Enabling Precision Health and Medicine (2018-2019)

Background

The landmark sequencing of the human genome in 2003 heralded a new era in biomedical research, one that promised to accelerate the pace of discovery and open up entirely new avenues to understanding the genetic molecular basis of disease. A key result thus far has been the development of genomics-based tools to diagnose, predict disease onset or recurrence, tailor treatment options and assess treatment response. These advancements have developed concurrently with electronic medical records, digital (e-health) technologies and the shift toward patient-centered care.

As a result of the tools now available to characterize biospecimens and collect a range of personal data through wearables and apps, researchers face an influx of heterogeneous datasets and many challenges (and opportunities) for data analysis. Translating these discoveries into actionable diagnostics, interventions and therapies remains a substantial challenge. A complex array of scientific, regulatory, ethical and financial hurdles lie between the laboratory bench and the integration of a safe and effective application into clinical practice.

Project Description

This Bass Connections project will focus on the challenges in developing applications to support healthy living (precision health) and improve patient care (precision medicine).

Precision Health

Team members will develop the infrastructure for a new campus initiative to promote health awareness and engagement, establish healthy behaviors and enable student-centered research and learning opportunities. The initiative will initially focus on sleep behaviors and health. The team will work on the selection of a web/app-based platform to enable collection of sleep and demographic data and dissemination of educational content and activities to promote healthy sleep behavior for a select group of students.

Precision Medicine

Team members will expand the use of a validated digital family health history tool called MeTree™ for different patient populations and medical specialties in the U.S. and abroad. MeTree™ is a patient-facing web-based family health history-driven risk assessment application. The app is integrated into clinical practices, including Duke’s electronic health record, and provides clinical decision-making support to patients and their primary care providers about risk level for 30 different conditions and evidence-based recommendations for how to manage that risk. It was built with input from a wide group of stakeholders and piloted in primary care practices in North Carolina. The impact of MeTree on patients and providers and the type of care patients receive is currently being evaluated in a large multiinstitutional study of patients in five national healthcare settings, including Duke. The team will develop novel research projects to better understand opportunities for expansion and potential barriers to utilization by different patient populations.

Anticipated Outcomes

Novel application that will be used for a student campus initiative on healthy living, support for future grant applications and publications with student authorship; data to be used in the support of expansion of a digital family health history tool or app, support for future grant applications and publications with student authorship

Student Opportunities

The team will likely include 10-12 undergraduates (biology or other life sciences, public policy, global health, economics, statistics) and two graduate students who will be involved in project oversight/management, instruction and mentorship.

Students will gain experience conducting literature reviews, designing a study or application, contributing to data collection and analysis, learning about the range of policies relevant to the application, identifying potential areas of disparities or gaps in knowledge and preemptively developing solutions.

Evaluation of student performance will occur through assignment of a grade for interim results submitted through the semester, as well as an overall grade for the course and the receipt of course credit. Participation will account for a substantial portion of the student’s final grade.

Timing

Fall 2018 – Spring 2019  

  • Fall 2018: Weeks 1-5: Weekly meetings and reading assignments; meet with client, develop understanding of project, learn how to conduct literature review, acquire knowledge and skills specific to project (e.g., human subjects certification, protocol development, data analysis); Weeks 6-11: Work as team to define and achieve goals of deliverable(s), meet with team leaders or senior students for assistance as needed; Weeks 12-14: Finalize draft of deliverables, meet and present to team leaders and clients, submit IRB protocol (if applicable), begin to outline project goals for spring semester
  • Spring 2019: Continue activities, finalize deliverables

Crediting

Independent study credit available for fall and spring semesters

See earlier related team, Enabling Precision Health and Medicine (2017-2018).

Faculty/Staff Team Members

Geoffrey Ginsburg, School of Medicine*
Susanne Haga*
Lori Orlando, School of Medicine-Medicine: General Internal Medicine
Ryan Shaw, School of Nursing

* denotes team leader

Status

Active, New