1 00:00:06,657 --> 00:00:07,658 ALL RIGHT. 2 00:00:07,658 --> 00:00:09,326 SO WELCOME EVERYBODY. 3 00:00:09,326 --> 00:00:12,897 WE HAVE 56 PEOPLE AND TODAY IS A 4 00:00:12,897 --> 00:00:15,766 RECAP OF DAY ONE AND I MAY HAVE 5 00:00:15,766 --> 00:00:17,435 SOME MISSPELLS BUT I'M GOING TO 6 00:00:17,435 --> 00:00:19,603 TRY IN 20 MINUTES TO RECAP EIGHT 7 00:00:19,603 --> 00:00:29,847 HOURS OR SO OF WORK. 8 00:00:29,847 --> 00:00:34,852 THIS IS A RAPID FIRE VIM. 9 00:00:34,852 --> 00:00:36,187 -- SUMMARY. 10 00:00:36,187 --> 00:00:37,688 I SUGGESTED WE'LL LOOK AT DATA 11 00:00:37,688 --> 00:00:40,758 AND GET TO INSIGHTS AND THE 12 00:00:40,758 --> 00:00:43,627 INSIGHTS RELATE TO AVAILABLE 13 00:00:43,627 --> 00:00:45,863 DATA INDIVIDUALLY INITIATED DATA 14 00:00:45,863 --> 00:00:51,335 WITH A DIGITIZATION OF A LOT OF 15 00:00:51,335 --> 00:00:55,973 INFORMATION AND RESEARCH 16 00:00:55,973 --> 00:01:00,511 AGGREGATION AND ANALYSIS TO 17 00:01:00,511 --> 00:01:03,447 IMPROVE OPTIMUM HEALTH. 18 00:01:03,447 --> 00:01:06,117 COMPUTING POWER HAS INCREASED A 19 00:01:06,117 --> 00:01:08,619 MILLION FOLD AND THAT'S AN 20 00:01:08,619 --> 00:01:19,096 AMAZING REVOLUTION AND IT'S 21 00:01:20,231 --> 00:01:26,270 GOTTEN CHEAPER FIRST TALK WAS 22 00:01:26,270 --> 00:01:36,781 FROM ERIC TOPOL AND THERE WAS 23 00:01:37,915 --> 00:01:38,649 READING COMPREHENSION GETTING 24 00:01:38,649 --> 00:01:40,851 BETTER AND BETTER FOR MACHINES 25 00:01:40,851 --> 00:01:43,320 AND THEN OTHER TASKS ARE 26 00:01:43,320 --> 00:01:45,389 CATCHING UP. 27 00:01:45,389 --> 00:01:51,962 I THINK HE EMPHASIZED MULTIMODAL 28 00:01:51,962 --> 00:01:54,165 SELF-SUPERVISED TRAINING AND 29 00:01:54,165 --> 00:01:57,134 AOMICS AND GRAPHS COMBINED WITH 30 00:01:57,134 --> 00:01:58,435 MEDICAL DOMAIN KNOWLEDGE TO BE 31 00:01:58,435 --> 00:02:01,305 THE GET FLEXIBLE INTERACTIONS 32 00:02:01,305 --> 00:02:03,073 WITH PHYSICIANS AND PATIENTS. 33 00:02:03,073 --> 00:02:06,777 I THINK HE SHOWED US A NUMBER OF 34 00:02:06,777 --> 00:02:08,312 ANECDOTES AND SHOWED US SOME 35 00:02:08,312 --> 00:02:08,612 DATA. 36 00:02:08,612 --> 00:02:11,348 THIS IS ONE OF HIS DATA SLIDES 37 00:02:11,348 --> 00:02:13,784 WHERE HE SHOWED SPECIALIZED 38 00:02:13,784 --> 00:02:14,418 FINE-TUNED MEDICAL LARGE 39 00:02:14,418 --> 00:02:16,687 LANGUAGE MODELS HAVE NOW GOTTEN 40 00:02:16,687 --> 00:02:19,056 QUITE GOOD AND WHEN THEY USE 41 00:02:19,056 --> 00:02:22,393 JUST A NON-SPECIALIZED MACHINE, 42 00:02:22,393 --> 00:02:24,094 THEY GET PREDICTION RATES AND 43 00:02:24,094 --> 00:02:26,363 ACCURACIES THAT ARE NOT VERY 44 00:02:26,363 --> 00:02:27,531 GOOD BUT COMBINING THINGS YOU 45 00:02:27,531 --> 00:02:28,999 CAN GET MUCH BETTER SO I THINK 46 00:02:28,999 --> 00:02:30,201 IT'S THE PROMISE OF THE FUTURE 47 00:02:30,201 --> 00:02:33,571 TO GET BETTER ACCURACY WHEREAS 48 00:02:33,571 --> 00:02:35,606 NOW THERE'S LOTS OF INTERESTING 49 00:02:35,606 --> 00:02:37,942 ANECDOTES BUT WE'RE IMPROVING 50 00:02:37,942 --> 00:02:39,944 AND IMPROVING AND THERE'S 51 00:02:39,944 --> 00:02:40,611 IMPRESSIVE PROGRESS IN A.I. AND 52 00:02:40,611 --> 00:02:42,346 RADIOLOGY. 53 00:02:42,346 --> 00:02:47,384 SO THAT WAS THAT. 54 00:02:47,384 --> 00:02:57,928 THEN WE SWITCHED TO MANISH DESAI 55 00:03:01,932 --> 00:03:04,301 AND LOOKING AT ATRIAL 56 00:03:04,301 --> 00:03:06,937 DEFIBRILLATION COMPARED TO A 57 00:03:06,937 --> 00:03:07,338 CLINICAL DEVICE 58 00:03:07,338 --> 00:03:10,074 AND THE STUDY ENROLL 400,000 59 00:03:10,074 --> 00:03:10,774 PEOPLE. 60 00:03:10,774 --> 00:03:11,876 NOTIFICATIONS WERE RARE WHICH 61 00:03:11,876 --> 00:03:14,111 SAY GOOD THING OTHERWISE YOU 62 00:03:14,111 --> 00:03:17,114 HAVE TOO MANY FALSE POSITIVES. 63 00:03:17,114 --> 00:03:19,850 COMPLETION RATE WERE A CHALLENGE 64 00:03:19,850 --> 00:03:22,019 AND TALKED ABOUT THE CHALLENGES 65 00:03:22,019 --> 00:03:23,888 OF DATA CLEANING, LINKAGE, 66 00:03:23,888 --> 00:03:27,324 KNOWING YOU HAVE ACTUALLY THE 67 00:03:27,324 --> 00:03:29,093 SAME PEOPLE IN REAL WORLD 68 00:03:29,093 --> 00:03:32,062 STUDIES SO THIS WAS A GOOD 69 00:03:32,062 --> 00:03:33,430 DEMONSTRATION OF HOW MUCH HARDER 70 00:03:33,430 --> 00:03:36,133 A REAL WORLD STUDY CAN BE AND 71 00:03:36,133 --> 00:03:38,302 WITH PILOT STUDIES THEY GOT TO 72 00:03:38,302 --> 00:03:41,538 SUCCESS. 73 00:03:41,538 --> 00:03:44,074 NEXT WE TALKED ABOUT BIG DATA 74 00:03:44,074 --> 00:03:47,244 FOR PUBLIC HEALTH RESEARCH BY 75 00:03:47,244 --> 00:03:52,049 RANDI FORAKER AND SHOWED THE N3C 76 00:03:52,049 --> 00:03:54,151 DATA INTEGRATION WHICH WAS 77 00:03:54,151 --> 00:03:56,186 IMPRESSIVE IN GETTING TO BOTH 78 00:03:56,186 --> 00:03:57,821 HARMONIZATION OF LARGE DATA SETS 79 00:03:57,821 --> 00:03:59,456 AND THEN SPENT A FAIR AMOUNT OF 80 00:03:59,456 --> 00:04:04,328 TIME ON THE CONCEPT OF SYNTHETIC 81 00:04:04,328 --> 00:04:04,828 CLINICAL DATA. 82 00:04:04,828 --> 00:04:06,597 THAT WAS EXCITING IN THAT YOU 83 00:04:06,597 --> 00:04:08,399 BALANCE THE IDEA THAT IF YOU 84 00:04:08,399 --> 00:04:11,068 WANT TO MAXIMALLY PROTECT 85 00:04:11,068 --> 00:04:12,503 PRIVACY YOU BECOME 86 00:04:12,503 --> 00:04:12,870 UNINFORMATIVE. 87 00:04:12,870 --> 00:04:15,806 IF YOU WANT TO MAXIMALLY PROTECT 88 00:04:15,806 --> 00:04:17,141 UTILITY THEN IT CAN'T BE 89 00:04:17,141 --> 00:04:18,676 SYNTHETIC AND HAS TO BE 90 00:04:18,676 --> 00:04:22,680 IDENTIFIABLE AND PROTECTED BUT 91 00:04:22,680 --> 00:04:24,815 YOU CAN GET STRE REASONABLE 92 00:04:24,815 --> 00:04:26,150 COMPROMISES OF GRADING SYNTHETIC 93 00:04:26,150 --> 00:04:29,086 DATA FOR SPECIFIC PURPOSES WHICH 94 00:04:29,086 --> 00:04:30,788 IS DIFFERENT THAN DE-IDENTIFIED 95 00:04:30,788 --> 00:04:33,057 DATA AND THEY CREATED MULTIPLE 96 00:04:33,057 --> 00:04:34,191 DATA SETS AND YOU CAN REQUEST OF 97 00:04:34,191 --> 00:04:36,760 SOME BY TALKING TO HER. 98 00:04:36,760 --> 00:04:39,830 THE LESSONS LEARNED IS THAT 99 00:04:39,830 --> 00:04:42,733 SYNTHETIC DATA CAN ENHANCE A.I. 100 00:04:42,733 --> 00:04:44,368 MACHINE LEARNING, ACCELERATE 101 00:04:44,368 --> 00:04:45,803 RESEARCH, FACILITATE SHARING AND 102 00:04:45,803 --> 00:04:50,040 EXPAND DATA ACCESS. 103 00:04:50,040 --> 00:04:54,144 THEN WE WENT TO INTEROPERABILITY 104 00:04:54,144 --> 00:04:59,383 OF MACHINE IMAGING AND BEYOND BY 105 00:04:59,383 --> 00:05:04,088 DAVID MENDELSON AND EMPHASIZED 106 00:05:04,088 --> 00:05:04,855 HAVING COMMON RULES AND 107 00:05:04,855 --> 00:05:06,557 EVERYBODY OBEY THE SAME RULES 108 00:05:06,557 --> 00:05:10,160 WITH WELL DEFINED TECHNICAL 109 00:05:10,160 --> 00:05:12,296 SPECIFICATIONS AND HOW IT WAS 110 00:05:12,296 --> 00:05:15,466 FROM THE STANDARDS AND HAVING A 111 00:05:15,466 --> 00:05:16,900 PARTICIPANT DIRECTORY SO WHICH 112 00:05:16,900 --> 00:05:20,237 USER IS USING FOR WHAT PURPOSE. 113 00:05:20,237 --> 00:05:22,373 AND THEN HE SHOWED THAT 114 00:05:22,373 --> 00:05:24,241 PATIENT-CENTERED CLINICAL AND 115 00:05:24,241 --> 00:05:26,710 IMAGING DATA SHARING IS COMING 116 00:05:26,710 --> 00:05:28,479 AND MORE IN THE FUTURE BUT THE 117 00:05:28,479 --> 00:05:31,648 IDEA IS TO HAVE E.H.R. PATIENT 118 00:05:31,648 --> 00:05:32,883 PORTALS, SHARING SCREENS AND 119 00:05:32,883 --> 00:05:35,686 THEN THE PATIENT CAN CONTROL WHO 120 00:05:35,686 --> 00:05:39,456 GETS TO SEE WHICH DATA AND FOR 121 00:05:39,456 --> 00:05:41,258 EXAMPLE FIRE AND IMAGES AND 122 00:05:41,258 --> 00:05:44,695 PROTOCOLS CAN ALLOW FOR CLINICAL 123 00:05:44,695 --> 00:05:45,896 CONSUMER AND RESEARCH. 124 00:05:45,896 --> 00:05:50,601 SO IT'S QUITE EXCITING TO BE 125 00:05:50,601 --> 00:05:52,936 ABLE TO GET AGGREGATION ACROSS 126 00:05:52,936 --> 00:05:54,038 MANY HOSPITAL HEALTH SYSTEMS AND 127 00:05:54,038 --> 00:05:56,240 ONE PERSON TURNED THEIR CAMERA 128 00:05:56,240 --> 00:05:57,074 ON, THANK YOU VERY MUCH. 129 00:05:57,074 --> 00:05:59,043 I LIKE SEEING PEOPLE, THIS IS 130 00:05:59,043 --> 00:05:59,243 GOOD. 131 00:05:59,243 --> 00:06:02,579 WE'RE IN OUR RAPID FIRING. 132 00:06:02,579 --> 00:06:04,948 THE CONCLUSIONS WERE 133 00:06:04,948 --> 00:06:05,749 INTEROPERABILITY ARE ACHIEVED 134 00:06:05,749 --> 00:06:09,953 WEN STANDARDS ARE FOLLOWED AND 135 00:06:09,953 --> 00:06:12,923 THEY'RE NOT EXCITING BUT THEIR 136 00:06:12,923 --> 00:06:14,358 CRITICAL AND REAL WORLD 137 00:06:14,358 --> 00:06:15,359 SOLUTIONS PROVIDING THE BASIS 138 00:06:15,359 --> 00:06:16,427 FOR RESEARCH AND COLLABORATION 139 00:06:16,427 --> 00:06:18,762 WITH THE IDEA THAT WE CAN'T HAVE 140 00:06:18,762 --> 00:06:20,431 HEALTH SYSTEMS OWNING PEOPLE'S 141 00:06:20,431 --> 00:06:20,998 DATA. 142 00:06:20,998 --> 00:06:24,768 WE NEED TO HAVE IT SHARED 143 00:06:24,768 --> 00:06:25,335 ACCORDING TO THE STANDARDS 144 00:06:25,335 --> 00:06:28,705 BROADLY. 145 00:06:28,705 --> 00:06:31,809 FROM THERE WE WENT TO MICHAEL 146 00:06:31,809 --> 00:06:32,242 SNYDER. 147 00:06:32,242 --> 00:06:34,545 VERY DYNAMIC AND POWERFUL 148 00:06:34,545 --> 00:06:35,145 INSPIRATIONAL TALK. 149 00:06:35,145 --> 00:06:39,116 AND THE IDEA WAS TO LONGITUDINAL 150 00:06:39,116 --> 00:06:40,784 PERSONAL OMIC PROFILE. 151 00:06:40,784 --> 00:06:43,387 MORE DATA PER PERSON THAN YOU 152 00:06:43,387 --> 00:06:45,422 CAN EVER IMAGINE. 153 00:06:45,422 --> 00:06:47,658 OFTEN EPIDEMIOLOGY WAS 10,000 154 00:06:47,658 --> 00:06:49,760 PEOPLE AND 1,000 VARIABLES. 155 00:06:49,760 --> 00:06:52,596 HERE WE'RE TALKING ABOUT 10 156 00:06:52,596 --> 00:06:54,264 PEOPLE AND 10 MILLION VARIABLES 157 00:06:54,264 --> 00:06:55,532 AND CHALLENGE YOU HOW MAKE SENSE 158 00:06:55,532 --> 00:06:58,068 OF THAT. 159 00:06:58,068 --> 00:07:00,437 I THINK HE SHOWED US TOOLS ARE 160 00:07:00,437 --> 00:07:02,306 NEEDED TO MAKE SENSE OF THAT AND 161 00:07:02,306 --> 00:07:05,209 SHOWED A FUN AND INTRIGUING 162 00:07:05,209 --> 00:07:07,077 EARLY COVID DETECTION SYSTEM AND 163 00:07:07,077 --> 00:07:10,247 YOU USE A FIT BIT AND LOOK AT 164 00:07:10,247 --> 00:07:13,117 THE HEART RATE GOING UP AND IT 165 00:07:13,117 --> 00:07:15,252 TURNS OUT IT GOES UP FOUR DAYS 166 00:07:15,252 --> 00:07:16,420 BEFORE COVID SYMPTOMS. 