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Precision Medicine: Not just “genes, drugs, and disease” | The OBSSR Connector

Precision Medicine: Not just “genes, drugs, and disease” | The OBSSR Connector

The OBSSR Connector

Precision Medicine Infographic

Precision Medicine: Not just “genes, drugs, and disease”

Posted February 2, 2015 by William Riley, PhD in Behavioral and Social Sciences

Figure outlines in blue with one outline of a woman in purple

William Riley, PhD

William Riley, PhD

OBSSR Acting Director
In addition to his current role as Acting Director at OBSSR, Dr. Riley is Chief of the Science of Research and Technology Branch, Behavioral Research Program in the Division of Cancer Control and Population Sciences at the National Cancer Institute. His research interests include the use of mobile phones and other mobile devices to assess and intervene on tobacco use, dietary intake, physical activity, sleep, and medication adherence.
At last week’s State of the Union, the President announced, “Tonight, I’m launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes – and to give all of us access to the personalized information we need to keep ourselves and our families healthier.”
On January 30th, at the White House, the President further described his vision for a $215 million initiativethat will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients.
On the day of the President’s announcement, the New England Journal of Medicine published “A New Initiative on Precision Medicine,” by Dr. Francis Collins and Dr. Harold Varmus, directors of the National Institutes of Health and the National Cancer Institute, respectively.
The article describes two main components of this initiative, “a near-term focus on cancers and a longer-term aim to generate knowledge applicable to the whole range of health and disease.”
This longer-term aim seeks to generate a cohort of one million or more Americans to “enable better assessment of disease risk, understanding of disease mechanisms, and the prediction of optimal therapy for many more diseases, with the goal of expanding the benefits of precision medicine into myriad aspects of health and healthcare.”

Not just “genes, drugs, and disease”

We at the Office of Behavioral and Social Sciences Research (OBSSR) are very excited about this opportunity. Many in the behavioral and social sciences community will hear this precision medicine announcement and conclude that this initiative is just about “genes, drugs, and disease.” This conclusion is incorrect. 
As Drs. Collins and Varmus write, “The initiative will encourage and support the next generation of scientists to develop creative approaches for detecting, measuring, and analyzing a wide range of biomedical information – including molecular, genomic, cellular, clinical, behavioral, physiological, and environmental parameters.”

Smartphones: An essential tool at the palm of the hands

OBSSR has been involved in the initial planning of this million-person cohort, and the NIH is committed to including behavioral, physiological and environmental measures in this cohort. The recent advances in mobile and wireless sensor technologies to assess these behavioral, physiological, and environmental parameters are an integral aspect of this initiative.
Just through their smartphones, cohort participants will be able to allow access to real-time data that can characterize location and activity, obtain heart rate, provide an estimate social interaction, capture specific events via audio or video, and query them about physical, mental, and social experiences.
But, most importantly, the smartphones afford a unique opportunity of a true partnership between researchers and cohort participants in this precision medicine effort. The participants will also be able to fully engage with the process, access their data and the research findings that emanate from it.

Toward integration of biobehavioral perspective throughout NIH

In the initial strategic plan for OBSSR, one of the three goals of the office was to integrate a biobehavioral interdisciplinary perspective into all NIH research areas.
By leveraging technologies to better and more intensively assess behaviors and environmental influences that contribute to health and illness, the behavioral and social sciences are able to contribute to an interdisciplinary precision medicine initiative.
Behavioral and environmental measurement tools can be used to:
  1. better characterize disease processes and treatment outcomes,
  2. assess not only disease states but also the physical, mental, and social functional status,
  3. monitor behavioral (e.g. smoking/diet) and environmental (e.g., particulate matter) exposures that contribute to disease and that interact with genetic influences on disease and treatment, and
  4. provide potential behavioral and environmental predictors of treatment response beyond that obtained from genetics alone.
This precision medicine initiative is much more than just “genes, drugs, and disease.” It is a comprehensive effort to better understand which treatments work for which individuals under which conditions. 

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