.(Research Clinician/Assistant Professor)

The Internship: OverviewDuration: 12 weeks

Day 1: Orientation

Week 1: Compliance, IT, Exploring datasets, and learning the ICD-9 coding system

Week 2: PI in-person visit

Week 3 :

…

Week 10:

Weeks 11/12: Documenting/Summarizing progress and verifying codes

programming, literature reviews, conference calls, weekly meetings, projects, learning their corporate culture, making caffeinated coffee, eating fruit & nuts, and introducing myself to

100+ people

Life as an Intern: Daily Schedule

Time Activity7:00 a.m. – 8:00a.m. Arrive, make coffee, read emails, read The CHAT,

and the occasional conference call

8:00 a.m. – 10:00 a.m. Working on task for the day

10:00 a.m. – 10:30 a.m. Weekly meetings, company meetings, grab a snack from the bistro

10:30 a.m. - 11:30 a.m. Working on task for the day

11:30 a.m. - 12:30 p.m. Lunch ( Lunch was provided on Wednesdays )

12:30 p.m. – 2:00p.m. Working on task for the day

2:00 p.m. – 3:00 p.m. Popular conference call hour on any given day

3:00 p.m. – 4:00 p.m. Working on task for the day and summarizing the day

4:00 p.m. – 5:00 p.m. Leave for the day

Life as an Intern

Expectation Prior to Internship

Reality

Complete a project Complete an aim of a project and work on multiple side projects

Structured days Flexible schedule

Work at a cubicle Work in an office

Conference calls are not awkward Conference calls can actually be fairly awkward

Project I: AHRQ R21 GrantBackground:• Individuals living with multiple chronic conditions

(MCC) – receive inadequate quality of health care – experience suboptimal health outcomes

• Health care systems are poorly designed to provide high quality of care for children with multiple chronic conditions (CMCC) and their families.

• Relevant to public health – rapidly advance our understanding of the U.S. population of CMCC

Project I: AHRQ R21 GrantPrimary Aim: Adapt a publicly available, comprehensive diagnosis

classification scheme developed by AHRQ to count the number of chronic conditions, name each chronic condition, and describe the combinations of chronic conditions endured for each CMCC.

Data: Healthcare Costs and Utilization Kid’s Inpatient Database 2009 (HCUP KID) and Medicaid data from Truven Health Analytics (2009-2012)• HCUP KID: 3.4 million individual records• Medicaid data: 8.6 billion records

Exclusion Criteria: Normal newborns and only one chronic condition

Project I: AHRQ R21 Grant

Project I: AHRQ R21 GrantMy role:

• Cleaning data• Sub-setting data• Presenting data findings and problems to

research team• Conducting sub-analyses on healthcare cost

and utilization • Building laying out framework for

Classification and Regression Tree (CART) model

Project II: Side ProjectPreliminary analysis

Objective: Determine if a trend exists year to year regarding the percentage of discharges and length of stays in children’s hospitals (CH) using two different definitions

Data: HCUP KID years 2000-2012

Method: Cochran—Armitage Trend Test

Definition #1 Definition #2

1 = Freestanding CH 1 = Freestanding and Non-Freestanding

2 = Non-Freestanding CH 2 = Other hospitals

3 = Other hospitals

Project III: New Proposed ProjectsTitle: Prediction of Medical Expenditures (ME) in Children

Objective: To predict the expected medical expenditures and health care utilization (HCU) in medically complex children using CCC/CCI/CCS in future years.

Data: Medicaid data from Truven Health Analytics and

Exclusion Criteria: Records that contains missing values and patients 17 years old

Study Design/Method: Fit a two-stage regression model to predict ME and HCU in children.

Stage 1: Logistic Regression/Stage 2: Linear Regression

Potential Papers:

1. Use CCI to predict total payments for future years

2. Compare predictive ability of CCC vs. CCI vs. CCS

3. Using prior 2-3 years to predict future years—a longitudinal prediction study

GRA Project

GRA ProjectTwo part genomics project

Part I: Determine differentially expressed (DE) genes found among the different DE analysis methods

-pre and post treatment

Part II: Assess

1) control of the type I error rate under the null hypothesis assuming unpaired or paired measurements through a simulation study

2) impact of ignoring the paired design among samples (Summer ‘14)

GRA Project: Part I

Paired Methods

*Excludes EBseq from Venn Diagram

Unpaired Methods

Figure 1: Number of Differentially Expressed Genes (Statistical Framework)

Frequentist Methods N=4543Bayesian Methods N=2609

Figure 2: Number of Differentially Expressed Genes (Method’s Statistical Theory)Table 1: Number of Common Differentially Expressed When Methods Overlap

GRA Project: Part II

• Simulation study– Normal context– Varying – Null scenario

• remain the same for each treatment group

– Fold change (FC)/Power scenario• Different for each treatment group

Null Scenarios

Fold change (FC)/Power scenarios

GRA Project: Part II• Simulation study

– Normal context– Varying – Null scenario

• remain the same for each treatment group– Fold change (FC)/Power scenario

• Different for each treatment group

• Future Work– Run scenarios in the Poisson and Negative Binomial contexts

• Create a usable sandwich estimator for the lme4 package in R • Vary overdispersion in the NB context• Compare results

Work-School-Life Balance

Work-School-Life Balance….Ha!

Work

School

Life

Most Valuable Lessons Learned

Most Valuable Lessons Learned

• Importance of programing skills• Government data is messy• Document, document, document• Don’t be afraid to ask• Importance of productive conference calls• Communication skills can always be improved • Awareness of professionalism

Bloopers

What happens when you let two grown men decorate your office?Every office needs at least one running joke…

Drs. Brooke Fridley, Jo Wick, and Matt MayoJackie Jorland

Drs. Matt Hall, Troy Richardson, Jay Berry

Acknowledgements

Questions