167 00:07:16,420 --> 00:07:18,555 THAT COULD BE POWERFUL IF WE 168 00:07:18,555 --> 00:07:22,159 COULD DO IT WELL AND SORT OF GET 169 00:07:22,159 --> 00:07:25,929 AHEAD OF EPIDEMICS TO ISOLATE 170 00:07:25,929 --> 00:07:26,797 BUT YOU HAVE TO HAVE PEOPLE 171 00:07:26,797 --> 00:07:29,466 TRUST THE DATA AND HE DECIDED TO 172 00:07:29,466 --> 00:07:38,142 FLY DISHIS -- DESPITE HIS HEART 173 00:07:38,142 --> 00:07:40,611 RATE SIGNAL AND OTHER STRESS 174 00:07:40,611 --> 00:07:43,514 TRIGGERS TRIGGER THE ALG MYTH 175 00:07:43,514 --> 00:07:45,883 AND STRESS, INTENSE EXERCISE, 176 00:07:45,883 --> 00:07:47,784 TRAVEL, OTHER THINGS TRIGGER THE 177 00:07:47,784 --> 00:07:49,620 ALGORITHM AND I ADDED THIS, I 178 00:07:49,620 --> 00:07:52,156 THINK WE NEED TO THINK EVEN ON 179 00:07:52,156 --> 00:07:53,390 AN INDIVIDUAL PERSONAL LEVEL HOW 180 00:07:53,390 --> 00:07:55,425 DO WE ASSESS ACCURACY THINGS 181 00:07:55,425 --> 00:07:57,628 LIKE POSITIVE PREDICTIVE, 182 00:07:57,628 --> 00:07:59,563 NEGATIVE PREDICTIVE VALUE, 183 00:07:59,563 --> 00:08:01,798 SENSITIVITY, SPECIFICITY AND 184 00:08:01,798 --> 00:08:09,173 REMEMBER IT'S ALL A FUNCTION OF 185 00:08:09,173 --> 00:08:11,842 FRAMEWORK AND LIKELY TIMES THE 186 00:08:11,842 --> 00:08:13,577 PRE TEST ODDS AND I THINK WE 187 00:08:13,577 --> 00:08:15,846 NEED TO INTEGRATE BAYESIAN 188 00:08:15,846 --> 00:08:18,715 THINKING INTO WELL, IN THIS 189 00:08:18,715 --> 00:08:20,017 ALGORITHM SAYS IT'S RED AND I'LL 190 00:08:20,017 --> 00:08:21,985 HAVE COVID IN FOUR DAYS HOW 191 00:08:21,985 --> 00:08:28,625 LIKELY IS THAT AND THAT WILL BE 192 00:08:28,625 --> 00:08:28,959 AF 193 00:08:28,959 --> 00:08:31,228 AFFECTED BY WHO I AM AND WHO WAS 194 00:08:31,228 --> 00:08:34,164 I EXPOSED AND DECIDING TO FLY OR 195 00:08:34,164 --> 00:08:39,169 TAKE A MEDICATION OR HOSPITALIZE 196 00:08:39,169 --> 00:08:40,170 MY SELF. 197 00:08:40,170 --> 00:08:44,308 THIS IS EXCITING BUT LOTS TO DO. 198 00:08:44,308 --> 00:08:46,743 IT WAS INTERESTING TO SEE HE 199 00:08:46,743 --> 00:08:47,945 CO-FUNDED 17 COMPANIES AND 200 00:08:47,945 --> 00:08:49,780 THERE'S TONS OF EXCITEMENT IN 201 00:08:49,780 --> 00:08:51,114 THIS SPACE. 202 00:08:51,114 --> 00:08:52,015 VENTURE CAPITAL PLAYS BY 203 00:08:52,015 --> 00:08:53,250 DIFFERENT RULES THAN THE NIH. 204 00:08:53,250 --> 00:08:55,118 THIS IS AN NIH SPONSORED 205 00:08:55,118 --> 00:08:56,486 WORKSHOP AND IT'S ABOUT 206 00:08:56,486 --> 00:08:57,321 INTEGRATING AND HOW DO WE 207 00:08:57,321 --> 00:09:01,024 BALANCE ALL THOSE THINGS. 208 00:09:01,024 --> 00:09:04,728 THE GOOD THING IS WE'RE IN SLIDE 209 00:09:04,728 --> 00:09:08,599 22 OUT OF 42 AND MAY MAKE IT. 210 00:09:08,599 --> 00:09:10,534 WE'RE AT 161 ATTENDEES. 211 00:09:10,534 --> 00:09:11,268 THAT'S WONDERFUL AND TECHNICALLY 212 00:09:11,268 --> 00:09:17,174 WE'RE DOING WELL. 213 00:09:17,174 --> 00:09:24,715 SO THEN WE HAD RASHMEE SHAH AND 214 00:09:24,715 --> 00:09:28,785 HAD A SUGGESTION TO BUILD 215 00:09:28,785 --> 00:09:29,920 MULTIPURPOSE SYSTEM AND EACH 216 00:09:29,920 --> 00:09:32,155 LABEL CAN OUT SURVIVE THE 217 00:09:32,155 --> 00:09:34,157 PROJECT AND THEN THAT PROJECT 218 00:09:34,157 --> 00:09:35,859 WOULD THEN TRANSFER KNOWLEDGE TO 219 00:09:35,859 --> 00:09:37,361 THE NEXT PERSON SO IT'S THE 220 00:09:37,361 --> 00:09:40,163 FIRST PROJECT WELL DEFINED 221 00:09:40,163 --> 00:09:41,798 ATRIAL DEFIBRILLATION AND THE 222 00:09:41,798 --> 00:09:42,866 NEXT PROJECT CAN HAVE THAT 223 00:09:42,866 --> 00:09:45,168 UNDERSTANDING AND BENEFIT FROM 224 00:09:45,168 --> 00:09:45,335 IT. 225 00:09:45,335 --> 00:09:48,005 I THINK WE ARE EVOLVING TO THOSE 226 00:09:48,005 --> 00:09:49,373 SYSTEMS WITH REGISTRIES AND 227 00:09:49,373 --> 00:09:50,340 OTHER THINGS AND THINK THE 228 00:09:50,340 --> 00:09:50,907 INTEGRATION AND SHARING IS 229 00:09:50,907 --> 00:09:54,411 IMPORTANT. 230 00:09:54,411 --> 00:10:00,851 NEXT WE HAD A TALK BY EBONY 231 00:10:00,851 --> 00:10:03,854 BOULWARE FROM WAKE FOREST FROM 232 00:10:03,854 --> 00:10:06,123 EQUITY FRAMEWORK IN THE USE OF 233 00:10:06,123 --> 00:10:06,890 BIG DATA. 234 00:10:06,890 --> 00:10:08,759 REALLY IMPORTANT NOT TO FORGET 235 00:10:08,759 --> 00:10:13,430 WE HAVE HUGE DISPARITIES 236 00:10:13,430 --> 00:10:15,098 GLOBALLY AND IN THE U.S. 237 00:10:15,098 --> 00:10:16,233 HIGH BLOOD PRESSURE STARTS OUT 238 00:10:16,233 --> 00:10:17,901 NOT BEING THAT DIFFERENT AT 239 00:10:17,901 --> 00:10:20,437 YOUNG AGES AND THEN AS WE GET 240 00:10:20,437 --> 00:10:23,707 OLDER, AFRICAN AMERICANS HAVE A 241 00:10:23,707 --> 00:10:26,209 DISPROPORTIONATE BURDEN OF BLOOD 242 00:10:26,209 --> 00:10:27,811 PRESSURE, DIABETES AND STROKE. 243 00:10:27,811 --> 00:10:29,780 OUR SYSTEM HAS A PROBLEM AND WE 244 00:10:29,780 --> 00:10:31,982 NEED TO ADDRESS THIS ISSUE OF 245 00:10:31,982 --> 00:10:33,817 DISPARITIES BECAUSE OVER ALL OUR 246 00:10:33,817 --> 00:10:37,187 PERFORMANCE IS JUDGED BY OUR 247 00:10:37,187 --> 00:10:38,889 OVER ALL PERFORMANCE AND IT'S 248 00:10:38,889 --> 00:10:41,124 THE RIGHT THING TO DO. 249 00:10:41,124 --> 00:10:44,494 SHE SUGGESTED DISPARITIES ARE A 250 00:10:44,494 --> 00:10:48,799 LAYERED COMPLEX DETERMINATES 251 00:10:48,799 --> 00:10:49,299 SYSTEM. 252 00:10:49,299 --> 00:10:51,268 IT'S NOT JUST CELLS, IT STARTS 253 00:10:51,268 --> 00:10:52,302 WITH COMMUNITIES. 254 00:10:52,302 --> 00:10:54,404 WHEN DISCRIMINATION STARTED 255 00:10:54,404 --> 00:10:56,206 HISTORICALLY WITH REDLINING IT 256 00:10:56,206 --> 00:10:56,473 CONTINUES. 257 00:10:56,473 --> 00:10:58,308 THERE'S FUNDAMENTAL SOCIAL NORMS 258 00:10:58,308 --> 00:11:02,412 AND POLICIES, INSTITUTIONS, 259 00:11:02,412 --> 00:11:04,514 CONTEXT, INDIVIDUALS AND 260 00:11:04,514 --> 00:11:05,615 EVENTUALLY GETS EXPRESSED IN 261 00:11:05,615 --> 00:11:06,983 BIOLOGY AND IT'S FASCINATING TO 262 00:11:06,983 --> 00:11:08,385 STUDY AT EVERY SYSTEM AND CAN 263 00:11:08,385 --> 00:11:10,654 TRY TO FIX IT PROBABLY AT THE 264 00:11:10,654 --> 00:11:12,356 ROOT CAUSE OF SOCIAL AND POLICY 265 00:11:12,356 --> 00:11:16,193 BUT IF IT GETS TOO LATE YOU HAVE 266 00:11:16,193 --> 00:11:19,296 SOMEBODY WITH HYPERTENSION, 267 00:11:19,296 --> 00:11:20,497 DIABETES OR STROKE YOU CAN USE 268 00:11:20,497 --> 00:11:22,833 THE HEALTH SYSTEM TO ADDRESS THE 269 00:11:22,833 --> 00:11:24,501 INEQUALITIES AT EACH STEP. 270 00:11:24,501 --> 00:11:34,444 SHE GAVE US SOME EXAMPLES AND 271 00:11:34,444 --> 00:11:35,379 MACHINE LEARNING GETTING THINGS 272 00:11:35,379 --> 00:11:38,715 WRONG IF IT'S ONLY TRAINED IN 273 00:11:38,715 --> 00:11:39,850 LIGHT-SKINNED PATIENTS AND 274 00:11:39,850 --> 00:11:41,518 THERE'S EVIDENCE THE COLOR OF 275 00:11:41,518 --> 00:11:43,754 YOUR FINGER MATTERS AS TO WHAT 276 00:11:43,754 --> 00:11:46,390 THE PULSE OX READS AND THE 277 00:11:46,390 --> 00:11:48,191 MACHINES HAVE NOT BEEN TRAINED 278 00:11:48,191 --> 00:11:50,260 FOR PEOPLE WITH EVERY SKIN COLOR 279 00:11:50,260 --> 00:11:53,163 SO WE NEED TO BE CAREFUL. 280 00:11:53,163 --> 00:11:55,332 SHE SUGGESTED THAT DATA BIGNESS 281 00:11:55,332 --> 00:11:56,800 DOES NOT CHANGE THE FUNDAMENTAL 282 00:11:56,800 --> 00:11:59,169 EQUITY PRINCIPLES AND WE NEED TO 283 00:11:59,169 --> 00:12:02,205 BE AWARE THAT DATA AND ANALYTIC 284 00:12:02,205 --> 00:12:04,141 TECHNIQUES CAN MANIFEST IN BIAS 285 00:12:04,141 --> 00:12:06,176 DUE TO ASSUMPTIONS, DIFFERENCES 286 00:12:06,176 --> 00:12:11,648 IN DATA, DIFFERENCES EN 287 00:12:11,648 --> 00:12:13,583 COMPLETE -- IN COMPLETENESS 288 00:12:13,583 --> 00:12:15,419 BEING LINKED AND DATA HOURSES 289 00:12:15,419 --> 00:12:17,387 NOT HARMONIZED MAY BE DIFFERENT 290 00:12:17,387 --> 00:12:20,724 BY THINGS RELATED TO 291 00:12:20,724 --> 00:12:22,159 INEQUALITIES AND SOCIAL STATUS. 292 00:12:22,159 --> 00:12:25,762 AND IN SUMMARY SHE SUGGESTED 293 00:12:25,762 --> 00:12:27,564 THERE'S A LOT OF PROMISE SO 294 00:12:27,564 --> 00:12:29,232 SHE'S AN OPTIMIST BUT THERE ARE 295 00:12:29,232 --> 00:12:31,301 REAL PITFALLS AND WE NEED AN 296 00:12:31,301 --> 00:12:33,336 EQUITY MIND SET IS WHAT SHE 297 00:12:33,336 --> 00:12:33,603 SUGGESTED. 298 00:12:33,603 --> 00:12:35,906 CRITICAL TO ENSURING BIG DATA 299 00:12:35,906 --> 00:12:38,108 STUDIES ARE JUST VALID AND 300 00:12:38,108 --> 00:12:38,575 GENERALIZABLE. 301 00:12:38,575 --> 00:12:41,578 I THINK WE NEED TO BE TECHNICAL. 302 00:12:41,578 --> 00:12:43,680 WE NEED TO BE SMART BUT NEED TO 303 00:12:43,680 --> 00:12:44,414 REMEMBER THESE THINGS AND 304 00:12:44,414 --> 00:12:45,215 INCLUDE THAT IN THE IS SUMMARY 305 00:12:45,215 --> 00:12:50,187 FROM THE WORKSHOP. 306 00:12:50,187 --> 00:12:51,655 THEN WE GOT TECHNICAL. 307 00:12:51,655 --> 00:12:53,924 KEENAN WALKER SHOWED US HIS 308 00:12:53,924 --> 00:12:54,558 UNDERSTANDING OF ALZHEIMER'S 309 00:12:54,558 --> 00:12:55,759 DISEASE BIOLOGY AND I THINK TO 310 00:12:55,759 --> 00:12:59,529 ME THE IMPRESSIVE THING IS THAT 311 00:12:59,529 --> 00:13:01,932 HE DREW 10 DIFFERENT LINES OF 312 00:13:01,932 --> 00:13:03,700 EVIDENCE FROM DIFFERENT COHORTS. 313 00:13:03,700 --> 00:13:06,970 SO THIS IS AN EXAMPLE WHERE HE 314 00:13:06,970 --> 00:13:09,406 SHOWED SYNAPTIC FUNCTION AND 315 00:13:09,406 --> 00:13:12,676 EXTRA CELLULAR MATRIX 316 00:13:12,676 --> 00:13:13,977 ORGANIZATION AND HAD SIGNALS 317 00:13:13,977 --> 00:13:16,279 FIVE TO 10 YEARS AND 25 YEARS 318 00:13:16,279 --> 00:13:17,447 BEFORE DEMENTIA. 