Precision Health: Predicting and Preventing Health--Not just treating it

RUTHANN RICHTER
June 5, 2015

Precision health takes a big-data approach to disease prevention and detection, focusing on the various factors that help maintain health throughout life.

Imagine a system where doctors can quickly comb through millions of anonymized patient records to find people with conditions and medical experiences just like yours. Through this massive, searchable database, doctors could determine how best to treat you, based on what has worked effectively for others with similar symptoms and characteristics.

Stanford Medicine is laying the groundwork for such a system, which will be able to quickly analyze information from large patient databases, medical literature, mobile monitoring and patients’ real-life experiences with drugs, among other sources, to provide an evidence-based approach to medicine that’s not been possible before.

The planned system is an example of how clinicians at Stanford Medicine are tapping health data to provide targeted, predictive and personalized care, an approach known as “precision health.” What makes precision health unique is that it goes beyond treating existing diseases and conditions to predicting and preventing diseases before they manifest, said Lloyd Minor, MD, dean of the School of Medicine. It stands at the intersection of medicine, technology and big data, offering new ways to keep people healthy.

“Precision health is a way of translating data into information that can lead us to take care of our health in a way that we might not have done before,” Minor said. “We are poised to have a whole new level of precision in maintaining health.”

The dean led a discussion about precision health during a town hall meeting June 5 for the Stanford Medicine comunity at the Li Ka Shing Center for Learning and Knowledge.

Moving beyond precision medicine

Precision health at Stanford Medicine has its roots in advances in both basic research and biomedical data science, which have given researchers the power to analyze vast quantities of information from a variety of sources: electronic medical records, genomic sequences, insurance and pharmaceutical records, wearable sensors and social and environmental data.

In sifting through this data, physicians and researchers can better predict individual risks for specific diseases, develop approaches to early detection and prevention, and arm clinicians with information to help them make real-time decisions about the best way to care for patients.

“Through our initiatives in precision health, we will be able to harness the availability of very large data sets and our ability to interpret and analyze that data to gain a more sophisticated understanding of the determinants of health and well-being, as well as specific risk factors and approaches for individual patients,” Minor said.

Innovative environment

Stanford Medicine is well-positioned to advance what’s possible through precision health because of its innovative and entrepreneurial culture, its ties to Silicon Valley, its multidisciplinary approach to problems and its leadership in biomedical data science and in multiple clinical disciplines, including stem cell biology, immunology, cancer biology, neuroscience, genomics, imaging and population health sciences.

We are poised to have a whole new level of precision in maintaining health.

Through collaborations that apply computation to clinical problems, scientists will be able to develop approaches that directly impact patients in the clinic. In cancer care, for instance, Stanford has a rare mix of expertise in both fundamental science and translational medicine, including cancer stem cells, genomic oncology, advanced diagnostics and clinical-trial infrastructure, all of which can be mined to develop targeted approaches to prevention and treatment.

“Our initiatives in precision health will influence how we care for patients in myriad ways,” said Amir Dan Rubin, president and CEO of Stanford Health Care. “We have already seen the impact with Stanford Hospital’s clinical genomics service, a collaboration that is enabling early and accurate diagnosis of disease and is a sterling example of personalized, patient-centered care.”

“Precision health is a natural extension of the personalized, patient-centered approach we bring to every patient,” said Christopher Dawes, president and CEO of Lucile Packard Children’s Hospital Stanford and Stanford Children’s Health. Both Dawes and Rubin joined Minor at the June 5 town hall discussion.

The move to early diagnosis

Large-scale data analysis also is enabling researchers to develop more targeted and cost-effective methods for early diagnosis of disease before symptoms ever develop. Maximilian Diehn, MD, PhD, assistant professor of radiation oncology, and his colleagues did a study using a national library of DNA sequences of tumors to develop a technique sensitive enough to detect a single molecule of tumor DNA among thousands of healthy molecules. That means a blood sample could one day be enough to diagnose many types of solid cancers or to monitor the level of cancer in a patient’s body.

In another recent study, School of Medicine researchers detected a pattern of gene activity that could lead to the development of a blood test to quickly and accurately detect sepsis, a deadly, whole-body inflammation syndrome. Sepsis is linked to 750,000 deaths each year in the United States and is the most common cause of hospital deaths. But it can be hard to pinpoint the condition, which can kill patients in a matter of hours. The researchers used publicly available patient data to identify specific immune-response genes associated with the condition, laying the groundwork for a simple diagnostic test for sepsis.

Capitalizing on Silicon Valley connection

Other studies, which take advantage of Stanford’s close ties to Silicon Valley, aim to use large collections of data to discern the factors that keep people healthy — or send them along a disease trajectory. In collaboration with Google X and Duke University, Stanford researchers are conducting a pilot study, ultimately involving 10,000 healthy volunteers, to understand the biological markers of health, down to the molecular and cellular level.

In another study, researchers are collaborating with Apple Inc. on a first-of-its-kind iPhone app called MyHeart Counts, which will collect data about physical activity and cardiac risk factors in order to advance understanding of the human heart. Researchers will be able to gauge the “heart age” of participants and study what motivates people to improve their heart health.

“These partnerships with Silicon Valley innovators take advantage of new technologies, including mobile health devices, to do systematic studies of all the factors at play in maintaining a healthy state,” Minor said. “That is the heart of precision health — using all the resources at our disposal to not only diagnose and treat the sick, but to broaden our understanding so that we can better advise patients on how sustain their health throughout their lives.”

Original article appeared here.