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Published May 04, 2020
Research by two students from the Wyoming WWAMI Medical Education Program at the University of Wyoming was selected for presentation during a recent symposium hosted by the University of Washington School of Medicine (UWSOM).
Peter Wilcox and Jesse Hinshaw’s WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) research project was highlighted at the 2020 Transition to Residency Medical Student Scholars Symposium April 23. The symposium was presented in a virtual format, due to restrictions imposed by the COVID-19 pandemic.
Wilcox, Wyoming WWAMI class of 2016, from Riverton, and Hinshaw, class of 2018, of Encampment, co-wrote “Needles in the Electronic Health Record Haystack: Identifying Predictive Factors for Women at Risk for Heritable Breast and Ovarian Cancer.” Wilcox and Hinshaw worked alongside a team of students and faculty from the UWSOM.
The Wyoming WWAMI Medical Education Program is located in UW’s College of Health Sciences and serves as Wyoming’s medical school.
Wilcox, a graduating senior at the UWSOM, worked on his electronic health records project as part of an extracurricular scholarly activity during his third and fourth years of medical school. While many students submitted projects, only five were selected for presentation at the symposium.
“The University of Washington School of Medicine ranks 13th among all U.S. medical schools in terms of research,” says Tim Robinson, director of the Wyoming WWAMI Medical Education Program. “All UWSOM medical students are required to do a research project for graduation, and the UWSOM graduating class generally exceeds 240 students. It’s a great honor for students to have their projects selected for presentation at the Transition to Residency Medical Student Scholars Symposium.”
Hinshaw, a second-year medical student, provided data he collected for a separate yet connected project to support the findings for the presentation. His work was as an electronic medical records reviewer to collect and condense details concerning breast and ovarian cancer risk factors.
The symposium was presented live via Zoom, allowing audience members, including over 60 classmates and medical school faculty, to view and ask questions of the student presenters.
During the live Zoom presentation, Wilcox presented research showing gaps in the medical records of women patients seen at least five times or hospitalized within the University of Washington medical system that could have provided clues associated with a patient’s predisposition to certain types of cancer.
“Some 268,000 women this year will be diagnosed with breast cancer in the United States, and 40,000 will die from the disease,” Wilcox says. “Of these women, somewhere between 5 and 10 percent possess genes placing them at significantly higher risk for breast, ovarian and other cancers compared to the general population.”
While physicians may be limited in resourcing patient information during a single visit, Wilcox and Hinshaw focused on how a patient’s medical history can be examined to find clues, or “needles in haystacks,” to help predict risk for hereditary breast or ovarian cancers.
“For many women, this risk information already exists in their medical record but is scattered in many places and is difficult to access in a practical way,” Wilcox says.
To find these missing bits of information, Wilcox and Hinshaw, along with their team of medical student investigators, systematically scoured randomly generated medical records of female patients treated while in the University of Washington system.
“We spent up to an hour per chart searching for clues hinting to a woman’s genetic predisposition to cancer and noting where this data was most likely to be located,” Wilcox says. “We found that, of 299 women reviewed, 25 met criteria for referral to medical genetics, and half had never been referred.”
The medical students uncovered tiny gaps, over time, of missing information related to the medical records of these patients. How could these gaps in patient information be bridged, and how effective would presenting these findings in a virtual format be?
“In the future, we may be able to automatically search the medical record to identify women at risk for these cancers and inform their doctor they should be referred,” Wilcox says. “We are proposing that, if we could automate the process of combing the electronic medical record for hereditary breast/ovarian cancer risk, it may be possible to improve medical genetics referral rates, identify more women with genetic predisposition, and reduce disease and death due to breast and ovarian cancers.”
Wilcox plans to continue his work in research at the Seattle Cancer Care Alliance before moving on to residency with his wife, Sabrina, who also is a WWAMI medical student from Wyoming.
Hinshaw will enter his third year of required clerkships, rotating through specialties across the WWAMI region and the University of Washington hospital system.
“I really loved working on this project as a part of being a summer scholar for the American College of Medical Genetics,” Hinshaw says. “While in Seattle, I worked in three different genetics clinics and worked on this research project with Peter as well.”
For more information about the Wyoming WWAMI Medical Education Program, go to www.uwyo.edu/wwami/.