319 00:13:17,447 --> 00:13:21,651 AND THEN HE WAS ABLE TO SHOW 320 00:13:21,651 --> 00:13:23,053 THAT CERTAIN MOLECULES WERE 321 00:13:23,053 --> 00:13:24,521 LIKELY TO BE CAUSAL AND SOME 322 00:13:24,521 --> 00:13:26,523 WERE NOMINATED AS THERAPEUTIC 323 00:13:26,523 --> 00:13:28,592 TARGETS AND HE WAS ABLE TO 324 00:13:28,592 --> 00:13:30,827 INTEGRATE EVIDENCE FROM ONE 325 00:13:30,827 --> 00:13:33,864 COHORT, ANOTHER COHORT, BLOOD, 326 00:13:33,864 --> 00:13:34,498 CSF, ETCETERA. 327 00:13:34,498 --> 00:13:36,500 SO THAT I THINK IS THE FUTURE OF 328 00:13:36,500 --> 00:13:41,271 INTEGRATION. 329 00:13:41,271 --> 00:13:45,075 THE ULTIMATE IN INTEGRATION AND 330 00:13:45,075 --> 00:13:47,143 COLLABORATION IS THE U.K. BIO 331 00:13:47,143 --> 00:13:49,079 BANK IS SOMETHING WE CAN LEARN A 332 00:13:49,079 --> 00:13:52,015 LOT FROM AND THAT WAS IMPRESSIVE 333 00:13:52,015 --> 00:13:53,550 FROM MEGAN CONROY TELLING US AT 334 00:13:53,550 --> 00:13:56,453 THIS POINT, NOT THE FUTURE, 335 00:13:56,453 --> 00:13:57,787 CURRENTLY, U.K. BIO BANK HAS 336 00:13:57,787 --> 00:14:02,359 ENORMOUS DATA AND BIO CHEMISTRY 337 00:14:02,359 --> 00:14:06,129 ON 500,000 PEOPLE AND 338 00:14:06,129 --> 00:14:07,831 METABOLOMICS AND DNA AND IMAGING 339 00:14:07,831 --> 00:14:12,736 ON 100,000 PEOPLE AND 340 00:14:12,736 --> 00:14:13,904 IMPRESSIVELY ANALYSIS PLATFORM 341 00:14:13,904 --> 00:14:17,073 THAT ALLOWS EVERYBODY TO ANALYZE 342 00:14:17,073 --> 00:14:27,617 IT IN ONE PLACE WITH 5,000 USERS 343 00:14:31,454 --> 00:14:33,356 AND HOW WE CONNECT THIS TO OTHER 344 00:14:33,356 --> 00:14:35,592 STUDIES AND DO SIMILAR THINGS 345 00:14:35,592 --> 00:14:37,894 BUT THERE'S A LOT TO BE LEARNED. 346 00:14:37,894 --> 00:14:48,438 IT WAS NEAT THAT AFTER NILANJAN 347 00:14:49,973 --> 00:14:51,341 CHATERJEE TALKED ABOUT COMBINING 348 00:14:51,341 --> 00:14:53,410 DATA ACROSS PARTIAL DATA SETS. 349 00:14:53,410 --> 00:14:56,613 WE CANNOT HAVE THE MICHAEL 350 00:14:56,613 --> 00:14:59,482 SNYDER 12 OMICS PER PERSON ON 351 00:14:59,482 --> 00:15:01,084 EVERY PERSON IN EVERY STUDY IN 352 00:15:01,084 --> 00:15:01,885 EVERY HEALTH SYSTEM. 353 00:15:01,885 --> 00:15:05,322 THIS IDEA OF HOW TO TRANSFER 354 00:15:05,322 --> 00:15:07,857 INFORMATION AND INTEGRATE 355 00:15:07,857 --> 00:15:09,392 INSIGHTS, IT WAS TECHNICAL BUT I 356 00:15:09,392 --> 00:15:14,631 THINK IT ADDRESSES THE COMMON 357 00:15:14,631 --> 00:15:22,105 IMPORTANT GAP IN OUR KNOWLEDGE. 358 00:15:22,105 --> 00:15:23,907 GENERALLY WE HAD AN EXCITING DAY 359 00:15:23,907 --> 00:15:26,610 AND HAD A TUTORIAL THIS MORNING 360 00:15:26,610 --> 00:15:29,879 AS WELL. 361 00:15:29,879 --> 00:15:32,382 I WILL TURN IT TO JESSILYN AND 362 00:15:32,382 --> 00:15:34,618 FIX THE SPELLING OF HER NAME 363 00:15:34,618 --> 00:15:36,886 WHILE MAYBE SHE MAKES A COMMENT 364 00:15:36,886 --> 00:15:37,420 ABOUT THIS. 365 00:15:37,420 --> 00:15:40,790 WITH APOLOGIES, WELCOME AND GOOD 366 00:15:40,790 --> 00:15:48,465 MORNING, PROFESSOR DUNN. 367 00:15:48,465 --> 00:15:50,367 >> THANK YOU, DR. CORESH. 368 00:15:50,367 --> 00:15:52,369 IT WAS A FANTASTIC RECAP OF 369 00:15:52,369 --> 00:15:52,636 YESTERDAY. 370 00:15:52,636 --> 00:15:53,970 THERE WAS A LOT OF MATERIAL TO 371 00:15:53,970 --> 00:15:55,305 GO THROUGH AND I THINK YOU 372 00:15:55,305 --> 00:15:57,240 DISTILLED IT TO A POINT WHERE 373 00:15:57,240 --> 00:15:58,508 FOR FOLKS WHO MIGHT HAVE MISSED 374 00:15:58,508 --> 00:16:02,379 ONE OR TWO TALKS OR MAYBE EVEN 375 00:16:02,379 --> 00:16:04,047 THE ENTIRE DAY HOPE FULLY 376 00:16:04,047 --> 00:16:05,315 THEY'RE RELATIVELY CAUGHT UP AND 377 00:16:05,315 --> 00:16:07,450 CAN CATCH THE SLIDES OF THE 378 00:16:07,450 --> 00:16:09,019 TALKS THEY MIGHT BE MORE 379 00:16:09,019 --> 00:16:11,187 INTERESTED IN CATCHING UP ON AND 380 00:16:11,187 --> 00:16:14,190 SO WITH THAT I AM THRILLED TO 381 00:16:14,190 --> 00:16:16,326 INTRODUCE OUR KEY NOTE SPEAKER. 382 00:16:16,326 --> 00:16:17,260 WE HAVE AN EXCITING 383 00:16:17,260 --> 00:16:19,329 >> EXCUSE ME, LET THE TECHNICAL 384 00:16:19,329 --> 00:16:24,634 PEOPLE CUE THIS UP AND WE MAY 385 00:16:24,634 --> 00:16:26,469 HAVE TWO MINUTES FOR QUESTIONS. 386 00:16:26,469 --> 00:16:28,772 WE'RE AHEAD BY THREE MINUTES AS 387 00:16:28,772 --> 00:16:30,440 MY CLOCK SHOWED. 388 00:16:30,440 --> 00:16:31,675 >> YOU ARE CORRECT. 389 00:16:31,675 --> 00:16:32,509 WE SURE ARE. 390 00:16:32,509 --> 00:16:36,146 THAT WOULD BE FANTASTIC IF WE 391 00:16:36,146 --> 00:16:38,114 CAN GET OUR SLIDES UP. 392 00:16:38,114 --> 00:16:39,716 IF THERE'S ANY QUESTIONS FEEL 393 00:16:39,716 --> 00:16:45,855 FREE TO PUT THEM IN THE Q&A BOX. 394 00:16:45,855 --> 00:16:48,658 WE ASK THAT YOU PUT THEM IN THE 395 00:16:48,658 --> 00:16:50,560 Q&A BOX RATHER THAN THE CHAT AND 396 00:16:50,560 --> 00:16:54,064 HELP US KEEP TRACK OF THEM. 397 00:16:54,064 --> 00:16:55,365 >> WE'RE GETTING PEOPLE UP AND 398 00:16:55,365 --> 00:16:56,933 GOING AND YOU CAN GIVE US CHATS 399 00:16:56,933 --> 00:16:59,569 IF YOU REFER BUT WE'LL BE -- WE 400 00:16:59,569 --> 00:17:09,913 HAVE THREE MINUTES. 401 00:17:40,276 --> 00:17:42,345 >> WE'LL HAVE THREE-DIFFERENT 402 00:17:42,345 --> 00:17:43,713 SPEAKERS WHO ARE GOING TO BE 403 00:17:43,713 --> 00:17:45,048 TALKING ABOUT HOW BIG DATA AND 404 00:17:45,048 --> 00:17:48,518 DATA INTEGRATION TECHNIQUES ARE 405 00:17:48,518 --> 00:17:51,855 APPLIED IN REAL WORLD 406 00:17:51,855 --> 00:17:53,890 CARDIOVASCULAR EPIDEMIOLOGIC 407 00:17:53,890 --> 00:17:55,992 RESEARCH AND WITH THE SESSIONS 408 00:17:55,992 --> 00:17:59,229 WE HAD TUTORIALS THAT HAVE 409 00:17:59,229 --> 00:18:00,096 HANDS-ON EXAMPLES. 410 00:18:00,096 --> 00:18:02,198 SO FOR ANYBODY WHO MAY HAVE 411 00:18:02,198 --> 00:18:05,401 MISSED THE TUTORIALS WE HAVE 412 00:18:05,401 --> 00:18:06,836 RECORDINGS AVAILABLE TO GET A 413 00:18:06,836 --> 00:18:07,637 HANDS ON EXAMPLE HOW THIS 414 00:18:07,637 --> 00:18:11,441 RESEARCH WAS PERFORMED. 415 00:18:11,441 --> 00:18:15,612 IN THE AFTERNOON WE'LL HAVE 416 00:18:15,612 --> 00:18:18,615 ANOTHER KEY NOTE ON NAVIGATING 417 00:18:18,615 --> 00:18:20,250 GENOMICS DATA AND CURRENT TOOLS 418 00:18:20,250 --> 00:18:22,519 AND TECHNIQUES AND HAVE AN 419 00:18:22,519 --> 00:18:23,720 EXCITING AFTERNOON SESSION OF 420 00:18:23,720 --> 00:18:26,422 FIVE DIFFERENT SPEAKERS TALKING 421 00:18:26,422 --> 00:18:27,457 ABOUT FUTURE TRENDS, NOVEATIONS 422 00:18:27,457 --> 00:18:30,693 AND APPLICATIONS OF BIG DATA AND 423 00:18:30,693 --> 00:18:31,060 EPIDEMIOLOGY. 424 00:18:31,060 --> 00:18:33,763 SO WITH THAT I THINK WE HAVE A 425 00:18:33,763 --> 00:18:36,599 PRETTY EXCITING DAY PLANNED. 426 00:18:36,599 --> 00:18:39,402 I DON'T KNOW THAT THERE ARE ABE 427 00:18:39,402 --> 00:18:44,774 QUESTIONS THAT HAVE POPPED UP 428 00:18:44,774 --> 00:18:47,177 INTO THE Q&A 429 00:18:47,177 --> 00:18:52,682 >> THERE'S ONE QUESTION. 430 00:18:52,682 --> 00:18:57,387 DO WE HAVE IN THE U.S. ANYTHING 431 00:18:57,387 --> 00:18:59,022 LIKE THE U.K. BIO BANK. 432 00:18:59,022 --> 00:18:59,923 >> WE HAVE THE PERFECT ANSWER 433 00:18:59,923 --> 00:19:07,030 RIGHT NOW. 434 00:19:07,030 --> 00:19:11,901 >> WE'LL HEAR ABOUT THE U.S. s 435 00:19:11,901 --> 00:19:13,603 VERSION OF THIS SORT OF LARGE 436 00:19:13,603 --> 00:19:15,972 SCALE POPULATION LEVEL STUDY THE 437 00:19:15,972 --> 00:19:16,706 "ALL OF US" INITIATIVE WE'LL 438 00:19:16,706 --> 00:19:20,443 HEAR FROM THE "ALL OF US" CEO 439 00:19:20,443 --> 00:19:22,345 DR. DENNY ABOUT. 440 00:19:22,345 --> 00:19:24,180 SO BEFORE WE GET THAT SESSION 441 00:19:24,180 --> 00:19:26,282 KICKED OFF, DR. CORESH IS THERE 442 00:19:26,282 --> 00:19:26,950 ANYTHING ELSE YOU WOULD WANT TO 443 00:19:26,950 --> 00:19:29,018 MENTION? 444 00:19:29,018 --> 00:19:30,553 >> I THINK WE ARE PERFECTLY ON 445 00:19:30,553 --> 00:19:30,753 TIME. 446 00:19:30,753 --> 00:19:33,690 YOUR INTRODUCTION WAS LOVELY AND 447 00:19:33,690 --> 00:19:34,324 LET'S GO. 448 00:19:34,324 --> 00:19:34,858 >> 449 00:19:34,858 --> 00:19:36,759 >> SOUNDS GREAT. 450 00:19:36,759 --> 00:19:38,661 I AM PLEASED TO INTRODUCE 451 00:19:38,661 --> 00:19:42,165 DR. DENNY WHO IS THE CHIEF 452 00:19:42,165 --> 00:19:42,732 EXECUTIVE OFFICER OF THE 453 00:19:42,732 --> 00:19:45,368 NATIONAL INSTITUTES OF HEALTH, 454 00:19:45,368 --> 00:19:46,769 "ALL OF US" RESEARCH PROGRAM. 455 00:19:46,769 --> 00:19:49,205 "ALL OF US" SEEKS TO ENROLL AT 456 00:19:49,205 --> 00:19:50,773 LEAST 1 MILLION DIVERSE 457 00:19:50,773 --> 00:19:52,742 PARTICIPANTS TO BUILD AN 458 00:19:52,742 --> 00:19:54,344 INDISPENSABLE RESOURCE TO 459 00:19:54,344 --> 00:19:55,545 ACCELERATE PRECISION MEDICINE 460 00:19:55,545 --> 00:19:57,447 FOR ALL POPULATIONS. 461 00:19:57,447 --> 00:19:59,015 PRIOR TO JOINING NIH JOSH WAS A 462 00:19:59,015 --> 00:20:00,416 PROFESSOR OF INFORMATICS AND 463 00:20:00,416 --> 00:20:03,052 MEDICINE AND FOUNDING DIRECTOR 464 00:20:03,052 --> 00:20:06,055 OF THE CENTER FOR PRE VISION 465 00:20:06,055 --> 00:20:06,823 MEDICINE AND VICE PRESIDENT FOR 466 00:20:06,823 --> 00:20:09,225 PERSONALIZED MEDICINE FOR 467 00:20:09,225 --> 00:20:11,261 VANDERBILT MEDICAL CENTER AND 468 00:20:11,261 --> 00:20:12,562 PRACTICING PHYSICIAN. 469 00:20:12,562 --> 00:20:15,131 HE LED DISCOVERY AND PROJECTS IN 470 00:20:15,131 --> 00:20:16,799 PRECISION MEDICINE INCLUDING 471 00:20:16,799 --> 00:20:19,402 CLINICAL PHARMACO GENOMIC AND 472 00:20:19,402 --> 00:20:20,837 VANDERBILT'S DNA BIO BANK. 473 00:20:20,837 --> 00:20:23,773 HE WAS A PIONEER IN THE RECORDS 474 00:20:23,773 --> 00:20:26,676 FOR GENOMIC STUDIES INCLUDING 475 00:20:26,676 --> 00:20:30,046 THE INITIAL DESCRIPTIONS OF 476 00:20:30,046 --> 00:20:32,815 PHENOME WIDE ASSOCIATION 477 00:20:32,815 --> 00:20:33,449 STUDIES, PHEWAS AND PHENOTYPE 478 00:20:33,449 --> 00:20:33,816 RISK SCORES. 