Enabling Precision Health and Medicine (2017-2018)
As healthcare professionals gain greater access to genomic data, computational power and diagnostic tools, there is an increased need to translate genetic discoveries into actionable diagnostics and therapies. However, there is a complex array of scientific, regulatory, ethical and financial hurdles that exist between the laboratory bench and the safe and effective integration of new applications into clinical practice.
This team brought together Duke’s Center for Applied Genomics and Precision Medicine (CAPGM), the Center for Genomic and Computational Biology (GCB) and the School of Medicine to assess how precision health medicine is changing the landscape of healthcare with the goal of developing diagnostic tests from genomics and other technologies that can meet the real-world needs of patients in the Duke Health System.
Twelve undergraduate students with interests ranging from the biological and physical sciences to biomedical engineering and computer science met with Duke clinician-scientists to learn more about the various issues, developments and opportunities in precision health medicine. Ultimately, the team decided to investigate two issues: family health history and infectious disease.
Family health history (FHx) is currently one of the most effective tools for guiding clinical decision making. The FHx sub-team focused on expanding the utility and use of the MeTree application, a patient-facing, web-based family history risk assessment application developed by Duke Health that generates action-oriented suggestions tailored for both patients and physicians. In order to assess attitudes and barriers to the uptake of clinical decision support systems like MeTree in young adult populations, the team conducted an online survey to identify attitudes to collecting FHx data, perceived value and the efficacy of a newly developed video-based educational intervention compared to printed material.
A total of 294 respondents completed the survey. Their study found the video intervention group significantly more likely to: 1) engage in FHx behaviors (such as collection of FHx data, conversation with family members and recommendation of the MeTree application), 2) endorse the value of FHx collection for the purpose of risk reduction and 3) feel comfortable sharing their FHx with MeTree. The group’s study also suggested that many of the top-cited barriers to FHx collection, including concerns about family dynamics, privacy and family health information accuracy, were all addressable and potentially actionable through health education interventions.
This sub-team focused their work on a genomic analysis of the virulence factors of Burkholderia cenocepacia. B. cenocepacia is a human pathogen that causes infection in immunocompromised patients and is commonly associated with infections in patients with underlying lung diseases like cystic fibrosis.
The team collected and sequenced 21 samples of B. cenocepacia from cystic fibrosis patients who underwent lung transplantation with the goal of developing a rapid and robust diagnostic assay distinguishing pathogenic from benign genetic markers. The long-term goal of this research is to compare the team’s sequencing data with corresponding clinical data to determine the relationship between genetics and specific clinical outcomes.
Fall 2017 – Spring 2018
Sarina Madhavan, Emily Bullis, Rachel Myers, Chris J. Zhou, Elise M. Cai, Anu Sharma, Shreya Bhatia, Lori A. Orlando, Susanne B. Haga. “Awareness of Family Health History in a Predominately Young Adult Population.” 2019. PLoS ONE 14(10).
Enabling Precision Health and Medicine: Improving Family Health History (FHx) Collection with CDSS Tools (poster by Emily Bullis, Sarina Madhavan, Chris Zhou, Anu Sharma, Elise Cai, Shreya Bhatia, Lori Orlando, Susanne Haga), presented at Bass Connections Showcase, April 18, 2018
Genomic Analysis of Virulence Factors of Burkholderia cenocepacia (poster by Noelle Garbaccio, Othmane Jadi, Malcolm McDonald, Alex Shang, Henry Taylor, Austin Zhang, Greg Wray), presented at Bass Connections Showcase, April 18, 2018
This Team in the News
See related team, Enabling Precision Health and Medicine (2018-2019). Additional support for this project was provided by the Duke School of Medicine and the Office of the Vice Provost for Interdisciplinary Studies.
- Geoffrey Ginsburg, School of Medicine-Medicine: Cardiology
- Susanne Haga, Sanford School of Public Policy|School of Medicine-Population Health Sciences
- Gregory Wray, Duke Global Health Institute|Arts & Sciences-Biology
/undergraduate Team Members
Shreya Bhatia, Neuroscience (BS)
Elise Cai, Biology (BS)
Noelle Garbaccio, Biology (BS), Global Health (AB2)
Othmane Jadi, Biology (BS), Computer Science (AB2)
Sarina Madhavan, Program II (BS)
Malcolm McDonald, Neuroscience (BS)
Alexander Shang, Biomedical Engineering (BSE), Electrical & Cmputr Egr (BSE2)
Anu Sharma, Biology (BS)
Henry Taylor, Interdept Biology/CompSci (BS)
Austin Zhang, Neuroscience (BS)
Jiayang Zhou, Biomedical Engineering (BSE)
/yfaculty/staff Team Members
Gregory Crawford, School of Medicine-Pediatrics
Lori Orlando, School of Medicine-Medicine: General Internal Medicine