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Jennifer Quesnel: When you're using math, applying rules, visualizations,
algorithms, using machine-learning to get these really, really big sets of
data working for you, you can really get insight into what's happening
biologically, health wise. This is where we get the field of bio-informatics.
Scientists analysing these huge amounts of data really fast, really
accurately. And we already have these vast amounts of data kept in a lot of
our medical records, big data sets, real world data, and it's not always
pretty or polished. This is where our third and final summer research student
enters the picture. Vaidehee Lanke earned her bachelor's degree of science in
bioinformatics. Then she went to McGill for her master's in epidemiology. Now
she is back home in Saskatoon studying medicine. And Vaidehee Lanke is our
guest today on Researchers Under the Scope.

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Music

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Jennifer Quesnel: Hi, welcome to Researchers Under the Scope. I'm your host,
Jen Quesnel. Our guest today is Vaidehee Lanke, who spent this past summer
working with epidemiologist Dr. Nadeem Muhajarine. Their research project
looked at some large data sets around perinatal mental health and opiate use
disorder, looking at how mothers are feeling before, during, after they give
birth, and how and where that connects with opiate use disorder. Vaidehee
Lanke and I sat down to talk about it this fall. Here's our conversation.

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Vaidehee Lanke: Thanks so much for having me. I'm so excited to be here.

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Jennifer Quesnel: Vaidehee, welcome to Researchers Under the Scope.

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Jennifer Quesnel: I'm excited to hear about your summer research project.
What is the question that you set out to answer?

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Vaidehee Lanke: The question we set out to answer was: what is the
association between opioid use disorder and perinatal mental health
conditions? Our work is rooted in the context that opioid use disorder is
tied to very adverse effects and poor outcomes, both maternally and fetally—
things like maternal death, stillbirth, and poor fetal growth.
The lab I worked with, led by Dr. Nadeem Muhajarine at the Saskatchewan
Population Health and Evaluation Research Unit, is part of a larger Canadian
perinatal opioid project. We’re working across five provinces, including our
own, to track national opioid use, understand the social determinants, and
see what the health impacts are for both parents and infants.
My slice of this project focuses on the mental health aspect. We know that
substance use disorders and mental health conditions are associated.
Individuals with mental health conditions—like mood disorders, anxiety, or
depression—are at higher risk of substance use disorders, and vice versa.
We’ve also seen that when mental health conditions and substance use disorder
co-occur during pregnancy, they lead to higher-risk pregnancies and poorer
health outcomes for both the parent and the infant.
So what I really wanted to study was: how does the co-occurrence of mental
health conditions and opioid use disorder change over time in our province?
Specifically, which mental health conditions are most affected, how severe
they are, what types of opioid use we’re seeing, and when this is happening
during pregnancy—before, during, or after birth. Ultimately, the goal is to
contribute to evidence-based medicine by helping us understand when and how
to intervene, and what kinds of solutions we can provide to better support
perinatal mental health in the context of opioid use disorder.

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Jennifer Quesnel: I have so many questions relating to this. And when we say
opiate use, what are we talking about? Opiate use disorder means?

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Vaidehee Lanke: So opioid use disorder is a disorder that's made by clinical
diagnosis, and it takes into consideration many different factors, including
the type of opioid you're using, the behavioural pattern you have with that
use, withdrawal, tolerance, and really the impact on someone's life. The
functionality piece of it is really critical, and that's made as a clinical
diagnosis. In our study, we looked at data from the Health Research Data
Platform of Saskatchewan, and specifically their discharge data sets and
ambulatory data sets and medical billing data sets, so anyone that would have
opioid use disorder would be classified within those administrative data
sets. Then we could use that data within our project.

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Jennifer Quesnel: And the opiates that the people in the study might have
been using would include, like, I'm thinking, is it fentanyl or codeine? What
counts?

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Vaidehee Lanke: Anything that would be an opioid. We’re more specifically
looking at the outcome of it—opioid use disorder—but any opioid that someone
might have consumed and then ended up in one of those administrative data
sets, we would have access to that data to include in our population-level
study. So yes, the ones you mentioned, like codeine, would be included, but
we’re more looking at that outcome of opioid use disorder.

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Speaker 1: Order,

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Jennifer Quesnel: Once you brought the data in, what methods did you use to
sort of try to sift through it?

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Vaidehee Lanke: I want to take a moment to talk about bringing that data in
and what a large partnership this is for us. It's with the Saskatchewan
Population Health and Evaluation Research Unit, led by Dr. Muhajarine and his
wonderful team. Over the summer we were really establishing that partnership
and bringing that data into the project, because these are very large
administrative data sets that require many different steps to ensure that we
have proper access, that patient confidentiality and privacy are respected and
protected, and that our technology platforms and coding software are set up.
That access piece is really big and requires a lot of human resources and
development. I’m grateful to have witnessed that process. The second part of
my summer was starting to distill what this data means. A big part was
merging these different data sets together so we have a cohort of people that
we can then study. To start that off, we did a little pilot on one of the
data sets to flush out the code, to see what the initial trends look like
with mental health conditions and opioid use disorder in perinatal
populations. We've just wrapped up that pilot project, and now we're going to
head on to the bigger piece of merging all three data sets together.

