The UCLA Institute for Precision Health (IPH) has accelerated efforts to build the largest genomic resource based on patients’ de-identified DNA samples, which can be used to develop uniquely tailored treatments and interventions to change the way health care is delivered.
Through the ATLAS Community Health Initiative, the IPH is creating a biobank consisting of blood, saliva and other tissue samples collected from patients during the course of routine care who volunteer to participate. These biospecimens, which are “de-identified” to preserve patients’ confidentiality, will be used, along with clinical, environmental and lifestyle information, to provide important insights that will help researchers and physicians to move toward health care that is tailored to the individual patient.
“We need to look at the whole person to determine when an individual can maximally benefit from targeted screening, given that it will be influenced by individual and other lifestyle factors,” says Clara Lajonchere, PhD, deputy director for the UCLA Institute for Precision Health. “This initiative is a critical step in building a core infrastructure that will pave the way for studies designed to increase the precision with which we can approach diagnostics and therapeutics.”
Creating a database to facilitate studies showing meaningful differences in how people’s genetic makeup interacts with environmental and lifestyle factors in health and disease requires large numbers of volunteer participants, Dr. Lajonchere notes. ATLAS aims to leverage the diversity of patients within the UCLA Health system and Los Angeles County to reflect the breadth of the communities served, which is critical.
“The majority of what we know about the genetics of disease is based largely on European populations,” says Daniel Geschwind, MD, PhD, vice chancellor for precision medicine and director of the Institute for Precision Health. “We now know that what is a genetic liability in a European population does not necessarily apply to individuals of Asian or African-American descent.”
“Our goal is not just to enroll 150,000 patients but to ensure that participants are representative of the UCLA Health population in terms of gender, race, ethnicity, age, sociodemographics, health status and disease burden,” explains Arash Naeim, MD, PhD, UCLA Health’s chief medical officer for clinical research and an associate director for both the Clinical Translational Science Institute and the Institute for Precision Health. “Health care in the future will be much more nuanced.”
All UCLA Health patients at participating locations are being offered an iPad to watch a universal consent video that explains the study goals and how it works. They are then given the choice to opt in or to decline participation. In the fall, patients will be able to complete the universal consent process on their mobile devices or personal computers.
With access to the de-identified samples, researchers from across the UCLA campus — including computer science, engineering and informatics — will use sophisticated big-data analytics and complex machinelearning strategies to develop so-called disease-risk-prediction models that can ultimately be used to guide decisions about patients’ health care.
“ATLAS is creating a powerful big-data engine that brings together patients’ clinical and health information with biological data so that we can better understand what health conditions patients might be most at risk for and what therapies and prevention strategies can be tailored for them,” Dr. Lajonchere says. “We want all of our patients to have the opportunity to be part of something bigger that is ultimately going to benefit generations to come. This is the future of medicine, and the future of medicine is now.”