BOSTON—Wellness is difficult to define or measure, for both rheumatologists and their patients. However, wellness should be our ultimate goal as we move into the future of medicine, said Leroy Hood, MD, PhD, president of the Institute for Systems Biology (ISB) in Seattle.
“Ninety-nine percent of our effort and resources have focused on the disease side. I want to show you how important I think wellness is going to be,” said Dr. Hood, who delivered the opening lecture, P4 Medicine Is Transforming Healthcare: A Longitudinal, Framingham-like Study of 100,000 Well Patients Over 20 to 25 Years, at the ACR/ARHP Annual Meeting in Boston on Nov. 15.
Dr. Hood outlined five goals of his laboratory’s visionary work in personalized, genomics-driven medicine. He spoke about creating new metrics to quantify wellness, using these metrics to optimize wellness for patients with chronic disease, utilizing these metrics to analyze the earliest mechanisms of transition to active disease, creating a wellness industry, and taking all of these findings to the developing world. He spun a future vision of a “systems approach” to medicine, where multidisciplinary teams analyze a patient’s genomic profile, family medical history, and lifestyle, and then craft a personalized risk assessment and plan to prevent health problems.
Bold New Direction
This paradigm shift won’t be easy, because scientists are conservative and reluctant to embrace change, Dr. Hood said.
“Most biologists were firmly opposed to the Human Genome Project, as was the National Institutes of Health!” he noted. “I realized then that biology departments of the future needed to be cross-disciplinary to develop the analytical tools we needed to process all the data.” Medicine embraced technology and engineering, and new diagnostic and treatment tools were the result, Dr. Hood said.
In 2005, Dr. Hood and his organization articulated their concept of systems or P4 medicine: predictive, preventive, personalized and participatory. By 2008, he began a strategic partnership with the government of Luxembourg to develop new, systems-driven technologies with a $100 million investment over five years. In 2013, Dr. Hood and his team proposed the 100K Wellness Project, a longitudinal, digital, Framingham-like study of 100,000 well participants to analyze their genetic data, laboratory test results and lifestyle factors, such as smoking and diet, to create disease-risk profiles.
Using a cloud-based, systems approach, rheumatologists could one day match patients to proper drugs for their conditions or identify new drug target candidates.