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Jennifer Quesnel: How would you say the pilot project went—perfectly,
according to plan, or any hiccups?

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Vaidehee Lanke: Research is like a winding pathway, so perhaps both is the
answer to that question. At the end of the day, we were able to get to the
point where we could see our trends from 2016 to 2024 for our research
question, but it wasn't without its fair share of learning curves when it
comes to code.

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Vaidehee Lanke: Sometimes you're pouring over it and it's that little comma
or semicolon that makes all the difference. Then there’s working in
partnership with bigger teams to access that data and bring meaning to it,
because you have these numbers and you're trying to figure out what they
mean, and what they mean going forward. Many lessons are learned, and that's
really helpful for a pilot because we can apply them to our bigger project.
This was a dream project for me, because it brought together all my different
worlds. Before medical school, I came from epidemiology and public health,
and now medicine. This was a project right at that intersection. I've always
wondered what work like this could look like in my future, and I feel like I
got a glimpse into my part in that intersection of health. Any research
project builds a life toolkit—not only quantitative and qualitative data
skills, but critical thinking: how to look at massive amounts of data and
make sense of it, how to evaluate evidence for validity, how to apply the
scientific method. These are crucial skills for everyone, but especially for
a physician working with patients. You gain an appreciation for all the human
effort and dedication it takes to do research.

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Vaidehee Lanke: It is immense. When I walk through Health Sciences, where we
have our classes all day, every day, I realise that in this building, on
every floor and across campus, people are doing incredible research. That
research is already shaping medicine and will continue to shape the medicine
that my colleagues and I practice in the future. It's important that we take
the time to learn about that research, to learn about the scientific method,
and to build those bridges, because researchers and medical practitioners can
impact each other's work so profoundly. I see myself helping build those
bridges in the future.

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Jennifer Quesnel: Yeah, I was kind of wondering—from the actual hands-on,
hospital side of things, the clinical side, to the epidemiology and public
health side, and the data sets—where do you see this really having value in
the future?

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Vaidehee Lanke: I think epidemiology and public health are kind of the
backbones of medicine, because they help us understand the distribution and
determinants behind health events. Take this project: trying to look at what
kinds of opioids are being used, where they are being used the most, how
opioid use has changed across the years, and how it's connected to something
as important as mental health conditions. Epidemiology and public health help
us answer what the social determinants of health are—what factors are driving
certain communities to experience certain health conditions.

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Vaidehee Lanke: They can also show us where workflow and health systems need
improvement, and when we put in an intervention, what that intervention is
doing. Is it helping, and how can we improve it? It all distils down to
evidence-based medicine and providing a foundation for it. This summer has
been almost like a peek-a-boo into how evidence-based medicine is formed—the
human power and the science behind it. For me, it’s reaffirmed that I want to
be part of that bridge between epidemiology, public health, and medicine, and
I'm really excited to see where that takes me.

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Jennifer Quesnel: What's ahead for you? And can you see yourself going back
into Dr. Muhajarine's lab?

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Vaidehee Lanke: Yes, I'm there. I have never left the lab, so I'm going to be
there to complete this project. The impact of the work really matters to me,
and being able to support perinatal health. Our bigger vision is to support
interventions—especially when they need to be implemented. Is it before,
during, or after pregnancy, and how can our work support the co-treatment of
mental health conditions and opioid use disorder? That impact really matters
to me, and I'm excited to see this project carry through. Beyond this
project, two things stand out from reflecting on this project and my year in
medicine. One is really trying to build that bridge between researchers and
medicine. Sometimes it feels like we’re in two worlds that are very connected
but, on the surface, in silos. I want to help build those bridges and
relationships. The second is: how do we take what we're doing here—not only
in this lab, but across campus—and bring that work out to our communities and
make it accessible? That piece really matters to me. Podcasts like this are
super important for building those bridges. I'm also thinking about writing
and creative arts, so our communities have access to the research we're doing
and we can learn from them. Building those partnerships is how we shape
research and allow it to reach its full impact.

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Jennifer Quesnel: Behind each paper that is published, and behind all of the
evidence and data that goes into them, there are so many stories and so many
humans who benefit. I'm really pleased to have you here on the podcast and to
be sharing with us. Thank you so much.

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Vaidehee Lanke: Thank you so much for having me. This has been wonderful.

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Jennifer Quesnel: Vaidehee Lanke is in her second year of medical school.
This year, she won the Dean's Award for her work on the pan-Canadian
perinatal opioid use surveillance system. You may have heard her name before:
she won the Governor General's Academic Medal going into the U of S, the
Schulich Leader Scholarship, and was a finalist for the McCall MacBain
Scholarship. Before she went to McGill to earn her master's in epidemiology,
she was the University of Saskatchewan's most outstanding graduate in
Bioinformatics three years ago. She's one to keep an eye on. Researchers
Under the Scope is a presentation of the Office of the Vice Dean of Research
at the University of Saskatchewan's College of Medicine. We record and
produce this podcast on Treaty Six territory, and we pay our respects to the
First Nations and Métis ancestors of this place, and we reaffirm our
relationship with one another. Thank you for listening to this show, for
being a part of science. I'm your host, Jennifer Quesnel. Thanks for sharing
your ears with Researchers Under the Scope.