Escolar Documentos
Profissional Documentos
Cultura Documentos
Precision Medicine
Concept is not new
Consider prescription eyeglasses, blood transfusions
Prospects for broader application raised by recent advances
in basic research, technology development, genomics,
proteomics, metabolomics, EHRs, Big Data, mHealth, etc.
Reinforced by 2011 National Research Council report
Right
Drug
Right
Dose
Right
Time
Right
Person
Patient Partnerships
Technologies
Genomics
Data Science
Now 2014
(most recent data)
$22,000,000
$1000 - $5000
2 years
<1 day
1 million (<2%)
20-30%
>90%
n x 16
Computing Power
.Sotonight,ImlaunchinganewPrecision
MedicineInitiativetobringusclosertocuring
diseaseslikecanceranddiabetes,andtogive
allofusaccesstothepersonalizedinformation
weneedtokeepourselvesandourfamilies
healthier.Wecandothis.
www.nih.gov/precisionmedicine
$ Million
NIH
Cancer
Cohort
$200
FDA
$10
$5
TOTAL
$70
$130
$215
Near-Term Timelines
NIH Advisory Committee to the Director PMI WG
Public workshops to inform September 2015 report
Potential participants
Leaders of current cohorts
mHealth technology developers
EHR developers
Potential international partners
CVDinFamilyCohorts:
MexicanAmerican
OldOrderAmish
DiverseHLBS
ClinicalCohorts:
AsthmaandCOPD
Meta-Cohort
NHLBI Core
Cohorts
iPSCs
Astute Clinicians
Phenotyping
Cohort Datasets
Proteomics/Metabolomics
Genomics
Biorepositories
Mobile Health
Imaging
Public Health
Implementation
Science
Observational
Studies
Collaboration/
Role of
Industry
Basic
Research
Clinical
Research
Environment
Socio-Cultural
Context
Health
Economy
Systems
Community
Parks
Quality
MedicalCare
Schools
Culture
Family
Behavior
Individual
Individual
Genetics
Allergens
Asthma Health
Care System
Community
Genetics
School
Family
Discovery of Mediators/Biomarkers
Are there distinctive biological factors that
drive racial/ethnic disparities in asthma?
Clinical Studies
Do health disparities reflect the right
drug/right dose problem?
Best African American Response to
Asthma Drugs (BARD)
mHealth
Patient-Centered
Asthma Control
Empowering Patient SelfManagement of Asthma
Geospatial air quality monitor
Inhaler use alerts
Patient-based breathing test
Patient-reported outcomes
Genomics
CDC, 1996
Infection Socio-Cultural
Context
Health
Economy
Systems
Community
Parks
Quality
MedicalCare
Schools
Culture
Family
Sickle Cell
Duffy Antigen
G-6-PD
Behavior
Individual
Individual
Genetics
JAMA. 2014;312(20):2115-2125
Association of Trypanolytic
ApoL1 Variants with Kidney
Disease in African-Americans
360
370
380
A A A T T T A A A T A CCC T T A TGT A A A A T A
G Genovese, DJ FriedmanJB
Kopp, E Pays, MR Pollack
Pharmacogenomics
Angiotensin
Blockers in AfricanAmericans with
high-risk
APOL1/SCT
genotype
New therapies
New drugs
targeting
mediators
downstream of
APOL1 /SCT to
prevent kidney
failure
Melanie Nix
Emily Whitehead
Hugh and
Beatrice Rienhoff
Elana Simon
Kareem
Abdul-Jabbar
Noah and
Alexis Beery
ZEO: Sleep-Wake
Cycle Citizen Data
PatientsLikeMe: Enables
patients to share experience;
knowledge and relationships
for change
Questions