479 00:20:33,816 --> 00:20:35,585 IN ADDITION TO HIS ROLE WITH 480 00:20:35,585 --> 00:20:37,987 "ALL OF US" HE OVERSEES THE 481 00:20:37,987 --> 00:20:40,456 PRECISION HEALTH INFORMATICS 482 00:20:40,456 --> 00:20:43,192 SECTION AT THE NHGRI AND ELECTED 483 00:20:43,192 --> 00:20:44,861 MEMBER OF THE NATIONAL ACADEMY 484 00:20:44,861 --> 00:20:46,095 OF MEDICINE AND AMERICAN SOCIETY 485 00:20:46,095 --> 00:20:47,897 FOR CLINICAL INVESTIGATION AND 486 00:20:47,897 --> 00:20:50,133 THE AMERICAN COLLEGE OF MEDICAL 487 00:20:50,133 --> 00:20:50,433 INFORMATICS. 488 00:20:50,433 --> 00:20:56,773 YOU CAN FOLLOW JOSH ON TWITTER 489 00:20:56,773 --> 00:20:58,608 AT ALL OF US CEO. 490 00:20:58,608 --> 00:21:00,143 >> THANK YOU, DR. DUNN. 491 00:21:00,143 --> 00:21:02,812 IT'S GREAT TO BE HERE AND TALK 492 00:21:02,812 --> 00:21:06,582 WITH ALL OF YOU AND COMPLIMENT 493 00:21:06,582 --> 00:21:07,583 WHAT AN INCREDIBLE SHORT SUMMARY 494 00:21:07,583 --> 00:21:11,888 OF A FULL DAY OF ACTIVITIES IT 495 00:21:11,888 --> 00:21:12,522 WAS INCREDIBLE. 496 00:21:12,522 --> 00:21:15,325 I AM GOING TO TALK ABOUT THE 497 00:21:15,325 --> 00:21:17,293 "ALL OF US" RESEARCH PROGRAM 498 00:21:17,293 --> 00:21:20,096 WHICH IS WE ARE SIMILAR AND SORT 499 00:21:20,096 --> 00:21:23,933 OF GREW AND HAVE LEARNED A TON 500 00:21:23,933 --> 00:21:25,401 FROM OUR CLOSE COLLEAGUES IN THE 501 00:21:25,401 --> 00:21:28,771 U.K. BIO BANK AND TO THAT SET UP 502 00:21:28,771 --> 00:21:29,172 AND THAT QUESTION. 503 00:21:29,172 --> 00:21:33,042 SO PART OF WHAT WE'RE TRYING TO 504 00:21:33,042 --> 00:21:42,218 DO CERTAINLY LEVERAGE MULTIPLE 505 00:21:42,218 --> 00:21:43,019 DATA SOURCES. 506 00:21:43,019 --> 00:21:44,787 AS WE'RE THINKING ABOUT THE 507 00:21:44,787 --> 00:21:47,323 FRAMING OF THIS AND THE PLANNING 508 00:21:47,323 --> 00:21:50,560 FOR THIS EFFORT OF THE PRECISION 509 00:21:50,560 --> 00:21:52,562 MEDICINE INITIATIVE YOU MAY 510 00:21:52,562 --> 00:21:55,798 RECALL, WE TALKED ABOUT THE 511 00:21:55,798 --> 00:21:56,432 TRANSFORMATIONAL DIFFERENCE A 512 00:21:56,432 --> 00:21:58,968 LOT OF COHORTS HAVE MADE SUCH AS 513 00:21:58,968 --> 00:22:01,971 THE FRAMINGHAM HEART STUDY WITH 514 00:22:01,971 --> 00:22:05,608 WHAT WE WOULD CALL A MODEST 515 00:22:05,608 --> 00:22:07,877 NUMBER OF PEOPLE ENROLLED. 516 00:22:07,877 --> 00:22:09,812 CERTAIN NON-DIVERSE. 517 00:22:09,812 --> 00:22:13,216 THIS IS THE FIRST PAPER 13 YEARS 518 00:22:13,216 --> 00:22:16,486 AFTER IT STARTED AND LOTS OF 519 00:22:16,486 --> 00:22:18,054 FOUNDATIONAL KNOWLEDGE THAT 520 00:22:18,054 --> 00:22:20,189 TRANSFORMED OUR UNDERSTANDING OF 521 00:22:20,189 --> 00:22:22,425 HEART DISEASE, STROKE AND RISK 522 00:22:22,425 --> 00:22:24,260 FACTORS PROVIDING FOUNDATIONAL 523 00:22:24,260 --> 00:22:25,528 KNOWLEDGE AND THESE WERE 524 00:22:25,528 --> 00:22:27,930 INTERVENABLE THINGS WE CAN MAKE 525 00:22:27,930 --> 00:22:30,166 AN ON AND THESE AND OTHER 526 00:22:30,166 --> 00:22:32,668 COHORTS WITH THEIR TREATMENTS 527 00:22:32,668 --> 00:22:37,673 HAVE HELPED US SEE DRAMATIC 50, 528 00:22:37,673 --> 00:22:39,142 70% REDUCTION IN CARDIOVASCULAR 529 00:22:39,142 --> 00:22:41,244 AND RELATED DISEASES IN THE TIME 530 00:22:41,244 --> 00:22:48,251 SINCE THE COHORTS WERE LAUNCHED. 531 00:22:48,251 --> 00:22:49,786 HOW COULD WE DO THIS WITH THE 532 00:22:49,786 --> 00:22:50,453 PRECISION MEDICINE? 533 00:22:50,453 --> 00:22:53,756 WE WANT TO ACCELERATE MEDICAL 534 00:22:53,756 --> 00:22:54,757 BREAKTHROUGHS AND INDIVIDUALIZED 535 00:22:54,757 --> 00:22:55,391 PREVENTION TREATMENT AND CARE 536 00:22:55,391 --> 00:22:56,292 FOR ALL OF US. 537 00:22:56,292 --> 00:22:59,162 THE LAST PART IS KEY. 538 00:22:59,162 --> 00:23:03,032 THERE'S LOTS OF EFFORTS WE FELT 539 00:23:03,032 --> 00:23:05,401 WORLDWIDE ESPECIALLY IN GENOMICS 540 00:23:05,401 --> 00:23:08,071 THAT FOCUSSED ON EUROPEAN 541 00:23:08,071 --> 00:23:10,039 ANCESTRIES, SELF-DECLARED WHITE 542 00:23:10,039 --> 00:23:12,208 INDIVIDUALS AND WE WANTED TO 543 00:23:12,208 --> 00:23:13,476 REFLECT RICHLY THE DIVERSITY OF 544 00:23:13,476 --> 00:23:14,544 THE UNITED STATES. 545 00:23:14,544 --> 00:23:17,280 WE WANTED TO ENROLL 100 546 00:23:17,280 --> 00:23:19,348 PARTICIPANTS AND BE 547 00:23:19,348 --> 00:23:19,849 LONGITUDINAL. 548 00:23:19,849 --> 00:23:22,518 A PROCESS THAT WOULD LAST 549 00:23:22,518 --> 00:23:25,888 DECADES AS A PARTNERSHIP WITH 550 00:23:25,888 --> 00:23:27,090 OUR PARTICIPANTS NOT RESEARCH 551 00:23:27,090 --> 00:23:27,623 SUBJECTS. 552 00:23:27,623 --> 00:23:30,393 WE WANT TO DELIVER A LARGE, RICH 553 00:23:30,393 --> 00:23:33,830 BIO MEDICAL SET AND MAKE IT 554 00:23:33,830 --> 00:23:34,931 AVAILABLE TO AS MANY RESEARCHERS 555 00:23:34,931 --> 00:23:36,566 AS POSSIBLE AND HAS TO BE A 556 00:23:36,566 --> 00:23:36,833 COMMUNITY. 557 00:23:36,833 --> 00:23:38,434 WE SIT WITHIN THE O.D. AND SERVE 558 00:23:38,434 --> 00:23:41,604 AS A PLATFORM FOR THE REST OF 559 00:23:41,604 --> 00:23:43,573 THE NIH AND WE WANTED TO BE A 560 00:23:43,573 --> 00:23:45,808 LOCAL ECO SYSTEM OF RESEARCHERS, 561 00:23:45,808 --> 00:23:47,176 FUNDERS AND COMMUNITIES. 562 00:23:47,176 --> 00:23:48,578 OUR PARTICIPANT COMMUNITIES ARE 563 00:23:48,578 --> 00:23:50,580 IMPORTANT NOW. 564 00:23:50,580 --> 00:23:55,818 WE'LL EVENTUALLY MAKE "ALL OF 565 00:23:55,818 --> 00:23:57,386 US" AN INDISPENSABLE PART OF 566 00:23:57,386 --> 00:24:04,327 HEALTH RESEARCH. 567 00:24:04,327 --> 00:24:06,729 WE HAVE ENROLLED 700,000 PEOPLE 568 00:24:06,729 --> 00:24:12,502 SINCE WE LAUNCHED IN MAY OF 569 00:24:12,502 --> 00:24:13,503 2018. 570 00:24:13,503 --> 00:24:17,073 WE REPRESENT ALL 50 STATES AND 571 00:24:17,073 --> 00:24:19,709 MOST U.S. TERRITORIES. 572 00:24:19,709 --> 00:24:23,179 WE HAVE WHERE WE HAVE MORE 573 00:24:23,179 --> 00:24:24,113 INDIVIDUALS IN STATES 574 00:24:24,113 --> 00:24:26,782 REPRESENTED ARE GENERALLY WHERE 575 00:24:26,782 --> 00:24:33,222 WE HAVE MORE BRICK AND MORE 576 00:24:33,222 --> 00:24:36,459 MOR 577 00:24:36,459 --> 00:24:39,595 MORTAR AND WE HAVE SALIVA KITS 578 00:24:39,595 --> 00:24:42,665 AND WE HAVE COMPANIES THAT CAN 579 00:24:42,665 --> 00:24:46,068 GO TO YOUR HOUSE AND 60 OR SO 580 00:24:46,068 --> 00:24:48,271 MEDICAL CENTERS AND OTHER HEALTH 581 00:24:48,271 --> 00:24:49,705 CARE PROVIDER ORGANIZATIONS 582 00:24:49,705 --> 00:24:51,307 PARTNERED WITH US INCLUDING THE 583 00:24:51,307 --> 00:24:55,077 VETERANS AFFAIRS HOSPITALS. 584 00:24:55,077 --> 00:24:57,413 ABOUT 500,000 CONTRIBUTED BIO 585 00:24:57,413 --> 00:24:59,815 SPECIMENS AND THE MINIMUM IS DNA 586 00:24:59,815 --> 00:25:01,284 BUT MOST CONTRIBUTE BLOOD AS 587 00:25:01,284 --> 00:25:06,289 WELL WHICH GIVES US SERUM, 588 00:25:06,289 --> 00:25:07,590 PLASMA, DNA AND URINE IS 589 00:25:07,590 --> 00:25:17,900 COLLECTED AS WELL. 590 00:25:21,537 --> 00:25:26,342 >> THERE'S A TINY BIT OF DELAY 591 00:25:26,342 --> 00:25:30,613 BUT YOU CAN SAY NEXT SLIDE. 592 00:25:30,613 --> 00:25:32,248 >> ALL RIGHT. 593 00:25:32,248 --> 00:25:34,750 CAN SOMEONE ELSE ADVANCE? 594 00:25:34,750 --> 00:25:37,153 IT'S NOT DOING ANYTHING FOR ME. 595 00:25:37,153 --> 00:25:37,820 THERE WE GO. 596 00:25:37,820 --> 00:25:40,990 I MENTIONED OUR DIVERSITY. 597 00:25:40,990 --> 00:25:43,025 FOR NOW I'LL SAY NEXT SLIDE. 598 00:25:43,025 --> 00:25:46,662 WE FOCUSSED ON DIVERSITY AND 599 00:25:46,662 --> 00:25:49,865 WE'RE ABOUT HALF INDIVIDUALS 600 00:25:49,865 --> 00:25:51,367 SELF-DECLARING RACE AND 601 00:25:51,367 --> 00:25:53,436 ETHNICITY OTHER THAN 602 00:25:53,436 --> 00:25:55,171 NON-HISPANIC WHITE AND UNDER 603 00:25:55,171 --> 00:25:57,039 REPRESENTS IS NOT LIMITED TO 604 00:25:57,039 --> 00:25:59,041 RACE AND ETHNICITY AND YOU CAN 605 00:25:59,041 --> 00:26:00,543 SEE OTHER DIMENSIONS OF 606 00:26:00,543 --> 00:26:02,612 DIVERSITY WE CAPTURED INCLUDING 607 00:26:02,612 --> 00:26:03,846 AGE, INCOME, DISABILITY IS ONE 608 00:26:03,846 --> 00:26:05,781 WE ADDED THROUGH THE COURSE OF 609 00:26:05,781 --> 00:26:08,618 THE PROGRAM AND THEN CAUGHT UP 610 00:26:08,618 --> 00:26:10,953 OUR PARTICIPANTS WITH A 611 00:26:10,953 --> 00:26:12,488 SUPPLEMENTAL SURVEY AND SEXUAL 612 00:26:12,488 --> 00:26:15,424 AND GENDER MINORITIES AND 613 00:26:15,424 --> 00:26:16,058 LOCATION AND THINGS LIKE THAT AS 614 00:26:16,058 --> 00:26:26,168 WELL. 615 00:26:29,839 --> 00:26:31,340 >> WE'VE LEARNED PERIODICALLY 616 00:26:31,340 --> 00:26:32,775 IT'S A STRESS TEST. 617 00:26:32,775 --> 00:26:35,111 WE TAKE AWAY YOUR SLIDES AND SEE 618 00:26:35,111 --> 00:26:35,711 WHAT HAPPENS. 619 00:26:35,711 --> 00:26:37,513 >> GOING BACK TO THE SLIDE, OVER 620 00:26:37,513 --> 00:26:39,915 ALL MORE THAN 80% OF OUR 621 00:26:39,915 --> 00:26:41,651 PARTICIPANTS ARE UNDER 622 00:26:41,651 --> 00:26:45,488 REPRESENTED BIO MEDICAL RESEARCH 623 00:26:45,488 --> 00:26:47,223 FOR THE PROGRAM AND AS WE 624 00:26:47,223 --> 00:26:50,092 ALREADY TALKED ABOUT THE KINDS 625 00:26:50,092 --> 00:26:53,129 OF INFORMATION THAT WE COLLECT 626 00:26:53,129 --> 00:26:56,265 AND TO SURVEYS AT BASELINE, 627 00:26:56,265 --> 00:26:57,833 ELECTRONIC HEALTH RECORDS ARE A 628 00:26:57,833 --> 00:27:03,272 KEY PART OF THAT AND WITH THOSE 629 00:27:03,272 --> 00:27:05,708 WE ALSO ARE CAPTURING FROM A 630 00:27:05,708 --> 00:27:06,609 NUMBER OF SITES FROM ACROSS THE 631 00:27:06,609 --> 00:27:09,645 COUNTRY. 632 00:27:09,645 --> 00:27:12,782 AND I'M GUESSING SLIDES AREN'T 633 00:27:12,782 --> 00:27:13,449 WORKING. 634 00:27:13,449 --> 00:27:15,384 SOMEBODY ELSE CAN ADVANCE THEM. 635 00:27:15,384 --> 00:27:17,353 SHOULD I TRY TO SHARE MY SCREEN. 636 00:27:17,353 --> 00:27:19,622 >> WHOEVER IS ADVANCING THE 637 00:27:19,622 --> 00:27:20,690 SLIDES, PLEASE ADVANCE THE NEXT 638 00:27:20,690 --> 00:27:20,890 SLIDE. 