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 she is working to implement this series of code at more hospitals. She is also testing this automated process of identifying adverse events on ongoing clinical trials. In addition, she is developing an automated system to identify complex, non-laboratory adverse events. The results of this work will provide clinicians with a more accurate understanding of adverse events 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.
Anjali Khanna, MBBS, MPH
anjali.khanna@emory.edu
Ashleigh Hawk, MPH
ashleigh.hawk@emory.edu
Nicholas DeGroote, MPH
Sophie Lederer
Oluwafunbi Awoniyi, MD, MSc
Christiana Ziworitin-Ogola
Fernanda Carlosama Ruiz
Kaitlin Shinn, Medical Student, Emory University School of Medicine
Ngozi Ugboh, Graduate Student, Emory University Rollins School of Public Health
Zachary West, Medical Student, Emory University School of Medicine
Miller TP, Aplenc R. Evolution of hematology clinical trial adverse event reporting to improve care delivery. Current Hematologic Malignancy Reports, 2021. 16(2):126-131. PubMed PMID: 33786724.
Miller TP, Marx MZ, Henchen C, DeGroote NP, Jones S, Weiland J, Fisher B, Esbenshade AJ, Aplenc R, Dvorak CC, Fisher BT. Challenges and barriers to adverse event reporting in clinical trials: A Children’s Oncology Group Report. Journal of Patient Safety, 2021. [Epub Online September 2021]. PMID: 34570002.
Rosenfeld E, Getz KD, Miller TP, Seif AE, Fisher BT, Burrows E, De Leon D, Aplenc R, Morales Knashawn, Guevara J. Incidence and risk factors for hypoglycemia during maintenance chemotherapy in pediatric acute lymphoblastic leukemia. Pediatric Blood and Cancer, 2021. E29467. PMID: 34811879.
Ibrahimova A, Winestone LE, Miller TP, Kettler K, Seif AE, Huang YS, Elgarten C, Myers RM, Fisher BT, Aplenc R, Getz KD. Induction mortality and resource utilization in infants with acute leukemia. Pediatric Blood and Cancer, 2021. [Accepted]
Sung L, Miller TP, Phillips R. Improving symptom control and reducing toxicities for pediatric patients with hematological malignancies. Hematology Am Soc Hematol Educ Program 2020. 2020(1):280-286. PMID: 33275755. Dec 2020
West Z, Castellino S, Monroe C, Thomas A, McCracken C, Miller TP. Quantifying the difference in risk of adverse events by induction treatment regimen in pediatric acute lymphoblastic leukemia. Leukemia and Lymphoma, 2020. Dec 1: 1-14. Epub ahead of print. PMID: 33258395.
Shinn K, Wetzel M, DeGroote NP, Keller F, Briones M, Felker J, Castellino S, Miller TP. Impact of respiratory viral panel testing on length of stay in pediatric cancer patients admitted with fever and neutropenia. Pediatric Blood and Cancer, 2020. E28570. PMID: 32881268. Nov 2020
Cahen VC, Li Y, Getz KD, Elgarten CW, DiNofia AM, Wilkes JJ, Winestone LE, Huang YSV, Miller TP, Gramatges MM, Rabin KR, Fisher BT, Aplenc R, Seif AE. Identifying relapses & stem cell transplants in pediatric acute lymphoblastic leukemia using administrative data: capturing national outcomes irrespective of trial enrollment. Pediatric Blood and Cancer, 2020. e28315. PMID: 32391940. May 2020
Miller TP, Klosky KL, Zamora F, Swift M, Mertens AC. Feasibility and acceptability of an animatronic duck intervention for promoting adaptation to the in-patient setting among pediatric patients receiving treatment for cancer. Pediatric Blood and Cancer, 2019. 66(12):e27984. PMID: 31486586.
Miller TP, Fisher BT, Getz K, Sack L, Razzahi H, Seif AE, Bagatell R, Adamson PC, Aplenc R. Unintended Consequences of Evolution of the Common Terminology Criteria for Adverse Events. Pediatric Blood and Cancer, 2019. 66(7):e27747. PMID: 30968531. PMCID: PMC6681806.
Fitzgerald JC, Li Y, Fisher BT, Huang YS, Miller TP, Bagatell R, Seif AE, Aplenc R, Thomas NJ. Hospital variation in intensive care resource utilization and mortality in newly diagnosed pediatric leukemia. Pediatric Critical Care Medicine, 2018. 19(6):e312-e320. PMID: 29528977. PMCID: PMC5986594.
Getz KD, Miller TP, Seif A, Li Y, Huang YS, Fisher BT, Aplenc R. Opioid utilization among pediatric patients treated for newly diagnosed acute myeloid leukemia. PLOS One, 2018. 13(2):e0192529. PMID: 29420604. Feb 2018
Winestone LE, Getz KD, Miller TP, Li Y, Huang YS, Seif AE, Fisher BT, Aplenc R. Complications preceding early deaths in black and white children with acute myeloid leukemia. Pediatric Blood and Cancer, 2017. 64(12). PMID: 28727288. PMCID: PMC5733774.
Miller TP, Li Y, Kavcic M, Getz KD, Huang YS, Sung L, Alonzo TA, Gerbing R, Daves MH, Horton MH, Pulsipher MA, Pollard J, Bagatell R, Seif AE, Fisher BT, Luger S, Gamis AS, Adamson PC, Aplenc R. Center-level variation in accuracy of adverse event reporting in a clinical trial for pediatric acute myeloid leukemia: A report from the Children’s Oncology Group. Haematologica, 2017. 102(9):e340-e343. PMID: 28642300.
