A common criticism of precision medicine is that it may offer treatment benefits to individuals, but fail to address broader population disparities in health; precision medicine may even exacerbate health disparities if disadvantaged populations have disproportionately low utilization of novel screening and treatment technologies.1,2 In response to this criticism, the charge of the Analytics and Modeling (A&M) Core is to bridge the divide between individual-level precision medicine and population-level health disparities by leveraging two major strengths at Stanford University: (i) expertise in using omics data at the individual level to design and evaluate disease screening and treatment strategies, and (ii) expertise in computer modeling methods collectively referred to as ?systems science?, which integrate data from individuals (omics data, clinical data, behavioral survey data) with data on key contextual factors (social and economic barriers to healthcare access, cultural factors, environmental factors, health-related policies) to study the distribution of health in the population. Leveraging Stanford's unique expertise in these areas, the A&M core will pursue the following objectives: (1) to integrate data from the Native American arthritis and multi-ethnic breast cancer R01 projects into problem?specific systems science models to perform leverage point analysis, which involves integrating individual-level omics data with clinical, biological, and contextual data to identify which precision medicine interventions are best for improving individual patient outcomes, population-level health disparities, or both;5,6 (2) conduct cost-effectiveness analyses for the Latino obesity R01 project, by studying the cost-effectiveness of integrating personalized ?omics profiling (iPOP) into a multi-component, multi-setting intervention to reduce weight gain among Latino youth; and (3) serve as a center for excellence for the deployment of innovative data integration, analysis and modeling strategies to bridge the divide between precision medicine and population health. Our models will integrate multi-level data on omic risk variations within each studied population, social and cultural barriers that influence screening and treatment, screening performance, patient responses to test results, clinical gains to therapeutic efficacy from screening results, patient responses to suggested therapies, and patient outcomes from therapy. By integrating these diverse data into simulation models that link these individual-level factors to population disparities in disease risk and outcomes, we can identify the impact of altering key components ? the levers ? of patient outcomes and of population disparities, to inform the targeting and development of future precision medicine programs. Use systems science techniques, the A&M Core will create, validate, and implement models that identify how screening and treatment based on omics data can most effectively and cost-effectively reduce differential risk among vulnerable populations, in the interest of eventually leading precision medicine intervention strategies that will reduce population disparities in disease risk and treatment outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54MD010724-05
Application #
9896672
Study Section
Special Emphasis Panel (ZMD1)
Project Start
Project End
Budget Start
2020-04-01
Budget End
2021-03-31
Support Year
5
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Stanford University
Department
Type
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Basu, Sanjay; Raghavan, Sridharan; Wexler, Deborah J et al. (2018) Characteristics Associated With Decreased or Increased Mortality Risk From Glycemic Therapy Among Patients With Type 2 Diabetes and High Cardiovascular Risk: Machine Learning Analysis of the ACCORD Trial. Diabetes Care 41:604-612
Periyakoil, V J (2018) Square Pegs; Round Holes: Our Healthcare System Is Failing Seriously Ill Older Americans in Their Last Years. J Am Geriatr Soc 66:15-17
Bendavid, Eran (2018) The fog of development: evaluating the Millennium Villages Project. Lancet Glob Health 6:e470-e471
Berkowitz, Seth A; Basu, Sanjay; Meigs, James B et al. (2018) Food Insecurity and Health Care Expenditures in the United States, 2011-2013. Health Serv Res 53:1600-1620
Rigdon, Joseph; Baiocchi, Michael; Basu, Sanjay (2018) Preventing false discovery of heterogeneous treatment effect subgroups in randomized trials. Trials 19:382
Smith, Alexander K; Periyakoil, Vyjeyanthi S (2018) Should We Bury ""The Good Death""? J Am Geriatr Soc 66:856-858
Basu, Sanjay; Sussman, Jeremy B; Berkowitz, Seth A et al. (2018) Validation of Risk Equations for Complications of Type 2 Diabetes (RECODe) Using Individual Participant Data From Diverse Longitudinal Cohorts in the U.S. Diabetes Care 41:586-595
Salloum, Naji C; Buchalter, Erica Lf; Chanani, Swati et al. (2018) From genes to treatments: a systematic review of the pharmacogenetics in smoking cessation. Pharmacogenomics 19:861-871
Rhines, Allison S; Feldman, Marcus W; Bendavid, Eran (2018) Modeling the implementation of population-level isoniazid preventive therapy for tuberculosis control in a high HIV-prevalence setting. AIDS 32:2129-2140
Patel, Chirag J; Bhattacharya, Jay; Ioannidis, John P A et al. (2018) Systematic identification of correlates of HIV infection: an X-wide association study. AIDS 32:933-943

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