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In Our View: Precision medicine at heart of ‘All of Us’ project

The Columbian
Published: August 7, 2019, 6:03am

In addition to collecting information about lifestyles, genetics and health histories, a project that has landed temporarily in Clark County brings up interesting questions about the future of medicine.

The “All of Us” project, developed by the National Institutes of Health, has set up shop through Friday as part of a nationwide data-collection enterprise. A clinic is in operation at 5800 N.E. Fourth Plain Blvd., in the parking lot of Grocery Outlet Bargain Market, and U.S. citizens 18 and older are welcome to participate. The national goal is to eventually gather data from 1 million Americans to help advance medical treatments.

As the NIH explains: “Unlike research studies that are focused on a specific disease or population, ‘All of Us’ will serve as a national research resource to inform thousands of studies, covering a wide variety of health conditions. Researchers will use data from the program to learn more about how individual differences in lifestyle, environment, and biological makeup can influence health and disease.”

Initially proposed by the Obama administration, the 10-year, $1.5 billion project launched last year and presents a promising approach to the future of medicine. But it also raises questions about its ultimate effectiveness.

The goal is to advance the burgeoning field of precision medicine, which the National Cancer Institute explains as “an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease.” But Leigh Turner, a bioethicist at the University of Minnesota told “We need less hype and more honest accounts of the very serious challenges involved in developing highly tailored therapies for patients.”

Several studies in the United States and elsewhere over the past several decades have focused on collecting biological data to learn how genetic makeups impact various diseases. Sandra Soo-Jin Lee of Columbia University told NPR: “We’re building the infrastructure right now for the research enterprise — creating essentially these large libraries of individuals’ information and samples. … That has triggered a lot of questions about how you ethically recruit individuals into these types of large-scale projects, when it’s unclear how the samples and the data might be used in the future.”

Lee and other experts say a lack of genetic diversity in previous studies has slowed the progress of precision medicine. “In recent studies, where scientists are using more diverse resources, they’ve been able to find different variants that they were not aware of, that might be important in terms of understanding disease,” she said.

This presents a fascinating frontier in medicine — even if it can sound a bit convoluted. For those of us who have trouble getting past the child-proof lids on a bottle of aspirin, precision medicine is a little confusing.

For locals, however, the relevant part is that they can take part in the research by visiting the clinic between 10 a.m. and 5 p.m. through Friday. Participants may simply answer surveys about their lifestyle and environment; they also may provide a small amount of blood and urine to give researchers a more complete biological picture. Those who participate in the physical exam receive a $25 Amazon e-gift card.

Mel Lopez, who is working on the project, told The Columbian: “If we have a pool of 1 million or more of all walks of life, we can better personalize precision medicine.”