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Landmark Research Program Advances Precision Medicine for All of Us

Physician Contributor, Giovanni Filardo, PhD, MPH

Baylor Hamilton Heart and Vascular Hospital is one of three Baylor Scott & White Health locations currently serving as a study site for system’s participation in a landmark precision medicine study – the All of Us Research Program. All of Us is the largest study ever executed in the United States by the National Institutes of Health (NIH), with a goal of enrolling 1 million participants across the country.

Baylor Scott & White is currently the only healthcare provider in Texas enrolling participants in the study and will receive a total of $14 million in funding from NIH over five years. The system is collaborating through a consortium that includes Baylor Scott & White, Henry Ford Health System in Detroit, Essentia Health headquartered in Minnesota, Spectrum Health in Michigan and University of Massachusetts Medical School.

Accelerating Precision Medicine

All of Us plans to follow participants for a period of at least 10 years since enrollment — and potentially up to 15 or 20 years — to augment lab specimens collected at enrollment with longitudinal lifestyle and health information. Through these data, the study hopes to accelerate the field of precision medicine and improve personalized care for future generations.

"Most of the treatment we used today is mainly based on the condition to be treated" said Giovanni Filardo, PhD, MPH, director of epidemiology for Baylor Scott & White and The Bradley Family Endowed Chair in Cardiovascular Epidemiology for Baylor University Medical Center, part of Baylor Scott & White Health, who is principal investigator for the study. "Data from All of Us will allow for a paradigm shift – instead of basing decisions on the condition, data from the program will inform decisions, treatments and practices tailored to the individual patient given the condition."

Because of the large number of participants, diversity of the participants and the length of the study, the information collected will provide a variety of data points for researchers. It has the potential to identify genetic profiles that are more susceptible to certain conditions and advance the development of treatments that better address those unique profiles.

"You can go to a department store to buy a suit, but if it's not tailored, it may not look very sharp on you," Dr. Filardo said. "On the other hand, you can have a suit that is tailored to you. We’re trying to custom tailor the treatment to the patient. Right now, we do not have the tools (i.e., data) to do that in medicine."

Advancing Cardiovascular Medicine

As with many other diseases, All of Us has the potential to change the future treatment of heart and vascular conditions. Researchers hope it will provide a new understanding of what actually works for a variety of cardiovascular diseases and allow for management based on each patient’s individual profile. Because of the large number of participants, All of Us may provide insight into very rare cardiovascular diseases that currently do not have enough resources or funding for research. It will also provide significant data for very common conditions affecting heart and vascular health – such as hypertension, diabetes or atrial fibrillation (AFib).

"One example is the risk of AFib for those undergoing revascularization through PCI or cardiac surgery, where the risk of developing AFib can be between 30 to 60 percent depending on the procedure," Dr. Filardo said. "We might be able to find a genetic profile of those more likely to face AFib after surgery. This would allow us to more effectively identify them and prepare them before surgery to prevent AFib and therefore ensure longer survival."

Enrolling Participants

Baylor Scott & White has committed to enrolling 26,000 patients in North and Central Texas in the next five years. Participants, at enrollment, will complete lifestyle and health questionnaires, undergo a baseline exam, and provide samples of blood (or saliva) and urine. "The program has been neatly designed to make sure participants have a very positive experience," Dr. Filardo said. "From the participants' standpoint, we have minimal requirements. We’ll be asking for their participation maybe once or twice a year via very short surveys. The engagement is minimum, but the return for advancement in the medical field is enormous."

As data is collected, participants will also have the opportunity to view updates on the participant portal. If during the course of the study a participant is diagnosed with a condition, he or she can use the portal to connect with others with the same diagnosis and see what treatment they are receiving.

"I hope physicians will encourage their patients to participate," Dr. Filardo said. "The information we will get back will really inform clinicians in the future to come. It’s a win-win situation. If they help us get more people in the study, they will get more information from the study to do their work better."

Enrollment for All of Us is currently underway. Interested patients can enroll online or schedule an appointment to enroll in person at one of the participating Baylor Scott & White locations. For more information about the study or for patient enrollment, visit Baylor Scott & White's All of Us webpage or call 844.487.2794.



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