639 00:27:20,890 --> 00:27:22,158 >> GREAT. 640 00:27:22,158 --> 00:27:23,626 SO HERE'S THE NEXT SLIDE. 641 00:27:23,626 --> 00:27:26,662 THE KIND OF INFORMATION THAT WE 642 00:27:26,662 --> 00:27:28,831 ARE COLLECTING FROM INDIVIDUALS 643 00:27:28,831 --> 00:27:30,633 IN ADDITION TO THE TOP TWO I 644 00:27:30,633 --> 00:27:31,467 ALREADY MENTIONED. 645 00:27:31,467 --> 00:27:35,104 WE HAVE A BRIEF IN PERSON EXAM 646 00:27:35,104 --> 00:27:40,476 WITH PHYSICAL MEASURES AND I 647 00:27:40,476 --> 00:27:42,812 MENTION THE MEASURES AND WE HAVE 648 00:27:42,812 --> 00:27:44,847 DEVICE DATA AND WE HAVE GIVEN 649 00:27:44,847 --> 00:27:46,749 OUT MORE THAN 30,000 DEVICES TO 650 00:27:46,749 --> 00:27:48,084 INDIVIDUALS AND WE'LL BE GIVING 651 00:27:48,084 --> 00:27:49,318 OUT MORE AS WELL. 652 00:27:49,318 --> 00:27:54,857 THESE ARE LONGITUDINAL IN THE 653 00:27:54,857 --> 00:27:58,260 PROCESS. 654 00:27:58,260 --> 00:28:02,031 SO THE NEXT SLIDE TALKS ABOUT 655 00:28:02,031 --> 00:28:04,734 INFORMATION RETURN AND E.H.R. 656 00:28:04,734 --> 00:28:04,934 DATA. 657 00:28:04,934 --> 00:28:06,936 THIS GETS TO THE MULTIPLE 658 00:28:06,936 --> 00:28:08,904 SOURCES OF INFORMATION. 659 00:28:08,904 --> 00:28:14,043 SO WE GET -- THE ELECTRONIC 660 00:28:14,043 --> 00:28:15,077 HEALTH RECORD AUTHORIZATION FROM 661 00:28:15,077 --> 00:28:15,878 PATIENTS AND HEALTH CARE 662 00:28:15,878 --> 00:28:17,213 PROVIDERS ORGANIZATIONS SHARE 663 00:28:17,213 --> 00:28:18,814 THAT DATA WITH US. 664 00:28:18,814 --> 00:28:22,985 THE DATA GETS HARMONIZED USING 665 00:28:22,985 --> 00:28:25,087 THE PLATFORM AND WE ALSO 666 00:28:25,087 --> 00:28:25,654 UNDERSTAND OUR HEALTH CARE 667 00:28:25,654 --> 00:28:27,590 SYSTEM IS FRAGMENTED. 668 00:28:27,590 --> 00:28:30,126 WE LAUNCHED DURING COVID THE 669 00:28:30,126 --> 00:28:31,660 ABILITY FOR PEOPLE TO SHARE 670 00:28:31,660 --> 00:28:34,029 THEIR ELECTRONIC HEALTH RECORDS 671 00:28:34,029 --> 00:28:36,232 THROUGH INTERFACE THAT CONNECTS 672 00:28:36,232 --> 00:28:38,667 WITH THE END POINTS OF MORE THAN 673 00:28:38,667 --> 00:28:42,938 1,000 -- ACTUALLY WE HAVE 5,000 674 00:28:42,938 --> 00:28:47,610 OR 6,000 SITES CONTRIBUTED DATA 675 00:28:47,610 --> 00:28:51,981 NOW THROUGH THE PARTICIPANTS 676 00:28:51,981 --> 00:28:52,815 ACTUALLY LINKING THE SITES IN 677 00:28:52,815 --> 00:28:59,622 AND THEY SHARE IT TO US AND WE 678 00:28:59,622 --> 00:29:02,558 HAVE NOT ACTUAL LY HARMONIZED 679 00:29:02,558 --> 00:29:04,460 THAT WITHIN THE DATA MODEL YET 680 00:29:04,460 --> 00:29:06,195 BUT SOMETHING WE'RE WORK ON 681 00:29:06,195 --> 00:29:08,631 ACTIVELY AND SOME AUTHORIZE MORE 682 00:29:08,631 --> 00:29:09,198 THAN 10 DIFFERENT SITES FOR 683 00:29:09,198 --> 00:29:12,101 HEALTH CARE. 684 00:29:12,101 --> 00:29:14,637 ANOTHER NICE THING ABOUT THAT IS 685 00:29:14,637 --> 00:29:16,839 YOU GET TO SEE YOUR INFORMATION 686 00:29:16,839 --> 00:29:19,275 AFTER LINKING IT UP AND IT'S 687 00:29:19,275 --> 00:29:20,075 HARMONIZED WITHIN THE INTERFACE 688 00:29:20,075 --> 00:29:23,078 AND YOU CAN SEE THE LDLs ACROSS 689 00:29:23,078 --> 00:29:24,547 A NUMBER OF DIFFERENT SITES, 690 00:29:24,547 --> 00:29:24,747 FRENS. 691 00:29:24,747 --> 00:29:26,682 FROM THE BEGINNING WE WANTED TO 692 00:29:26,682 --> 00:29:30,519 RETURN VALUE TO PARTICIPANTS, 693 00:29:30,519 --> 00:29:32,521 THE RETURNING RESULT IS PERHAPS 694 00:29:32,521 --> 00:29:34,590 THE KEY KIND AND ONE ASPECT IS 695 00:29:34,590 --> 00:29:36,425 AROUND WHAT OUR PARTICIPANTS 696 00:29:36,425 --> 00:29:41,764 TOLD US WAS MOST IMPORTANT WAS 697 00:29:41,764 --> 00:29:43,532 GENETIC INFORMATION. 698 00:29:43,532 --> 00:29:49,772 WE ALSO RETURN OTHER THINGS AND 699 00:29:49,772 --> 00:29:50,840 AGGREGATE STUDY RESULT AND THIS 700 00:29:50,840 --> 00:29:52,541 GETS INTO THE KIND OF 701 00:29:52,541 --> 00:29:54,009 INFORMATION WE RECOVERED. 702 00:29:54,009 --> 00:29:59,815 WE STARTED WITH ANCESTRY AND 703 00:29:59,815 --> 00:30:02,952 TRAITS WHICH IS AN ENGAGEMENT 704 00:30:02,952 --> 00:30:05,354 TYPE OF ASPECT. 705 00:30:05,354 --> 00:30:09,291 AS YOU'D EXPECT HIGH LEVEL 706 00:30:09,291 --> 00:30:09,892 SUBCONTINENTAL ANCESTRY AND 707 00:30:09,892 --> 00:30:12,795 RIGHT NOW MINIMAL SET UP FOR 708 00:30:12,795 --> 00:30:15,498 TRAITS NON-HEALTH RELATED. 709 00:30:15,498 --> 00:30:17,099 YOU CAN SEE 137,000 PEOPLE 710 00:30:17,099 --> 00:30:18,467 LOOKED AT THAT NOW. 711 00:30:18,467 --> 00:30:21,003 END OF LAST YEAR WE LAUNCHED OUR 712 00:30:21,003 --> 00:30:22,705 HEALTH-RELATED RETURN OF GENETIC 713 00:30:22,705 --> 00:30:24,306 INFORMATION WHICH WE WORKED WITH 714 00:30:24,306 --> 00:30:28,844 THE FDA AND WE HAVE AN 715 00:30:28,844 --> 00:30:31,447 INVESTIGATIONAL DEVICE EXEMPTION 716 00:30:31,447 --> 00:30:34,250 FOR THIS INCLUDING HEREDITARY 717 00:30:34,250 --> 00:30:36,485 DISEASE RISK AND PHARMACO 718 00:30:36,485 --> 00:30:37,219 GENETICS AND DNA. 719 00:30:37,219 --> 00:30:39,555 THE PHARMACO GENETICS PIECE IS 720 00:30:39,555 --> 00:30:45,060 TIED TO GUIDELINES THAT WE CAN 721 00:30:45,060 --> 00:30:47,062 CALL WELL AND WORKING WITH THE 722 00:30:47,062 --> 00:30:52,768 FDA SINCE IT INVOLVES REGULATED 723 00:30:52,768 --> 00:30:57,373 MEDICATIONS IN THAT PROCESS AND 724 00:30:57,373 --> 00:30:59,174 WE'RE SEEING A LITTLE LESS THAN 725 00:30:59,174 --> 00:31:01,577 3% OF PEOPLE HAVE ACTIONABLE 726 00:31:01,577 --> 00:31:04,647 VARIANTS IN THE 59 GENES. 727 00:31:04,647 --> 00:31:09,051 OVER 96% OF PEOPLE HAVE A 728 00:31:09,051 --> 00:31:10,219 PHARMACO VARIANT THAT WOULD 729 00:31:10,219 --> 00:31:11,787 ALTER DRUG PRESCRIBING IF 730 00:31:11,787 --> 00:31:13,188 EXPOSED TO THE MEDICATION AND 731 00:31:13,188 --> 00:31:14,323 THAT'S PRETTY CONSISTENT WHILE 732 00:31:14,323 --> 00:31:15,891 THE VARIATIONS IN THE 733 00:31:15,891 --> 00:31:17,760 MEDICATIONS THAT WOULD BE 734 00:31:17,760 --> 00:31:18,928 INVOLVED ARE DIFFERENT BY 735 00:31:18,928 --> 00:31:21,530 DIFFERENT GENETIC ANCESTRIES. 736 00:31:21,530 --> 00:31:24,934 THE PERCENT OF PEOPLE IS PRETTY 737 00:31:24,934 --> 00:31:26,135 CONSISTENT ACROSS ALL GENETIC 738 00:31:26,135 --> 00:31:29,271 ANCESTRIES. 739 00:31:29,271 --> 00:31:35,544 SO NOW WE'RE GETTING TO DATA 740 00:31:35,544 --> 00:31:36,211 HARMONIZATION IN SUM. 741 00:31:36,211 --> 00:31:39,682 AND SO WE HAVE MULTIPLE TIERS OF 742 00:31:39,682 --> 00:31:41,884 DATA AS WE THINK ABOUT IT. 743 00:31:41,884 --> 00:31:44,787 THE FIRST PART IS TO SAY WE HAVE 744 00:31:44,787 --> 00:31:47,389 DATA FEEDS THAT COMES INTO OUR 745 00:31:47,389 --> 00:31:51,627 RAW DATA REPOSITORY AND THERE'S 746 00:31:51,627 --> 00:31:54,430 METHODOLOGY APPLIED AND THERE'S 747 00:31:54,430 --> 00:31:55,831 IDENTIFIERS AND DATA 748 00:31:55,831 --> 00:31:58,534 HARMONIZATION ACCORDING TO THE 749 00:31:58,534 --> 00:31:59,001 DATA MODEL. 750 00:31:59,001 --> 00:32:02,605 YOU CAN EXPLORE THE DATA NOW, NO 751 00:32:02,605 --> 00:32:04,440 LOG-IN REQUIRED ACROSS THE WORLD 752 00:32:04,440 --> 00:32:07,676 THROUGH THE DATA BROWSER. 753 00:32:07,676 --> 00:32:09,311 AND TWO AVAILABLE TIERS FOR 754 00:32:09,311 --> 00:32:10,679 INDIVIDUAL DATA ACCESS THROUGH 755 00:32:10,679 --> 00:32:13,115 THE CONTROL AND REGISTERED TIER 756 00:32:13,115 --> 00:32:14,550 THROUGH THE RESEARCH OR WORK 757 00:32:14,550 --> 00:32:14,817 BENCH. 758 00:32:14,817 --> 00:32:16,518 I'LL TALK MORE ABOUT THAT LATER 759 00:32:16,518 --> 00:32:19,388 AND WE ALSO ALLOW ACCESS TO 760 00:32:19,388 --> 00:32:21,957 PARTICIPANTS AND THERE'S CONTACT 761 00:32:21,957 --> 00:32:22,191 EFFORTS. 762 00:32:22,191 --> 00:32:25,628 THERE'S A LARGE EFFORT FOR 763 00:32:25,628 --> 00:32:27,262 PRECISION HEALTH COLLECTING 764 00:32:27,262 --> 00:32:29,698 OTHER KINDS OF DATA LIKE 765 00:32:29,698 --> 00:32:31,300 MICROBIOME AND DETAILED DIET AND 766 00:32:31,300 --> 00:32:33,969 WILL DO CONTROLLED FEEDING 767 00:32:33,969 --> 00:32:39,375 STUDIES AS WELL. 768 00:32:39,375 --> 00:32:41,210 THE NEXT SLIDE WILL TALK IN 769 00:32:41,210 --> 00:32:46,949 TERMS OF DATA HARMONIZATION. 770 00:32:46,949 --> 00:32:50,786 THIS GETS TO THE STANDARDS. 771 00:32:50,786 --> 00:32:52,688 THERE'S TOOLS THAT PROVIDE 772 00:32:52,688 --> 00:32:53,455 AUTOMATED QUALITY REPORTS. 773 00:32:53,455 --> 00:32:54,990 WE COULD TALK ABOUT THIS KIND OF 774 00:32:54,990 --> 00:32:57,526 THING FOR A LONG TIME SO I WON'T 775 00:32:57,526 --> 00:33:00,896 BUT THE KEY AND MESSAGE IS AS WE 776 00:33:00,896 --> 00:33:06,502 ALL KNOW THERE'S LOTS OF 777 00:33:06,502 --> 00:33:08,103 DIFFERENT VENDORS, E.H.R. 778 00:33:08,103 --> 00:33:10,005 VENDORS OUT THERE. 779 00:33:10,005 --> 00:33:12,174 THEY ALL KIND OF PROVIDE DATA IN 780 00:33:12,174 --> 00:33:14,076 DIFFERENT WAYS AND DIFFERENT 781 00:33:14,076 --> 00:33:15,944 INTERNAL FORMATS BY HARMONIZING 782 00:33:15,944 --> 00:33:17,646 TO A COMMON DATA MODEL AND THE 783 00:33:17,646 --> 00:33:19,448 EXISTING TOOLS YOU HAVE YOU CAN 784 00:33:19,448 --> 00:33:20,983 GET SOME SUCCESS METRICS. 785 00:33:20,983 --> 00:33:25,988 THAT'S WHAT YOU SEE THERE ON THE 786 00:33:25,988 --> 00:33:27,256 RIGHT IS JUST THAT OVER TIME 787 00:33:27,256 --> 00:33:30,526 MOST OF THEM GET GREENER AND 788 00:33:30,526 --> 00:33:32,828 THAT PROCESS OF GETTING HIGHER 789 00:33:32,828 --> 00:33:36,799 DATA QUALITY IS KIND OF A 790 00:33:36,799 --> 00:33:39,935 CONTINUOUS JOURNEY. 