Junior Faculty Fellow Spotlight: Charlene Ong, MD, Chobanian and Avedisian SOM
Charlene Ong, assistant professor of neurology and neurosurgery at Chobanian and Avedisian School of Medicine, is developing data-driven tools to help doctors detect and treat patients with acute brain injuries early. Her work also includes developing industry standards for brain swelling to ensure optimal patient care and outcomes.
Cerebral edema, or brain swelling, can be fatal or lead to permanent brain damage if not detected and treated early. Early detection often requires expensive testing and equipment, such as MRIs or CT scans. But what if there were symptom indicators that doctors could use to determine whether a patient was experiencing brain swelling? Having this ability would minimize radiation exposure, as well as a patient’s out-of-pocket costs. Using these symptoms to predict cerebral edema is also more widely accessible, as these indicators can be used to treat patients in remote areas or with insurance limitations.
Charlene Ong, MD, assistant professor of neurology and neurosurgery at Chobanian and Avedisian School of Medicine, has been working to identify these symptoms and establish guidelines for treating patients with cerebral edema. Dr. Ong’s research area focuses on developing and validating data-driven tools that doctors can use in treating patients with acute brain injuries. The Hariri Institute for Computing awarded Dr. Ong a 2024 Junior Faculty Fellowship to support this work.
Dr. Ong, in collaboration with other researchers, recently published a paper titled “Association of Dynamic Trajectories of Time-Series Data and Life-Threatening Mass Effect in Large Middle Cerebral Artery Stroke” in Neurocritical Care. The paper identifies biomarkers in patient data that doctors can use to determine whether a patient with an acute brain injury would develop brain swelling or begin recovering. The goal of this work was to enable doctors to detect brain swelling and develop treatment plans earlier.
Dr. Ong and her team analyzed data from 635 patients with confirmed large middle cerebral artery (MCA) strokes and identified symptom trends. They noticed that cerebral edema occurred following increases in white blood cell count and temperature. These symptoms presented before changes in medical imaging or clinical evidence, suggesting that inflammatory reactions happen ahead of brain swelling. Additionally, the study showed Cushing’s Triad, the three signs indicating increased brain pressure, can be predicted 24 hours ahead of surgery, when blood pressure increases and heart rate decreases. Doctors can use this information to identify patients susceptible to cerebral edema and respond quickly.
Dr. Ong also engaged in a survey study titled “Cerebral Edema Monitoring and Management Strategies” that identified the variations between doctors in treating brain swelling in patients with acute brain injuries. The study demonstrated the need for research that will inform clinicians about symptoms indicating swelling and develop treatment guidelines. Developing industry standards for brain swelling ensures optimal patient care and outcomes.
The Hariri Institute asked Dr. Ong about her research focus, projects on monitoring and treating patients with acute brain injuries, and future work as a Hariri Institute Junior Faculty Fellow:
Hariri Institute: Can you describe your research focus and its applications?
Dr. Ong: My research focuses on developing and implementing data-driven methodologies including sophisticated statistical approaches, and machine learning (ML) to improve neurological health outcomes. Specifically, I work on creating predictive models for neurological diseases, enhancing diagnostic accuracy, and personalizing treatment plans through advanced data analytics.
Hariri Institute: How did you become interested in this? Was there something that inspired this area of interest?
Dr. Ong: My interest in this field was sparked during my clinical training, where I observed the challenges in diagnosing and treating complex neurological conditions. The potential of data-driven strategies to leverage the large amounts of data we increasingly have access to and provide more precise, timely diagnoses and interventions led me to explore this area further. I am inspired by how excellent clinicians seemingly effortlessly synthesize a myriad of information in making their diagnostic decisions on a daily basis and the data scientists who creatively use rapidly improving models to simulate the way experts already operate. My goal is to integrate these complementary approaches to improve how we take care of patients.
Hariri Institute: What are the main goals or objectives of your research?
Dr. Ong: The main objectives of my research are to develop and validate techniques using non-invasive continuous data that can forecast both life-threatening deterioration before it occurs, as well as recovery potential for patients with acute brain injury. Ultimately, I aim to bridge the gap between cutting-edge technology and clinical practice, ensuring that patients receive the most effective and personalized care possible.
Hariri Institute: Has there been a recent development or finding that you find particularly exciting?
Dr. Ong: A recent finding that excites me is the measurable decline in quantitative pupil reactivity to light prior to neurologic deterioration in patients with large ischemic stroke. While it’s well known that unreactive pupils can be a harbinger of catastrophic neurologic injury, its potential to predict clinical deterioration has not been studied. Our hope is that we can use this easily available biomarker to augment and improve dynamic predictions of neurologic deterioration, providing a crucial window for life and function-sparing therapies.
Hariri Institute: What do you feel is most rewarding about your work – either as a professor or researcher?
Dr. Ong: The most rewarding aspect of my work is the interdisciplinary collaborations focused on making a tangible difference in patients’ lives at their most vulnerable.
Hariri Institute: How do you plan on using this fellowship opportunity?
Dr. Ong: I plan to use this fellowship opportunity to further refine and expand our predictive models for neurological diseases, incorporating more diverse datasets and advanced ML techniques. Additionally, the fellowship will provide valuable resources and collaboration opportunities to further study and translate these innovations from research to clinical practice, ensuring that more patients benefit from these advancements.
Of her fellowship, Dr. Ong said “The award will support our ongoing collaboration with Director Yannis Paschalidis’ group in identifying the NIH Stroke Scale using large language models from unstructured neurologic examinations. This support is essential to advance our data-driven strategies.”
The Hariri Institute’s Junior Faculty Fellowship recognizes early-career researchers at BU and supports their development through internal networking between fellows and the wider Hariri Institute community.
Learn more about current Junior Faculty Fellows and the program here.