All of Us: Program gathers data for precision medicine

GREELEY — Modern medicine has created miraculous cures for diseases and conditions that at one time baffled doctors. Yet the magic bullet that saves one patient or one group of patients doesn’t necessarily work on all.

And researchers — or families — are left to wonder why.

In recent years, medical scientists have adopted the term “precision medicine,” meaning medicine that is tuned to be the most effective with the specific, individual patient. Figuring out how to apply precision medicine, short of trial and error, is the goal of a new program just launched in Colorado at North Colorado Medical Center in Greeley.

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All of Us research program, headed in Colorado by regional medical director Dr. Michael Bradfield, a family physician at NCMC, will contribute to a national program to gather real patient data in hopes of finding the next great cure for major diseases.

Partners in the program include hospital systems like Banner Health, universities, regional medical centers, federal agencies such as the National Institutes of Health, and health-care foundations. Together, they will recruit 1 million people who agree to share their health histories with the program so that researchers can tap the data to spot trends and outcomes among similar genetic groups.

“It’s not a study but a resource,” said Bradfield. “It will be a catalyst for studies.”

“This will strive to develop ways to measure risks for a range of diseases based on environmental exposures, genetic factors, regional health practices and the interplay between these factors…Our hope is that in the coming years we will have access to a wide range of study results that will help them live healthier lives through better disease prevention and treatment,” he said.

Funded for 10 years by the NIH, precision medicine is seen as one of two primary health-care emphases, Bradfield said. The other emphasis is the opioid crisis.

Precision medicine treats patients based on lifestyle, gender and other characteristics of individuals. “Some people’s genetics predispose them for certain treatments,” he said. Figuring out what works most effectively is the long term aim of All of Us.

Bradfield’s four-person team at NCMC has just begun the program in Colorado. As of late May, 159 people had signed up to participate. In Banner overall, 27,000 have enrolled so far. Banner’s Arizona operations began participation two years ago.

Kim Arnett, research assistant, said people who sign up will first sign consent forms including one that gives permission for the program to access health histories. They’ll be asked to complete three surveys or questionnaires. Then, they’ll be examined by a health-care professional to gather baseline data — blood pressure, blood and urine testing results, and more — to be entered into the databank. The program hopes to establish relationships with participants that extend for many years, perhaps for the remainder of the participants’ lives.

“We want the database to represent the diversity of the United States,” Bradfield said. While the program is not targeting any specific populations, it does want populations under-represented in the past to be part of it — rural residents, for example, or those earning lower incomes.

Participants need to be 18 years old or older, with pediatric participants to be added later. Participants need to be able to give consent and not be incarcerated.

So far, those most interested seem to be people who have an interest in health care or people who have been frustrated with their care or the care of family members, Bradfield said.

“This is the largest thing since the Framingham study,” Bradfield said, referring to the cardiovascular disease study that began in 1948 in Framingham, Mass., which continues today.

Michael Risse, clinical research coordinator for All of Us at NCMC, said he became part of the program because he wants to be part of something that reduces trial and error in medicine.

Research assistant Daniel Marin said family health history drove him to join the effort.

Bradfield said the program is working with partners such as the University of Northern Colorado, Sunrise Community Health clinics, North Colorado Family Medicine and the Weld County Health Department to get the word out and to share survey data when possible.

Information about the program is now available online at http://www.joinallofus.org/en/videos/all-us-anthem with specifics about the local program at http://www.joinallofus.org/noco.

Eventually, a patient advisory board will be formed to help researchers determine what to study using the collected data.