791 00:33:39,935 --> 00:33:41,170 FOR INSTANCE AS WITH THE 792 00:33:41,170 --> 00:33:42,571 PANDEMIC THERE'S LOTS OF NEW 793 00:33:42,571 --> 00:33:45,708 LABS EACH SITE WAS CREATED THEIR 794 00:33:45,708 --> 00:33:46,942 OWN AROUND COVID AND LAB NAMES 795 00:33:46,942 --> 00:33:51,580 AND RANGES AND THINGS LIKE THIS. 796 00:33:51,580 --> 00:33:53,682 THINGS LIKELY DATA GOT WORSE FOR 797 00:33:53,682 --> 00:33:55,517 A WHILE UNTIL WE HARMONIZED 798 00:33:55,517 --> 00:33:56,085 THOSE LABS. 799 00:33:56,085 --> 00:33:58,387 IT'S A JOURNEY WE CONTINUE ON. 800 00:33:58,387 --> 00:34:00,189 THERE'S NOT A SET DESTINATION 801 00:34:00,189 --> 00:34:02,091 THAT WE WILL NECESSARY ACHIEVE 802 00:34:02,091 --> 00:34:04,193 BUT THE DATA SET GETS RICHER 803 00:34:04,193 --> 00:34:04,960 OVER TIME AND MORE HARMONIZED 804 00:34:04,960 --> 00:34:09,998 OVER TIME. 805 00:34:09,998 --> 00:34:13,102 THIS TELLS YOU WHAT WE HAVE 806 00:34:13,102 --> 00:34:14,903 RELEASED TO RESEARCHERS. 807 00:34:14,903 --> 00:34:17,673 WE HAVE ABOUT 250,000 WHOLE 808 00:34:17,673 --> 00:34:17,906 GENOMES. 809 00:34:17,906 --> 00:34:21,744 ABOUT HALF OF THESE ARE NOT 810 00:34:21,744 --> 00:34:22,578 EUROPEAN ANCESTRY AND YOU CAN 811 00:34:22,578 --> 00:34:23,979 SEE THE OTHER COMPONENTS. 812 00:34:23,979 --> 00:34:25,714 THE BIGGEST COMPONENT OF COURSE 813 00:34:25,714 --> 00:34:29,218 ARE SURVEYS, ELECTRONIC HEALTH 814 00:34:29,218 --> 00:34:31,286 RECORDS, 15,000 FITBIT RECORDS. 815 00:34:31,286 --> 00:34:33,422 SOME OF THOSE GO BACK TO AROUND 816 00:34:33,422 --> 00:34:33,889 2010. 817 00:34:33,889 --> 00:34:37,092 WE HAVE UP TO 10 YEARS OR MORE 818 00:34:37,092 --> 00:34:39,495 OF FIT BIT RECORDS THAT SHARED 819 00:34:39,495 --> 00:34:41,196 THEIR OWN DATA AND THE HEALTH 820 00:34:41,196 --> 00:34:42,965 RECORD GOES BACK TO 40 YEARS. 821 00:34:42,965 --> 00:34:46,235 SOME OF THE DATA GOES BACK TO 822 00:34:46,235 --> 00:34:46,568 1980. 823 00:34:46,568 --> 00:34:49,338 AMONG THE 245,000 GENOMES WE 824 00:34:49,338 --> 00:34:52,875 HAVE WE OBSERVED ABOUT A BILLION 825 00:34:52,875 --> 00:34:54,376 VARIANTS AND ABOUT 600 MILLION 826 00:34:54,376 --> 00:35:00,482 OF THOSE ACTUALLY ARE NOT IN 827 00:35:00,482 --> 00:35:05,754 NOMAD, 150 MILLION OCCUR AND 828 00:35:05,754 --> 00:35:07,623 THERE'S VARIATION LARGELY LINKED 829 00:35:07,623 --> 00:35:12,828 TO ELECTRONIC HEALTH RECORDS TO 830 00:35:12,828 --> 00:35:14,196 DO DEEPER ANALYSIS OF 831 00:35:14,196 --> 00:35:16,565 PHENOTYPES. 832 00:35:16,565 --> 00:35:18,100 THIS JUST GIVES YOU A SENSE OF 833 00:35:18,100 --> 00:35:19,268 THE RANGE OF FITBIT DATA AND THE 834 00:35:19,268 --> 00:35:21,737 KINDS OF THINGS WE HAVE IN 835 00:35:21,737 --> 00:35:22,104 THERE. 836 00:35:22,104 --> 00:35:23,639 WE JUST RELEASED SLEEP DATA. 837 00:35:23,639 --> 00:35:26,775 THERE'S OTHER KIND OF DATA THAT 838 00:35:26,775 --> 00:35:28,210 WE'LL BE RELEASING OVER TIME. 839 00:35:28,210 --> 00:35:31,780 WE ALSO LEFT PEOPLE WITH OTHER 840 00:35:31,780 --> 00:35:33,682 DEVICES THROUGH APPLE HEALTH 841 00:35:33,682 --> 00:35:34,883 KIT, FOR INSTANCE. 842 00:35:34,883 --> 00:35:36,552 THOSE DATA AREN'T AVAILABLE YET 843 00:35:36,552 --> 00:35:37,786 IN THE WORK BENCH BUT WE 844 00:35:37,786 --> 00:35:41,890 CONTINUALLY WORK TO HARMONIZE 845 00:35:41,890 --> 00:35:48,130 AND RELEASE THOSE. 846 00:35:48,130 --> 00:35:51,600 THIS IS A SENSE OF WHAT THE 847 00:35:51,600 --> 00:35:53,402 BROWSER LOOKS LIKE. 848 00:35:53,402 --> 00:35:57,706 WHAT YOU SEE THERE IS WHEN YOU 849 00:35:57,706 --> 00:35:59,708 HIT SOMETHING LIKE CANCER IT 850 00:35:59,708 --> 00:36:01,877 FOLLOWS THE TERMINOLOGY. 851 00:36:01,877 --> 00:36:06,548 SO THE ICD9s AND 10s ALL GET 852 00:36:06,548 --> 00:36:14,089 MAPPED UP TO A HIERARCHY AND SO 853 00:36:14,089 --> 00:36:17,826 SOME OF THE SEARCHS YOU CAN DO 854 00:36:17,826 --> 00:36:19,061 IN THE WORK BENCH WHEN YOU BUILD 855 00:36:19,061 --> 00:36:22,264 TOOLS YOU CAN DO THINGS LIKE 856 00:36:22,264 --> 00:36:26,101 PULL UP AND EVERYONE CAN PULL UP 857 00:36:26,101 --> 00:36:28,871 A BETA-BLOCKER AND IT WILL GIVE 858 00:36:28,871 --> 00:36:30,772 MEDS AND YOU CAN GO SPECIFICALLY 859 00:36:30,772 --> 00:36:32,074 AND LOOK FOR SPECIFIC DRUGS IF 860 00:36:32,074 --> 00:36:34,376 YOU WANT. 861 00:36:34,376 --> 00:36:36,245 THIS IS THE RESEARCHER WORK 862 00:36:36,245 --> 00:36:39,047 BENCH AND IT'S ALL GRAPHICAL AND 863 00:36:39,047 --> 00:36:42,517 VERY MUCH LIKE THE U.K. BIO 864 00:36:42,517 --> 00:36:44,953 BANKS R.A.P. PLATFORM. 865 00:36:44,953 --> 00:36:46,488 WE LAUNCHED A LITTLE BIT EARLIER 866 00:36:46,488 --> 00:36:52,094 SO WE HAVE MORE USERS AT THIS 867 00:36:52,094 --> 00:36:55,030 POINT BUT WE HAVE THIS ANALYSIS 868 00:36:55,030 --> 00:36:57,532 DONE IN OUR CLOUD. 869 00:36:57,532 --> 00:37:03,639 RIGHT NOW WE SUPPORT PYTHON AND 870 00:37:03,639 --> 00:37:06,775 SAS AND DOING IN TERM TESTING 871 00:37:06,775 --> 00:37:08,677 AND LOOKING AT TOOLS AVAILABLE. 872 00:37:08,677 --> 00:37:11,380 IT'S A PASSPORT ACCESS MODEL. 873 00:37:11,380 --> 00:37:16,585 COME INTO THE RESOURCE AND AS 874 00:37:16,585 --> 00:37:18,086 YOU ARE APPROVED AS A 875 00:37:18,086 --> 00:37:20,789 RESEARCHER, YOU'RE ABLE TO DO AN 876 00:37:20,789 --> 00:37:21,757 ANALYSIS, YOU'RE ABLE TO CREATE 877 00:37:21,757 --> 00:37:24,226 NEW WORK SPACES ON THE FLY. 878 00:37:24,226 --> 00:37:26,228 DON'T NEED TO DO SEPARATE IRB 879 00:37:26,228 --> 00:37:26,495 APPROVALS. 880 00:37:26,495 --> 00:37:28,297 ALL THE RESEARCH RIGHT NOW WE 881 00:37:28,297 --> 00:37:30,365 HAVE AVAILABLE IS NON-HUMAN 882 00:37:30,365 --> 00:37:34,603 SUBJECTS AND COVERED BY OUR 883 00:37:34,603 --> 00:37:37,673 COMMON IRB AND HOPING TO WORK 884 00:37:37,673 --> 00:37:39,775 WITH NOT FOR PROFIT 885 00:37:39,775 --> 00:37:41,009 ORGANIZATIONS AND BEGINNING TO 886 00:37:41,009 --> 00:37:41,476 ACCEPT INTERNATIONAL 887 00:37:41,476 --> 00:37:43,612 APPLICATIONS. 888 00:37:43,612 --> 00:37:46,315 THIS GIVES YOU A SENSE OF THE 889 00:37:46,315 --> 00:37:47,082 APPLICATION PROCESS. 890 00:37:47,082 --> 00:37:49,785 FIRST YOU CONFIRM THE 891 00:37:49,785 --> 00:37:51,253 INSTITUTIONAL AGREEMENT. 892 00:37:51,253 --> 00:37:53,188 AFTER THAT THERE'S ACCOUNT 893 00:37:53,188 --> 00:37:54,923 VERIFICATION STEP AND WE 894 00:37:54,923 --> 00:37:56,158 VERIFIED WHO YOU ARE AND 895 00:37:56,158 --> 00:37:58,560 VERIFIED YOU HAVE A CONNECTION 896 00:37:58,560 --> 00:38:00,062 TO THAT INSTITUTION. 897 00:38:00,062 --> 00:38:01,964 USUALLY THAT'S THROUGH AN E-MAIL 898 00:38:01,964 --> 00:38:03,999 ACCOUNT AT THE INSTITUTION. 899 00:38:03,999 --> 00:38:04,733 THERE'S SOME MANDATORY TRAINING 900 00:38:04,733 --> 00:38:07,903 EFFORTS AND THEN YOU CAN COME IN 901 00:38:07,903 --> 00:38:09,871 AND SIGN OUR DATA USER CODE OF 902 00:38:09,871 --> 00:38:10,839 CONDUCT AND THEN YOU'RE ABLE TO 903 00:38:10,839 --> 00:38:12,107 GET STARTED. 904 00:38:12,107 --> 00:38:15,877 YOU CAN -- IF YOU HAVE APPLIED 905 00:38:15,877 --> 00:38:17,312 BRAND NEW DE NOVO THROUGH THE 906 00:38:17,312 --> 00:38:18,880 PROGRAM YOU CAN MAKE IT THROUGH 907 00:38:18,880 --> 00:38:20,182 ALL FOUR STEPS IN ABOUT TWO 908 00:38:20,182 --> 00:38:22,884 HOURS AND START DOING WORK AND 909 00:38:22,884 --> 00:38:24,152 HAVE STARTED YOUR FIRST PROJECT 910 00:38:24,152 --> 00:38:25,887 IF YOU'RE INSTITUTION IS ALREADY 911 00:38:25,887 --> 00:38:27,055 SIGNED ON. 912 00:38:27,055 --> 00:38:28,757 MOST IN THE U.S. -- MOST 913 00:38:28,757 --> 00:38:29,324 ACADEMIC INSTITUTIONS HAVE 914 00:38:29,324 --> 00:38:32,227 ALREADY SIGNED ON. 915 00:38:32,227 --> 00:38:34,696 SO WE'RE ABOUT 7,000 916 00:38:34,696 --> 00:38:36,064 RESEARCHERS, ABOUT 580 917 00:38:36,064 --> 00:38:36,398 INSTITUTIONS. 918 00:38:36,398 --> 00:38:37,966 WE REALLY HAVE FOCUSSED JUST 919 00:38:37,966 --> 00:38:40,469 LIKE WITH OUR PARTICIPANTS AND 920 00:38:40,469 --> 00:38:41,603 ENGAGING UNDER REPRESENTED 921 00:38:41,603 --> 00:38:44,706 RESEARCHERS AND NOT YOUR TYPICAL 922 00:38:44,706 --> 00:38:47,843 R1 INSTITUTIONS AND 33% ARE 923 00:38:47,843 --> 00:38:49,945 DIVERSE BY RACE AND ETHNICITY 924 00:38:49,945 --> 00:38:53,181 INCLUDING ANY RACE OR ETHNICITY 925 00:38:53,181 --> 00:38:56,051 SELF-DECLARED NOT WHITE OR AS 926 00:38:56,051 --> 00:38:56,251 ASIAN. 927 00:38:56,251 --> 00:38:59,388 WE HAVE ABOUT 40% OF HBCUs 928 00:38:59,388 --> 00:39:00,022 SIGNED ON. 929 00:39:00,022 --> 00:39:02,657 WE CONTINUE TO GO AFTER OTHER 930 00:39:02,657 --> 00:39:03,392 MINORITY-SERVING INSTITUTIONS TO 931 00:39:03,392 --> 00:39:04,626 HELP BRING THEM ON BOARD. 932 00:39:04,626 --> 00:39:08,363 WE JUST FUNDED OUR MOST RESEARCH 933 00:39:08,363 --> 00:39:10,198 AWARD ABOUT A WEEK AGO THAT WILL 934 00:39:10,198 --> 00:39:14,970 HELP ENGAGE AMERICAN INDIAN, 935 00:39:14,970 --> 00:39:16,772 ALASKAN NATIVE COMMUNITIES OF 936 00:39:16,772 --> 00:39:17,906 RESEARCHERS AS WELL AND TRYING 937 00:39:17,906 --> 00:39:21,410 TO THINK BROADLY ABOUT THE 938 00:39:21,410 --> 00:39:22,110 ENGAGEMENT EFFORT. 939 00:39:22,110 --> 00:39:24,579 THESE ARE SOME OF THE 940 00:39:24,579 --> 00:39:25,080 PUBLICATIONS. 941 00:39:25,080 --> 00:39:26,481 THERE'S LOTS OF TRACK RECORDS OF 942 00:39:26,481 --> 00:39:29,885 OTHER PROGRAMS HERE. 943 00:39:29,885 --> 00:39:31,920 IT'S NOT SURPRISING THAT MORE 944 00:39:31,920 --> 00:39:33,288 THAN HALF THE PUBLICATIONS COME 945 00:39:33,288 --> 00:39:34,556 FROM THIS YEAR. 946 00:39:34,556 --> 00:39:36,758 IT TAKES A WHILE TO BUILD UP IN 947 00:39:36,758 --> 00:39:37,859 TERMS OF THE PROCESS. 948 00:39:37,859 --> 00:39:39,394 230 OR SO I THINK PUBLICATIONS 949 00:39:39,394 --> 00:39:41,863 NOW THAT ARE USING OUR DATA. 950 00:39:41,863 --> 00:39:43,365 HERE'S SOME EXAMPLES. 951 00:39:43,365 --> 00:39:47,102 WE'RE STARTING TO GET GENOMIC 952 00:39:47,102 --> 00:39:48,937 RESULTS MORE COMMONLY USED. 953 00:39:48,937 --> 00:39:53,208 SOME OF OUR MOST IMPACTFUL AND 954 00:39:53,208 --> 00:39:57,879 IF YOU LOOK AT MEASURES OF THAT 955 00:39:57,879 --> 00:39:59,915 INCLUDE DEVICE DATA LIKE 956 00:39:59,915 --> 00:40:01,016 FITBIT'S COUPLED TO DISEASE 957 00:40:01,016 --> 00:40:02,617 STATUS AND CHANGE IN COVID AND 958 00:40:02,617 --> 00:40:05,120 THINGS LIKE THAT. 959 00:40:05,120 --> 00:40:07,622 SO PEOPLE HAVE DONE -- I'LL 960 00:40:07,622 --> 00:40:08,190 MENTION THOSE STUDIES IN A 961 00:40:08,190 --> 00:40:10,158 LITTLE BIT. 962 00:40:10,158 --> 00:40:11,660 THIS WAS THE FIRST PAPER 963 00:40:11,660 --> 00:40:14,796 PUBLISHED AND THERE WAS 964 00:40:14,796 --> 00:40:15,864 REFERENCE TO MACHINE LEARNING 965 00:40:15,864 --> 00:40:25,173 AND A.I. APPROACHES EARLIER. 