A Bold Vision for Big Data and Health Equity

Working at a mobile vision clinic proved to be an eye-opening experience for Sally Liu Baxter.

During a college summer internship, she traveled with the mobile clinic, run by the University of California, San Diego, (UCSD). The clinic offered vision screenings to children in pre-K through elementary school, particularly in underserved districts where many children didn’t have access to health care.

“Every day, we were seeing kids who were super cute and energetic but were falling behind because of a basic need for glasses,” Dr. Baxter said. “They couldn’t see the blackboard or the front of the classroom.”

The work of the mobile clinic and impact in the community motivated Dr. Baxter to pursue the fields of medicine, public health, and, in particular, ophthalmology.

“It made it real for me,” Dr. Baxter said. “There really wasn’t a level playing field. There was something tangible we could fix.”

The experience informed Dr. Baxter’s decision to pursue advanced degrees and to integrate medical research and bioinformatics, the field that harnesses computer science, math, physics, and biology, to advance knowledge of eye diseases.

The Eyes Have It 

Now, she taps the All of Us Researcher Workbench to develop computer models that predict which patients may have a higher risk of developing advanced glaucoma, requiring surgery. Glaucoma is the leading cause of blindness in the United States, according to the Centers for Disease Control and Prevention. Nearly three million Americans have the disease. There are few early warning signs. Dr. Baxter’s research analyzes the data to predict risk for disease progression.

Dr. Baxter also has used the Workbench to develop better models to predict how certain chronic conditions, such as blood pressure, diabetes, and heart disease, increase the risk for more serious glaucoma.

Dr. Baxter’s research earned her the NIH Director’s Early Independence Award in 2020. In one study, she analyzed electronic health record (EHR) data from more than 1,200 All of Us participants with glaucoma. She used the EHR data to train a computer to predict with 80%–99% accuracy who would later require eye surgery. In 2021, the paper was one of the first to be published using All of Us data.

“The power of numbers,” Dr. Baxter says, “is huge.”

Family History of Higher Education

Dr. Baxter comes from a long line of academics, notably women in her family who were among the first in China to complete college degrees. Dr. Baxter was the first in her family to become a practicing physician.

Her parents immigrated to the United States from China as graduate students in the early 1980s to finish their engineering degrees. Dr. Baxter was born in rural Ohio in 1987. She spent her early years in Pennsylvania and then Indiana before her family moved to San Diego just before she started eighth grade.

“I was very lucky to have parents who prioritized education,” Dr. Baxter said. “They were very supportive of all my goals.”

Dr. Baxter’s grandfather Guangfu Zhou, who lived with her family for several years in the United States, also was an important influence in her life. He had been an English professor in China and cultivated her love of languages. He read Chinese poetry to her when she was young. She treasured their time together. She continues to speak Mandarin and is conversational in Spanish.

Science camp also was a key influence. In high school, Dr. Baxter spent four weeks at the California State Summer School for Mathematics & Science. This was a residential program where she experienced lab life working on experiments. She also studied with world-renowned geneticist and neuroscientist Fred Gage, from the Salk Institute for Biological Studies, known for his discovery of stem cells in the adult human brain.

“I just knew him as the expert in my biology book in high school,” Dr. Baxter said. “Then I was in his lab studying with him.”

From that time on, Dr. Baxter was hooked on science and convinced of her career path. That path included jumps and hurdles along the way.

Athletics and Academia 

Dr. Baxter, who started gymnastics at a young age, was motivated athletically. In high school, she was able to incorporate these skills into pole vaulting. She competed in the California state championship and became a Division 1 athlete, able to run and fly through the air with a pole at more than double her height of 5’7”.

Dr. Baxter’s athletic skills and scientific interests led her to Duke University in 2005, which offered competitive programs in both areas. A program called Duke Engage funded her internship with the mobile eye clinic at UCSD. The experience provided Dr. Baxter the opportunity to see the community impact of biomedical discoveries. “The human connection really showed me how scientific evidence can make a difference,” she said.

Following graduation from Duke, Dr. Baxter moved to London to earn her master’s degree in public health as a Marshall Scholar. There she met her future husband, Michael Baxter, a Rotary Scholar, also studying public health. They both had applied to medical school in the United States. Dr. Baxter completed her medical degree at the University of Pennsylvania in Philadelphia, while her husband finished at the Johns Hopkins School of Medicine in Baltimore.

They married at Michael’s alma mater, the U.S. Naval Academy in Annapolis, Maryland, and went on to defy the odds that face many academic families.

“I heard a wide range of negative things throughout my medical training,” Dr. Baxter said in a 2022 article, “Ophthalmology Management 40 Under 40.” Against advice not to get married or have children while pursuing medical training, the couple had three children over the course of medical school and residencies. Her mother, Hong Dai, and her mother-in-law, Joan Baxter, were both on hand to help after each child was born.

Dr. Baxter completed her residency in ophthalmology and fellowship in biomedical informatics at UCSD. Beyond her family support, she credits many mentors who encouraged and helped guide her career.

Robert N. Weinreb, M.D., chair and distinguished professor of ophthalmology at UCSD, has been a mentor to Dr. Baxter throughout her residency, fellowship, and early years as a faculty member at UCSD. He encouraged her not to take manuscript rejections personally and to persist with grant proposals.

“He helped me build a sense of resiliency,” Dr. Baxter said.

Dr. Weinreb said he was impressed with Dr. Baxter’s passion for learning and growth. “Her eagerness to absorb knowledge, ask insightful questions, and implement feedback set her apart,” he said. “With an exceptional ability to think critically, she tackles challenges head on and always embraces opportunities to stretch beyond her comfort zone.”

Now, Dr. Baxter is passing on the lessons she learned.

“I’m trying to pay it forward,” she said. She advises and assists dozens of early career researchers in her lab at UCSD.

Dr. Baxter is an All of Us participant. It gives her firsthand knowledge of how sharing health information can help researchers advance discoveries. In the future, she hopes to expand data and research on eye diseases.

“I really hope the research can move forward towards improving clinical care,” Dr. Baxter said. “There is so much progress we can make. This is just the beginning.”