Esbenshade AJ, Zhao Z, Aftandilian C, Saab R, Wattier RL, Beauchemin M, Miller TP, Wilkes JJ, Kelly MJ, Fernbach A, Jeng M, Schwartz CL, Dvorak CC, Shyr Y, Moons KGM, Sulis M-L, Friedman DL. Multi-site external validation of a risk prediction model for the diagnosis of blood stream infection in febrile pediatric oncology patients without severe neutropenia. Cancer, 2017. 123(19):3781-3791. PMID: 28542918. PMCID: 5610619.
Miller TP, Li Y, Getz KD, Dudley J, Burrows E, Pennington J, Ibrahimova A, Fisher BT, Bagatell R, Seif AE, Grundmeier R, Aplenc R. Using electronic medical record data to report laboratory adverse events. British Journal of Haematology, 2017. 177(2):283-286. PMID: 28146330. PMCID: 5384859.
Winestone LE, Getz KD, Miller TP, Wilkes JJ, Sack L, Li Y, Huang YS, Seif AE, Bagatell R, Fisher BT, Epstein A, Aplenc A. The role of acuity of illness at presentation in early mortality in black children with acute myeloid leukemia. American Journal of Hematology, 2017. 92(2):141-148. PMID: 27862214.
Miller TP, Aplenc R. Reply to H.S.L. Jim et al. Journal of Clinical Oncology, 2017. 35(10):1135. PMID: 28165896.
Rao, P, Li Y, Getz KD, Huang YS, Miller TP, Wilkes JJ, Seif AE, Bagatell R, Fisher BT, Gracia C, Aplenc R. Low Rates of Pregnancy Screening in Adolescents Prior to Teratogenic Exposures in a National Sample of Children’s Hospitals. Cancer, 2016. 122(21):3394-3400. PMID: 27618636.
Getz KD, Miller TP, Seif AE, Li Y, Huang YS, Alonzo T, Gerbing R, Sung L, Hall M, Bagatell R, Gamis A, Fisher BT, Aplenc R. Early discharge as a mediator of greater ICU-level care requirements in patients not enrolled on the AAML0531 clinical trial: a Children’s Oncology Group report. Cancer Medicine, 2016. 5(9):2412-6. PMID: 27474232. PMCID: PMC5055162.
Miller TP, Getz KD, Kavcic M, Li Y, Huang YS, Sung L, Alonzo TA, Gerbing R, Daves MH, Horton TM, Pulsipher M, Pollard J, Bagatell R, Seif AE, Fisher BT, Gamis A, Aplenc R. A comparison of discharge strategies after chemotherapy completion in pediatric patients with acute myeloid leukemia: A report from the Children’s Oncology Group. Leukemia and Lymphoma, 2016. Jan 4:1-8. PMID: 26727639. PMCID: PMC4899280.
Miller TP, Troxel AB, Li Y, Huang YS, Alonzo TA, Gerbing RB, Hall M, Torp K, Fisher BT, Bagatell R, Seif AE, Sung L, Gamis A, Rubin D, Luger S, Aplenc R. Comparison of Administrative/Billing Data to Expected Protocol-Mandated Chemotherapy Exposure in Children with Acute Myeloid Leukemia: A Report from the Children’s Oncology Group. Pediatric Blood and Cancer, 2015. 62(7):1184-9. PMID: 25760019. PMCID: PMC4433587.
Miller TP, Li Y, Kavcic M, Troxel AB, Huang YS, Sung L, Alonzo TA, Gerbing RB, Hall M, Daves MH, Horton TM, Pulsipher MA, Pollard J, Bagatell R, Seif AE, Fisher BT, Luger SM, Gamis AS, Adamson PC, Aplenc R. Accuracy of adverse event ascertainment on clinical trials for pediatric acute myeloid leukemia. Journal of Clinical Oncology, 2016. 34(13):1537-43. PMID: 26884558. PMCID: PMC4872308.
Getz KD, Li Y, Alonzo TA, Hall M, Gerbing RB, Sung L, Huang YS, Arnold S, Seif A, Miller TP, Bagatell R, Fisher, B, Adamson PC, Gamis A, Keren R, Aplenc R, Comparison of In-Patient Costs for Children Treated on the AAML0531 Clinical Trial: A Report from the Children’s Oncology Group. Pediatric Blood and Cancer, 2015. 62(10):1775-81. PMID: 25946708. PMCID: PMC4546551.
Getz KD, Miller TP, Seif AE, Li Y, Huang YS, Bagatell R, Fisher BT, Aplenc R, A comparison of resource utilization in children discharged versus children who remain hospitalized following chemotherapy for acute myeloid leukemia. Cancer Medicine, 2015. 49(9):1356-64. PMID 26105201. PMCID: PMC4567020.
National Cancer Institute/National Institutes of Health- K07CA211956-01A1 - 2017-Present
2017 – Present, Improving adverse event reporting on cooperative oncology group trials, K07 Cancer Prevention, Control, Behavioral Sciences, and Population Sciences Career Development Award
Role: PI
Aflac Childhood Cancer Campaign - 2019-Present
My Special Aflac Duck as a Tool to Reduce Distress in Pediatric Cancer Patients – a Multi-center Efficacy
Role: PI
Alex’s Lemonade Stand Foundation - 2021-Present
Renal toxicity following methotrexate clearance differs by race and ethnicity
Role: PI