966 00:40:25,173 --> 00:40:27,776 AND THEY FIRST TRAINED US AS A 967 00:40:27,776 --> 00:40:28,944 SINGLE SITE DATA. 968 00:40:28,944 --> 00:40:30,545 SALLY BAXTER AND HER COLLEAGUES 969 00:40:30,545 --> 00:40:36,151 AT UCSD AND FOUND THAT THAT THAT 970 00:40:36,151 --> 00:40:39,521 WORKED WELL AT UCSD WAS APPLIED 971 00:40:39,521 --> 00:40:43,258 TO ALL OF US AT AND RANDOM 972 00:40:43,258 --> 00:40:46,194 CHANCE BUT WHEN WE TRAINED SOME 973 00:40:46,194 --> 00:40:50,232 OF THEM ACROSS MULTI SITE, 974 00:40:50,232 --> 00:40:52,767 MULTIE.H.R. VENDOR AND 975 00:40:52,767 --> 00:40:57,639 GEOGRAPHIES AND INSURANCE STARTS 976 00:40:57,639 --> 00:41:01,276 OF STATUSES SOME ARE IN EXCESS 977 00:41:01,276 --> 00:41:03,678 OF 4.5 AND THE MODELS ARE SO 978 00:41:03,678 --> 00:41:07,816 MUCH BETTER AND THEY POINT OUT 979 00:41:07,816 --> 00:41:08,884 THE IMPORTANCE OF DIVERSE DATA 980 00:41:08,884 --> 00:41:10,218 SETS AND I LIKE SEEING THAT IN 981 00:41:10,218 --> 00:41:11,052 OUR DATA AND ONE THING WE MAKE 982 00:41:11,052 --> 00:41:16,758 AVAILABLE. 983 00:41:16,758 --> 00:41:19,394 THIS IS A PHEWAS LOOKING AT 984 00:41:19,394 --> 00:41:20,195 HEREDITARY CANCER GENES. 985 00:41:20,195 --> 00:41:25,867 MANY OF THESE ARE PART OF ACMG 986 00:41:25,867 --> 00:41:28,904 RECOMMENDED RETURN AGAINST FOR 987 00:41:28,904 --> 00:41:30,038 SECONDARY FINDINGS. 988 00:41:30,038 --> 00:41:33,508 WE LOOK AT PATHOGENIC VARIANTS 989 00:41:33,508 --> 00:41:35,043 IN THE 23 DIFFERENT GENES. 990 00:41:35,043 --> 00:41:36,611 THIS FROM MY LAB. 991 00:41:36,611 --> 00:41:39,214 YOUR LOOKING AT PHEWAS FOR THAT 992 00:41:39,214 --> 00:41:41,349 GENE. 993 00:41:41,349 --> 00:41:44,452 AND I KNOW IT'S HARD TO PICK OUT 994 00:41:44,452 --> 00:41:46,555 BUT THE ORANGE ARE REPLICATION 995 00:41:46,555 --> 00:41:48,323 AND GRAYS WOULD BE POTENTIALLY 996 00:41:48,323 --> 00:41:49,124 NEW FINDINGS. 997 00:41:49,124 --> 00:41:50,425 WHAT WE'RE ABLE TO FIND THROUGH 998 00:41:50,425 --> 00:41:52,294 THE ANALYSIS THAT WAS ABLE TO 999 00:41:52,294 --> 00:41:55,030 RAPIDLY HARMONIZE THE U.K. BIO 1000 00:41:55,030 --> 00:42:00,168 BANK AND CLINICAL COAND 1001 00:42:00,168 --> 00:42:01,703 U.S.-BASED SEQUENCE RESULTS INTO 1002 00:42:01,703 --> 00:42:04,406 A COMMON BACKBONE OF USING FEE 1003 00:42:04,406 --> 00:42:07,042 CODES OR THE PHEWAS-BASED 1004 00:42:07,042 --> 00:42:10,378 ARCHITECTURE TO PUT THE CODES 1005 00:42:10,378 --> 00:42:11,980 INTO ONE BACKBONE AND THE 1006 00:42:11,980 --> 00:42:20,055 PHENOTYPES WOULD BE HARMONIZED 1007 00:42:20,055 --> 00:42:28,029 VA 1008 00:42:28,029 --> 00:42:29,364 COULD BE VERIFIED QUICKLY AN LYF 1009 00:42:29,364 --> 00:42:30,065 THE ASSOCIATIONS AND IDENTIFIED 1010 00:42:30,065 --> 00:42:32,601 NEW ASSOCIATIONS IN TWO COHORTS 1011 00:42:32,601 --> 00:42:38,240 AND SO NEW CANCERS AND NEW 1012 00:42:38,240 --> 00:42:40,442 NON-NEOPLASTIC DISEASES AND 1013 00:42:40,442 --> 00:42:43,778 EXPANDS THE GENOME AND GIVES US 1014 00:42:43,778 --> 00:42:47,249 AFFECT SIZE AND MORE COHORT TO 1015 00:42:47,249 --> 00:42:49,317 THINK ABOUT THE HEREDITY DISEASE 1016 00:42:49,317 --> 00:42:49,517 RISK. 1017 00:42:49,517 --> 00:42:58,493 THIS IS A LARGE-SCALE GWAS DATA 1018 00:42:58,493 --> 00:43:04,966 AND GETS TO A MILLION EUROPEAN 1019 00:43:04,966 --> 00:43:07,902 ANCESTRY WITH BLOOD PRESSURE 1020 00:43:07,902 --> 00:43:08,169 READINGS. 1021 00:43:08,169 --> 00:43:09,504 THE FIRST ALL OF US GENOMIC SET 1022 00:43:09,504 --> 00:43:18,546 CAME OUT AND WE WERE ABLE TO 1023 00:43:18,546 --> 00:43:29,024 ADD A NUMBER OF PEOPLE FROM 1024 00:43:29,691 --> 00:43:34,362 AFRICAN ANCESTRY AND THERE WERE 1025 00:43:34,362 --> 00:43:40,735 OVER 100 NOVEL LOCI IT DID 1026 00:43:40,735 --> 00:43:41,970 PREDICT BLOOD PRESSURE IN PEOPLE 1027 00:43:41,970 --> 00:43:43,204 OF AFRICAN AMERICAN ANCESTRY BUT 1028 00:43:43,204 --> 00:43:47,642 WE'RE LOOKING AT A 13 MILLIMETER 1029 00:43:47,642 --> 00:43:51,413 MERCURY DIFFERENCE VERSUS A 5 1030 00:43:51,413 --> 00:43:54,015 MILLIMETER MERCURY OF DIFFERENCE 1031 00:43:54,015 --> 00:43:57,118 AND THE PREDICTION FOR 1032 00:43:57,118 --> 00:43:58,987 HYPERPENSION CHANGES AND IT 1033 00:43:58,987 --> 00:44:03,258 EMPHASIZES THE NEEDS TO DO THESE 1034 00:44:03,258 --> 00:44:06,695 ANALYSES IN DIVERSE POPULATIONS. 1035 00:44:06,695 --> 00:44:07,696 WE CAN SEE HERE THE 1036 00:44:07,696 --> 00:44:11,599 REPRODUCIBILITY OF THAT. 1037 00:44:11,599 --> 00:44:15,437 THIS IS A PHEWAS LOOKING AT STEP 1038 00:44:15,437 --> 00:44:18,039 COUNT AND INCIDENT DIAGNOSIS 1039 00:44:18,039 --> 00:44:18,673 OVER TIME. 1040 00:44:18,673 --> 00:44:21,743 YOU CAN SEE HERE THAT JUST NOT 1041 00:44:21,743 --> 00:44:23,845 SURPRISINGLY A WHOLE BUNCH OF 1042 00:44:23,845 --> 00:44:25,046 DISEASES ARE ASSOCIATED WITH 1043 00:44:25,046 --> 00:44:26,047 WALKING MORE. 1044 00:44:26,047 --> 00:44:28,450 SO WALKING MORE OR RUNNING MORE 1045 00:44:28,450 --> 00:44:31,619 PROTECTS AGAINST A BUNCH OF 1046 00:44:31,619 --> 00:44:32,020 DIFFERENT THINGS. 1047 00:44:32,020 --> 00:44:34,589 AND THEN WHAT I LIKED AS A 1048 00:44:34,589 --> 00:44:35,357 PRIMARY CARE PHYSICIAN WAS THE 1049 00:44:35,357 --> 00:44:37,225 STUFF ON THE RIGHT. 1050 00:44:37,225 --> 00:44:38,993 IT'S HARD TO GET SOMEONE GOING 1051 00:44:38,993 --> 00:44:40,795 FROM 2,000 STEPS A DAY TO 1052 00:44:40,795 --> 00:44:41,162 10,000. 1053 00:44:41,162 --> 00:44:43,798 YOU CAN SEE THERE'S A CONTINUOUS 1054 00:44:43,798 --> 00:44:45,900 SLOPE HERE AND IF YOU DOUBLE 1055 00:44:45,900 --> 00:44:49,270 FROM 2,000 TO 4,000 YOU MADE A 1056 00:44:49,270 --> 00:44:52,540 DIFFERENCE FROM MANY DISEASES 1057 00:44:52,540 --> 00:44:54,409 AND THE BEND IN THE CURVE IS 1058 00:44:54,409 --> 00:44:56,578 ABOUT 8,000 AND YOU HAVE 1059 00:44:56,578 --> 00:44:57,312 DRAMATICALLY REDUCED YOUR 1060 00:44:57,312 --> 00:44:58,947 DIABETES RISK IF YOU CAN GET TO 1061 00:44:58,947 --> 00:45:01,816 8,000 BUT IF YOU GET TO 6,000 1062 00:45:01,816 --> 00:45:03,451 YOU'VE DONE A LOT TOO AND IT'S 1063 00:45:03,451 --> 00:45:04,452 ACTIONABLE AND MEANINGFUL FOR 1064 00:45:04,452 --> 00:45:08,757 REAL PATIENTS IN THAT WAY. 1065 00:45:08,757 --> 00:45:11,092 THIS IS AN EXAMPLE OF THE POWER 1066 00:45:11,092 --> 00:45:14,629 OF HAVING THESE KINDS OF DATA 1067 00:45:14,629 --> 00:45:16,564 AVAILABLE AND IN COMMON DATA 1068 00:45:16,564 --> 00:45:17,399 MODELS. 1069 00:45:17,399 --> 00:45:19,067 THIS WAS MY LAST Ph.D. STUDENT 1070 00:45:19,067 --> 00:45:23,872 AT VANDERBILT BEFORE I MOVED TO 1071 00:45:23,872 --> 00:45:31,246 THE NIH AND USED MULTIPLE DATA 1072 00:45:31,246 --> 00:45:33,515 SETS AND FOUND DRUGS THAT MAY 1073 00:45:33,515 --> 00:45:35,784 LOWER CHOLESTEROL AND STUDIED AT 1074 00:45:35,784 --> 00:45:37,552 VANDERBILT ELECTRONIC HEALTH 1075 00:45:37,552 --> 00:45:46,728 RECORD TO LOOK AT WHEN ONES 1076 00:45:46,728 --> 00:45:51,332 WERE CHOLESTEROL. 1077 00:45:51,332 --> 00:45:55,336 YOU CAN SEE THERE'S AN EFFECT 1078 00:45:55,336 --> 00:45:57,138 AND PREDICTED BY THE GENE 1079 00:45:57,138 --> 00:45:57,872 EXPRESSION DATA WHICH IS WHAT WE 1080 00:45:57,872 --> 00:46:05,747 HOPE TO SEE. 1081 00:46:05,747 --> 00:46:07,715 YOU DID THIS AT VANDERBILT AND 1082 00:46:07,715 --> 00:46:10,952 TOOK A COUPLE YEARS TO BUILD 1083 00:46:10,952 --> 00:46:11,119 OUT. 1084 00:46:11,119 --> 00:46:12,854 CAN YOU DO THIS ANYWHERE ELSE? 1085 00:46:12,854 --> 00:46:14,856 HE TOOK HIS CODE AND VANDERBILT 1086 00:46:14,856 --> 00:46:17,759 MOVED TO THE OMOC COMMON DATA 1087 00:46:17,759 --> 00:46:21,062 MODEL THAT THE POINT AND HE 1088 00:46:21,062 --> 00:46:23,531 APPLIED TO ALL OF US AND IN A 1089 00:46:23,531 --> 00:46:24,833 WEEK AFTER HIS FIRST APPLICATION 1090 00:46:24,833 --> 00:46:27,402 WAS ABLE TO SEND ME A FIGURE 1091 00:46:27,402 --> 00:46:29,737 THAT LOOKED A LOT LIKE THIS ONE 1092 00:46:29,737 --> 00:46:34,876 THAT HAD THE PRELIMINARY RESULTS 1093 00:46:34,876 --> 00:46:39,013 OF THE SAME ANALYSIS IN ALL OF 1094 00:46:39,013 --> 00:46:45,186 US BY CUTTING AND PASTING THE OM 1095 00:46:45,186 --> 00:46:46,554 OC CODE WHICH WAS LONG AND THE 1096 00:46:46,554 --> 00:46:49,924 HARD WORK OF LOOKING THROUGH THE 1097 00:46:49,924 --> 00:46:51,693 MEDICATIONS AND PICKING WHAT 1098 00:46:51,693 --> 00:46:53,394 LABS TO CLEAN WAS PORTABLE 1099 00:46:53,394 --> 00:46:59,968 ACROSS DIFFERENT DATA SETS. 1100 00:46:59,968 --> 00:47:02,070 THIS STUDY LOOKS AT REPLICATION 1101 00:47:02,070 --> 00:47:04,239 OF KNOWN GENOMIC SIGNALS IN THE 1102 00:47:04,239 --> 00:47:04,839 U.K. BIO BANK. 1103 00:47:04,839 --> 00:47:07,342 IT'S IMPORTANT TO LOOK AT THE 1104 00:47:07,342 --> 00:47:09,043 COMMON AND RARE DISEASE TO SEE 1105 00:47:09,043 --> 00:47:11,145 THE AFFECT SIZE IS SIMILAR. 1106 00:47:11,145 --> 00:47:12,113 WHENEVER YOU RELEASE SOMETHING 1107 00:47:12,113 --> 00:47:13,515 NEW AND THERE'S A NUMBER OF 1108 00:47:13,515 --> 00:47:16,417 STUDIES THAT COME OUT LIKE THIS 1109 00:47:16,417 --> 00:47:17,619 NOW, IT'S HELPFUL TO SEE WHAT 1110 00:47:17,619 --> 00:47:20,088 YOU EXPECT TO SEE AND CAN DO THE 1111 00:47:20,088 --> 00:47:22,657 SIMILAR KIND OF ANALYSIS ACROSS 1112 00:47:22,657 --> 00:47:26,628 THE TWO DATA SETS COLLECTED IN 1113 00:47:26,628 --> 00:47:27,929 DIFFERENT WAYS. 1114 00:47:27,929 --> 00:47:30,431 EVERYONE IS OVER 18 AND THE U.K. 1115 00:47:30,431 --> 00:47:33,601 BIO BANK WAS 40 TO 69-YEAR-OLDS 1116 00:47:33,601 --> 00:47:34,502 IN A NATIONAL HEALTH CARE 1117 00:47:34,502 --> 00:47:35,036 SYSTEM. 