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Dr. Gui-shuang Ying

Dr. Ying Advances Biostatistics at Scheie

Scheie Vision Winter 2014

Gui-shuang Ying, PhD, sits in his office overlooking the Center City skyline, surrounded by stacks of binders.  Each binder, he explains, holds the information for one research project.  One glance at the binders is enough to tell that Dr. Ying has contributed very extensively to many projects.  He serves as an Associate Professor of Ophthalmology, the Director of the Biostatistics Consulting Service in the Center for Preventative Ophthalmology and Biostatistics, and an Associate Scholar in the Biostatistics Department of the Center for Clinical Epidemiology and Biostatistics.  

Born in a small town of Zhejiang Province in the People’s Republic of China, Dr. Ying began his medical education by attending medical school and completing a five-year medical training program in preventive medicine.  He also earned a Master’s degree in Health Toxicology in China.  Dr. Ying then traveled to the United States to pursue his interest in biostatistics at the University of Michigan (MS) and at the University of Pennsylvania (PhD).  

Today, Dr. Ying collaborates with faculty members on all stages of research projects, including facilitating initial study design, providing sample size and power calculations, developing data collection forms and databases, and publishing study findings.  What distinguishes Dr. Ying from other biostatisticians is his focus on both data analysis and the overall design and conduct of research.  For example, collaborators can approach Dr. Ying with a question of interest, and Dr. Ying will help design the best possible study to answer the question.
“My background in both medicine and biostatistics allows me to understand underlying disease processes and identify the steps necessary to meet the study goals,” Dr. Ying explained.  “I enjoy explaining the choice of the best design and the most appropriate statistical methods to my collaborators.  This really is my dream job.”  

In addition to his many collaborations, Dr. Ying serves as a senior biostatistician for several multi-center ophthalmology studies.  Currently, he is the Director of the Data Coordinating Center for two studies on retinopathy of prematurity (ROP), both funded by the National Eye Institute (NEI).  ROP is an eye disease affecting prematurely-born babies having received intensive neonatal care; the disease may be mild and resolve spontaneously or could lead to blindness in serious cases.  

Dr. Ying’s first study investigates a telemedicine approach for the detection of ROP.  This four-year study examines whether retinal images evaluated by trained readers can be used to decide which premature babies need clinical exams by ophthalmologists.  Since clinical exams on tiny babies are very time-intensive and expensive, developing this telemedicine approach could make the detection of ROP more efficient and cost-effective.  This study is led by Dr. Graham Quinn at the Children’s Hospital of Philadelphia (CHOP) and funded by an $8.5 million grant from the NEI.  

The second study, led by Dr. Gil Binenbaum at CHOP, seeks to develop and evaluate a prognostic model that uses postnatal weight gain to identify infants who are likely to develop severe ROP.  Preliminary results from this $2.5 million study found that babies who slowly gain weight have a higher risk of developing severe ROP.  The resulting prediction model based on postnatal weight gain accurately predicted the development of severe ROP.  Current work will determine whether this prediction model is accurate enough to determine the need for eye examinations.  

In addition to collaborating on and conducting research projects, Dr. Ying often proposes secondary statistical analysis of existing data from multi-center studies.  

“Multi-center studies are very expensive, and a lot of money is spent collecting a large amount of data,” said Dr. Ying.  “However, when a multi-center study is completed, large amounts of available data have not been used.  We can take advantage of this existing data and perform secondary statistical analyses to address clinically relevant questions.”

For instance, Dr. Ying has successfully obtained funding from the NEI to conduct secondary analysis of data from Vision in Preschoolers (VIP), a multi-center study that evaluates preschool vision screening tests.  As the principal investigator for this secondary data analysis grant, Dr. Ying worked closely with optometrists and ophthalmologists and published nine peer-reviewed papers in high-impact journals. 

More recently, Dr. Ying was awarded another grant from the NEI to perform secondary analysis of data from the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT). CATT is a multi-center clinical trial, sponsored by the NEI and led by Dr. Maureen Maguire.  The $26 million trial demonstrated that two anti-VEGF drugs (FDA approved Lucentis at $2000/dose versus off-label Avastin at $50/dose) provide equivalent visual outcome for the treatment of neovascular age-related macular degeneration.  Using the less expensive Avastin could lead to enormous cost savings, as Lucentis accounted for almost 10% of the entire Medicare part B drug budget in 2010.

“All doctors who treat eye diseases now know about this study,” Dr. Ying said.  “I am very happy to have been involved in such important research.  I am excited that the secondary analysis grant will provide me with the opportunity to address many clinically relevant questions by analyzing the rich CATT database.” 

Outside of his collaborative work, Dr. Ying conducts independent research on the development of risk prediction models in ophthalmology.  He recently developed a risk prediction model and risk score system for geographic atrophy in age-related macular degeneration, one of the leading causes of blindness in developed countries.  Dr. Ying and his collaborators also developed a clinical prediction model for ROP, the leading cause of preventable blindness in children. 

“These simple models, when validated, can be used to predict severe, vision threatening disease that informs clinicians and patients and allows selection of high-risk patients for clinical trials,” explained Dr. Ying.   

Dr. Ying is also a strong advocate for using the correct statistical methods to analyze the correlated data arising from measurements of both eyes.  

“In ophthalmologic and vision research, data is often collected from both eyes of a subject,” he explained. “Because data from two eyes of a subject is correlated, such data should not be analyzed in the same way as data from two independent subjects.  However, ophthalmologic investigators and vision scientists may not recognize the need to account for inter-eye correlation, or they might not be familiar with the correct methods to do so.  These correlated data are often analyzed inappropriately, leading to biased or very insufficient conclusions drawn from a study.” 

Dr. Ying enjoys collaborating with the Scheie faculty, residents, fellows, and medical students and feels fortunate to work in an Institute that highly values and supports research.  In the future, he plans to continue working on clinical research projects that have a substantial impact on prevention and treatment of eye disease.  He also hopes to educate more students through mentoring and teaching courses, while continuing to learn from new studies and new collaborators.  

Dr. Joan O’Brien, Chairman of the Department of Ophthalmology, recalls a conversation where Dr. Ying told her: “I like working with the famous people in ophthalmology, but I most enjoy working with the most junior people.  They are the ‘soon to be famous’ and if I can help them along that path, then that gives me real satisfaction.”

The Scheie Eye Institute is very grateful to Dr. Ying for his outstanding and extremely collaborative work and encourages current faculty and researchers to seek his assistance when beginning new research projects.  

“Dr. Ying gives enormously to the Department by working with scientists at all levels to help them perform the best research possible in answer to their scientific questions,” Dr. O’Brien said.  “He is truly outstanding in his skills; he cares deeply about each scientist and his or her work; and he is tireless in his pursuit of excellent.”  

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