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

Jason Stevenson, MD

jason.monroe.stevenson@emory.edu

Oluwafunbi Awoniyi, MD, MSc

Nicholas DeGroote, MPH

Michaela Henderson, MD

Jazmin Huerta

Sophie Lederer, MD

Christiana Ziworitin-Ogola, MPH

Pratik Patel, MD

Fernanda Carlosama Ruiz, MPH

Kaitlin Shinn, Medical Student, Emory University School of Medicine

Ngozi Ugboh, Graduate Student, Emory University Rollins School of Public Health

Emma Vallee

Zachary West, Medical Student, Emory University School of Medicine 

George PE, DeGroote NP, Henderson M, Jordan K, Ziworitin-Ogola C, Castellino SM, Miller TP. Missing the mark? Exploratory analysis of the 10-year-old cutoff as an independent marker of high-risk disease in pediatric B-ALL. Pediatr Blood Cancer. 2024 Mar;71(3):e30825. doi: 10.1002/pbc.30825. Epub 2023 Dec 25. PMID: 38146039; PMCID: PMC10843810.

Hsiao W, Li Y, Getz K, Cao L, Krause E, Ramos M, Lee J, Gramatges MM, Rabin KR, Scheurer ME, Aplenc R, Denburg M, Miller TP. Acute and chronic kidney injury during therapy for pediatric acute leukemia: A report from the Leukemia Electronic Abstraction of Records Network (LEARN). Pediatr Blood Cancer. 2023 Dec;70(12):e30696. doi: 10.1002/pbc.30696. Epub 2023 Sep 30. PMID: 37776085; PMCID: PMC10793071.

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, 2022. 18(3):e672-679. PMID: 34570002. PMCID: PMC8940729.

Miller TP, Getz KD, Li Y, Demissei B, Adamson PC, Alonzo TA, Burrows E, Cao L, Castellino SM, Daves MH, Fisher BT, Gerbing R, Grundmeier RW, Krause E, Lee J, Lupo PJ, Rabin KR, Ramos M, Scheurer ME, Wilkes JJ, Winestone LE, Hawkins DS, Gramatges MM, Aplenc R. Rates of laboratory adverse events by course in pediatric leukemia ascertained using automated electronic health record extraction: a retrospective cohort study report from the Children’s Oncology Group. Lancet Haematology, 2022. 9(9):e678-e688. PMID: 35870472. PMCID: PMC9444944.

Elgarten CW, Thompson JC, Angiolollo A, Chen Z, Conway S, Devidas M, Gupta S, Kairalla JA, McNeer JL, O’Brien MM, Rabin KR, Rau RE, Rheingold SR, Wang C, Wood C, Raetz EA, Loh ML, Alexander S, Miller TP. Improving infectious adverse event reporting for children and adolescents enrolled in clinical trials for acute lymphoblastic leukemia: a report from the Children’s Oncology Group. Pediatric Blood and Cancer, 2022. 69(11):e29937. PMID: 36083863. PMCID: PMC9529813.

Miller TP, Li Y, Masino A, Vallee E, Burrows E, Castellino SM, Hawkins DS, Ramos M, Lash TL, Aplenc R, Grundmeier RW. Automated ascertainment of typhlitis from the electronic health record. Journal of Clinical Oncology Clinical Cancer Informatics, 2022. 6:e2200081. PMID: 36198128.

Patel PA, DeGroote NP, Jackson K, Cash T, Castellino SM, Jaggi P, Esbenshade AJ, Miller TP. Infectious outcomes of pediatric patients with acute lymphoblastic leukemia/lymphoma undergoing evaluation for nonseverely neutropenic fever. Cancer, 2022. 128(23): 4129-4138. PMID: 36238979.

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. PMCID: PMC6938026.

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Federally Funded:

  • Collaborator/Sub-contract PI, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Non-invasive diagnosis of pediatric pulmonary invasive mold infections, $2000 per patient reimbursement. 2021 – present (05-31-2024)
  • Project Lead, National Cancer Institute, Winship Cancer Institute Cancer Center Support Grant - Administrative Supplement: Enhance the Utility of Data Available through the Childhood Cancer Data Initiative (CCDI) Ecosystem. $499,999. 2023 – present (03-31-2025)

Private Foundation Funded:

  • PI, Alex’s Lemonade Stand Foundation, Comparison of toxicities by central venous line type, Alex’s Lemonade Stand Foundation Million Mile Researcher Program. $8,815.12.  2023 – present (03-04-2024, NCE requested)
  • PI, The Andrew McDonough B+ Foundation, Improving Knowledge of Invasive Fungal Disease in Pediatric Cancer. $80,000. 2023 – present (05-31-2024)
  • PI, Alex’s Lemonade Stand Foundation, Incidence and trajectory of anxiety and depression in children with Acute Lymphoblastic Leukemia, Alex’s Lemonade Stand Foundation Million Mile Researcher Program. $8,471.02. 2024 – present (03-04-2025)

Contracts:

  • PI, National Institutes of Health and Information Management Systems, Incorporated (IMS), Extract Electronic Health Record Pilot (EHR). $314,100. 2023 – present (07-02-2024)

Other:

  • Co-I, Pediatric Research Alliance Center for Clinical Outcomes Research & Public Health, In-silico Modeling of Pediatric Acute Myeloid Leukemia to Predict Patient Outcomes. $25,000.  2022 – present (09-30-2024)
  • PI, Aflac Pilot Grant, Association between race, ethnicity, and genomic polymorphisms and development of serious adverse events in children with acute lymphoblastic leukemia. $50,000 2023 – present (07-31-2024)