Lupus Research on World Lupus Day: April Barnado
Today is World Lupus Day, which has been designated to call attention to the impact of lupus around the world. More than five million people globally struggle with this potentially fatal autoimmune disease that can damage virtually any part of the body from skin to eyes, heart to lungs, kidneys to brain, and anything in between.
April Barnado, MD, MSCI, is a Building Interdisciplinary Careers in Women’s Health (BIRCWH) K12 Scholar at Vanderbilt pioneering novel methods to use the electronic health record (EHR) to study outcomes in systemic lupus erythematosus (SLE). She’s gained international visibility for using phenome-wide association (PheWAS) techniques to show that men with lupus have an increased risk of atrial fibrillation compared to females with SLE.
We asked her to tell us about what has made her successful in research.
Tell us a bit about what you’re studying and where you plan to take it.
I have developed algorithms that incorporate billing codes, labs, and medications to identify SLE patients accurately in the EHR. Prior to this work, there were no validated algorithms in the literature. In collaboration with Vanderbilt biomedical informatics, I am performing phenome-wide association studies (PheWAS) in SLE to understand differences in comorbidities and outcomes in different groups of SLE patients.
SLE is a very heterogeneous disease where patients can have mild disease to life-threatening complications such as renal and neuropsychiatric involvement. My goal is to identify clusters of SLE patients who are at highest risk for developing these complications. Ultimately, I plan to expand this clustering to identify which SLE patients will respond to specific immunosuppressants.
Why does your project interest you?
I’m passionate about my project because it addresses challenges that impact patients, clinicians, and researchers while using novel methods in SLE. By better understanding why certain patients develop specific features of SLE and have different treatment responses, clinicians could deliver more personalized and effective care. Further, researchers could design better clinical trials to increase the chances of getting more medications approved for SLE.
How did you decide on it?
I wanted to address everyday clinical problems that impact both patients and clinicians. I also was drawn to Vanderbilt’s novel bioinformatics resources to study outcomes in SLE using a personalized medicine approach.
What made you decide to go into science and how did you get where you are now?
I have always had an interest in science, particularly in asking questions and then formulating a plan to answer these questions. I also had a desire to use that knowledge to impact people, so pursuing medicine seemed like a natural fit. I became interested in rheumatology in medical school while on a rheumatology rotation and was intrigued by SLE and how different patients suffered such different outcomes. I was fortunate to have worked with great faculty who encouraged me to pursue clinical research in SLE and supported and mentored me through medical school, residency, and fellowship.
What are you working on now or about to work on?
I submitted my K08 in February. I survived the submission process by starting early, tackling the grant piece by piece, and working closely with my mentors and administrative staff. I also was fortunate to get to present preliminary aims to a group of SLE experts at a conference to receive helpful feedback. I also took advantage of a studio and internal study section.
What’s your best advice for researchers coming up behind you?
Persistence is key in conducting studies and submitting manuscripts and grants. I also highly recommend resources such as Studios to get expert review on study design, manuscripts, and grants. [Ed. note: Studios pull together 3-10 experts to spend an hour and a half discussing your grant, paper, hypothesis, aims, or other topic.]
Dr. Barnado just had a paper come out last month that’s gotten attention in the rheumatology world: Developing Electronic Health Record Algorithms that Accurately Identify Patients with Systemic Lupus Erythematosus (in Arthritis Care Res).