Overview
Dr. Miller’s research is focused on obtaining a better understanding of adverse events of anti-cancer therapy in order to describe who is more likely to have toxicities and ultimately provide data that can be used to reduce toxicities of future therapies. Her long-term goals are: 1) to improve the current system of adverse event reporting in order to enhance how clinical trials are performed, and 2) to perform research in supportive care that will improve daily clinical care of and guidance for children with cancer. Her prior work, published in the Journal of Clinical Oncology, found global under-reporting of adverse events on cooperative oncology group clinical trials for pediatric acute myeloid leukemia using the current manual system of adverse event identification. These results indicate that clinicians, researchers and patients do not currently have an accurate understanding of true rates of toxicities of chemotherapy due to lack of accurate data in the published literature.
Currently, her primary research aims to develop a novel approach to adverse event ascertainment that will be more accurate and efficient than the current system used on cooperative oncology group clinical trials. This new approach uses electronic health record data to capture adverse events of therapy. She and her collaborators have developed a method that successfully and accurately identifies laboratory-based adverse events. This has been implemented at five hospitals across the United States and is in process at multiple additional hospitals. She is also testing this automated process of identifying adverse events on ongoing clinical trials and developing an automated system to identify complex, non-laboratory adverse events. In addition, she is using this automated process to extract data to send to cancer registries and other partners to provide granular data on treatment and outcomes. The results of this work will provide clinicians with a more accurate understanding of adverse events and outcomes during chemotherapy that can guide clinical decisions and discussions with patients and families and can be used as baseline comparisons during testing of novel experimental agents.