1118 00:47:35,036 --> 00:47:36,070 SO THERE'S DIFFERENCES BUT 1119 00:47:36,070 --> 00:47:37,805 SIMILAR RESULTS OF THINGS WE 1120 00:47:37,805 --> 00:47:47,348 EXPECT TO FIND. 1121 00:47:47,348 --> 00:47:49,417 GETTING NEW DATA AND FILLING IN 1122 00:47:49,417 --> 00:47:51,419 THE HOLES IS IMPORTANT IN THE 1123 00:47:51,419 --> 00:47:52,554 UNITED STATES AS WELL AS MOVING 1124 00:47:52,554 --> 00:47:56,291 BEYOND ELECTRONIC HEALTH RECORD 1125 00:47:56,291 --> 00:47:56,491 DATA. 1126 00:47:56,491 --> 00:47:57,725 WE ASKED THINGS LIKE HOME AND 1127 00:47:57,725 --> 00:47:59,127 WORK ADDRESS. 1128 00:47:59,127 --> 00:48:01,129 WE HAVE THAT LOCATION DATA. 1129 00:48:01,129 --> 00:48:03,765 WE HAVE NOT COMPARED IT TO 1130 00:48:03,765 --> 00:48:04,933 ENVIRONMENTAL DATA. 1131 00:48:04,933 --> 00:48:06,801 WE HAVE OTHER BIO SPECIMENS WE 1132 00:48:06,801 --> 00:48:10,271 CAN DO THINGS WITH AND THIS 1133 00:48:10,271 --> 00:48:13,808 AWARD FOR ACQUISITION OF DATA IS 1134 00:48:13,808 --> 00:48:15,543 REALLY DESIGN TO GO GET DATA TA 1135 00:48:15,543 --> 00:48:19,314 WE CAN LINK IN AND USE PRIVACY 1136 00:48:19,314 --> 00:48:21,282 PRESERVING DATA LINKAGE METHODS. 1137 00:48:21,282 --> 00:48:24,152 WORKING WITH OTHER KINDS OF 1138 00:48:24,152 --> 00:48:26,154 CLAIMS AND HIE KIND OF DATA 1139 00:48:26,154 --> 00:48:27,355 LOOKING AT ENVIRONMENTAL DATA 1140 00:48:27,355 --> 00:48:29,157 AND OTHER KINDS OF RESOURCES WE 1141 00:48:29,157 --> 00:48:31,926 CAN CONNECT TO AND THEN 1142 00:48:31,926 --> 00:48:33,061 HARMONIZING WITH THAT AND 1143 00:48:33,061 --> 00:48:34,395 BRINGING THAT INTO OUR DATA SET 1144 00:48:34,395 --> 00:48:36,631 TO MAKE AVAILABLE AND THIS WILL 1145 00:48:36,631 --> 00:48:38,967 ALSO IMPORTANTLY BE A BIG 1146 00:48:38,967 --> 00:48:40,034 INVESTIGATION INTO ENVIRONMENTAL 1147 00:48:40,034 --> 00:48:40,935 DATA WHICH I THINK IS REALLY 1148 00:48:40,935 --> 00:48:46,774 IMPORTANT. 1149 00:48:46,774 --> 00:48:48,309 THEN BRIEFLY ON THE FUTURE THE 1150 00:48:48,309 --> 00:48:49,844 BIGGEST THING WE'RE WORKING ON 1151 00:48:49,844 --> 00:48:51,713 IS PEDIATRICS. 1152 00:48:51,713 --> 00:48:53,581 YOU HAVE TO BE 18 OR OVER TO 1153 00:48:53,581 --> 00:48:56,017 ENROLL RIGHT NOW AND WE'RE HARD 1154 00:48:56,017 --> 00:48:58,186 AT WORK FOR A PEDIATRIC PROGRAM 1155 00:48:58,186 --> 00:49:02,156 AND EXPECT SHORTLY WE'LL START 1156 00:49:02,156 --> 00:49:07,695 OUR VERY ALPHA TESTS OF 1157 00:49:07,695 --> 00:49:09,497 ENROLLING THE EARLIEST 1158 00:49:09,497 --> 00:49:11,566 PARTICIPANTS STARTING WITH THE 0 1159 00:49:11,566 --> 00:49:15,003 TO 4 RANGE AND THEN WE WILL MOVE 1160 00:49:15,003 --> 00:49:19,941 ON TO BUILD THE PROTOCOLS AND 1161 00:49:19,941 --> 00:49:21,943 SURVEYS CHANGE AND THE PROCESSES 1162 00:49:21,943 --> 00:49:23,678 ARE DIFFERENT WITH DIFFERENT AGE 1163 00:49:23,678 --> 00:49:24,612 RANGES AND BIO SPECIMEN 1164 00:49:24,612 --> 00:49:26,214 COLLECTION AND PROCEDURES AND 1165 00:49:26,214 --> 00:49:28,049 THINGS LIKE THAT ALL VARY. 1166 00:49:28,049 --> 00:49:28,916 WE ARE STARTING WITH THE 1167 00:49:28,916 --> 00:49:30,218 YOUNGEST PART AND WE'LL BE 1168 00:49:30,218 --> 00:49:33,087 GROWING THAT TO BE WHAT WE HOPE 1169 00:49:33,087 --> 00:49:34,522 WILL BE ONE OF THE WORLD'S 1170 00:49:34,522 --> 00:49:36,024 LARGEST PEDIATRIC COHORTS. 1171 00:49:36,024 --> 00:49:39,127 THERE'S MORE GENOMICS COMING IN 1172 00:49:39,127 --> 00:49:39,327 2024. 1173 00:49:39,327 --> 00:49:41,429 WE'LL HAVE ANOTHER DATA RELEASE 1174 00:49:41,429 --> 00:49:43,698 WHICH WILL TAKE US OVER 400,000 1175 00:49:43,698 --> 00:49:45,967 GENOME SEQUENCES AND PRODUCING 1176 00:49:45,967 --> 00:49:47,769 MORE LONG READS AND DIGITAL 1177 00:49:47,769 --> 00:49:48,703 TECHNOLOGY GIVING OUT ANOTHER 1178 00:49:48,703 --> 00:49:55,343 30K OR SO DEVICES TO PEOPLE AND 1179 00:49:55,343 --> 00:49:57,545 WE RELEASED AT LEAST ONE NEW 1180 00:49:57,545 --> 00:50:03,017 SURVEY A YEAR AND WE FOCUSSED ON 1181 00:50:03,017 --> 00:50:06,020 MENTAL HEALTH AND WE HAVE 1182 00:50:06,020 --> 00:50:09,357 MODULES THAT GIVE US 1183 00:50:09,357 --> 00:50:11,893 QUANTITATIVE AND COGNITIVE 1184 00:50:11,893 --> 00:50:15,163 FACTORS MUCH MENTAL HEALTH AND 1185 00:50:15,163 --> 00:50:16,964 HEALTH AND DISEASE OVER TIME AND 1186 00:50:16,964 --> 00:50:19,067 I DEVELOPED THE ANCILLARY 1187 00:50:19,067 --> 00:50:20,101 STUDIES AND ENVIRONMENTAL DATA 1188 00:50:20,101 --> 00:50:21,836 ONE WE'VE BEEN THINKING ABOUT 1189 00:50:21,836 --> 00:50:24,138 AND THERE'S A NUMBER OF OTHER 1190 00:50:24,138 --> 00:50:25,707 ASPECTS WITH THE PARTNERSHIP 1191 00:50:25,707 --> 00:50:26,307 ACROSS THE NIH. 1192 00:50:26,307 --> 00:50:29,010 THEY'RE PARTNERSHIPS THE NIH AND 1193 00:50:29,010 --> 00:50:31,379 OTHER INSTITUTES AND CENTERS 1194 00:50:31,379 --> 00:50:34,348 INCLUDING NHLBI HAS BEEN AN 1195 00:50:34,348 --> 00:50:35,483 IMPORTANT DISCUSSANT ON. 1196 00:50:35,483 --> 00:50:36,818 WITH THAT I'M DONE WITH MY 1197 00:50:36,818 --> 00:50:37,018 SLIDE. 1198 00:50:37,018 --> 00:50:38,419 I WANT TO PUT THE LAST ONE WHICH 1199 00:50:38,419 --> 00:50:41,723 I MAKE THE POINT OF JUST THE 1200 00:50:41,723 --> 00:50:44,926 HUGEST THING IS OUR THANK YOU TO 1201 00:50:44,926 --> 00:50:47,295 OUR PARTICIPANTS. 1202 00:50:47,295 --> 00:50:48,296 THESE ARE REAL PARTICIPANTS WITH 1203 00:50:48,296 --> 00:50:50,531 THE EXCEPTION OF MY DAUGHTER WHO 1204 00:50:50,531 --> 00:50:53,768 I'M LOOKING FORWARD TO BEING 1205 00:50:53,768 --> 00:50:57,805 ABLE TO ENROLL IN THE FUTURE. 1206 00:50:57,805 --> 00:51:00,041 WE HAVE A NUMBER OF IMPORTANT 1207 00:51:00,041 --> 00:51:01,876 DISEASES THAT IN OUR FAMILY 1208 00:51:01,876 --> 00:51:03,244 HISTORY THAT HAVE MOTIVATED ME 1209 00:51:03,244 --> 00:51:06,280 TO BECOMING A DOCTOR AND ALSO 1210 00:51:06,280 --> 00:51:09,417 WITH ONE OF MY CHILDREN AS WELL. 1211 00:51:09,417 --> 00:51:11,753 IT IS -- WE ARE PERSONALLY VERY 1212 00:51:11,753 --> 00:51:12,620 INVESTED IN THE PROGRAM AND 1213 00:51:12,620 --> 00:51:15,256 EXCITED TO SEE ITS GROWTH. 1214 00:51:15,256 --> 00:51:17,358 THANK YOU FOR THE OPPORTUNITY TO 1215 00:51:17,358 --> 00:51:18,860 SPEAK TO YOU AND I'M HAPPY TO 1216 00:51:18,860 --> 00:51:20,695 TAKE ANY QUESTIONS ASSUMING WE 1217 00:51:20,695 --> 00:51:22,730 HAVE TIME FOR IT. 1218 00:51:22,730 --> 00:51:23,064 >> FANTASTIC. 1219 00:51:23,064 --> 00:51:24,966 THANK YOU SO MUCH DR. DENNY. 1220 00:51:24,966 --> 00:51:28,436 THAT WAS SUPER EYE-OPENING AND I 1221 00:51:28,436 --> 00:51:29,070 THINK HELPED A LOT OF PEOPLE 1222 00:51:29,070 --> 00:51:30,938 FIGURE OUT HOW TO BEGIN TO GET 1223 00:51:30,938 --> 00:51:31,906 INVOLVED WITH ALL OF US. 1224 00:51:31,906 --> 00:51:33,541 I HAVE A QUICK QUESTION TO KICK 1225 00:51:33,541 --> 00:51:36,677 OFF THE Q&A AND WE HAVE A LOT OF 1226 00:51:36,677 --> 00:51:39,247 QUESTIONS IN THE Q&A BOX. 1227 00:51:39,247 --> 00:51:41,883 THE FIRST IS WHETHER THERE IS 1228 00:51:41,883 --> 00:51:43,618 ANY OBLIGATION FOR PEOPLE WHO 1229 00:51:43,618 --> 00:51:47,755 ARE WORKING WITH THE DATA TO 1230 00:51:47,755 --> 00:51:50,024 RELEASE THEIR CODE WHEN THE 1231 00:51:50,024 --> 00:51:51,893 PUBLICATIONS COME OUT SUCH THAT 1232 00:51:51,893 --> 00:51:53,928 OTHER PEOPLE CAN BUILD OFF IT. 1233 00:51:53,928 --> 00:51:59,567 >> SO EVERYTHING'S IN OUR CLOUD. 1234 00:51:59,567 --> 00:52:02,470 AS SUCH, IT COULD BE THE CASE. 1235 00:52:02,470 --> 00:52:04,138 THERE'S NOT A REQUIREMENT FOR 1236 00:52:04,138 --> 00:52:04,305 IT. 1237 00:52:04,305 --> 00:52:05,473 WE DON'T HAVE THE CAPABILITY 1238 00:52:05,473 --> 00:52:07,208 WHERE YOU CAN JUST MAKE IT 1239 00:52:07,208 --> 00:52:09,844 DISCOVERABLE TO THE WORLD BUT 1240 00:52:09,844 --> 00:52:11,979 YOU CAN SHARE IT WITH ANYONE. 1241 00:52:11,979 --> 00:52:13,981 WHAT I WOULD LOVE TO SEE HAPPEN 1242 00:52:13,981 --> 00:52:15,917 IS FROM THE OTHER ASPECT THAT 1243 00:52:15,917 --> 00:52:18,719 JOURNALS WOULD SAY, HEY, PUT 1244 00:52:18,719 --> 00:52:24,358 YOUR URL OR YOUR BLI OR 1245 00:52:24,358 --> 00:52:27,695 SOMETHING FOR YOUR WORK SPACE IN 1246 00:52:27,695 --> 00:52:32,900 THE PAPER AND WE HAVE TECHNOLOGY 1247 00:52:32,900 --> 00:52:34,468 ACCESSIBLE AND HAVE SEARCHABLE 1248 00:52:34,468 --> 00:52:35,970 WORK SPACES. 1249 00:52:35,970 --> 00:52:41,609 WE MADE A NUMBER OF FEATURED 1250 00:52:41,609 --> 00:52:43,477 WORK SPACES PEOPLE CAN COPY AND 1251 00:52:43,477 --> 00:52:53,254 USE. 1252 00:52:53,254 --> 00:52:54,689 I STRONGLY ENCOURAGE PEOPLE TO 1253 00:52:54,689 --> 00:52:55,756 SHARE THEIR CODE. 1254 00:52:55,756 --> 00:52:56,924 >> THANKS. 1255 00:52:56,924 --> 00:52:58,593 THERE'S A COUPLE QUESTIONS IN 1256 00:52:58,593 --> 00:53:04,932 THE Q&A THEY THINK WILL MAYBE BE 1257 00:53:04,932 --> 00:53:13,007 BETTER ANSWERED BY LATER -- AND 1258 00:53:13,007 --> 00:53:15,676 THERE'S A QUESTION ON 1259 00:53:15,676 --> 00:53:16,010 INVESTIGATORS. 1260 00:53:16,010 --> 00:53:17,178 ARE THERE OPPORTUNITIES NOW OR 1261 00:53:17,178 --> 00:53:21,582 COMING UP ON THE HORIZON? 1262 00:53:21,582 --> 00:53:23,384 >> THERE WAS SOME OPPORTUNITIES 1263 00:53:23,384 --> 00:53:24,919 THAT PASSED AND THERE'S A WHOLE 1264 00:53:24,919 --> 00:53:30,491 SET OF RO3s AND R21s SOME OF 1265 00:53:30,491 --> 00:53:33,127 THEM HAVE BEEN AWARDED BUT THAT 1266 00:53:33,127 --> 00:53:35,263 WAS A PARTNERSHIP WITH 27 OTHER 1267 00:53:35,263 --> 00:53:36,898 INSTITUTES AND CENTERS AND 1268 00:53:36,898 --> 00:53:38,366 OFFICES. 1269 00:53:38,366 --> 00:53:40,868 BASICALLY, A VERY BIG, BROAD NIH 1270 00:53:40,868 --> 00:53:41,869 COLLABORATION. 1271 00:53:41,869 --> 00:53:43,571 THE OTHER THING WE'RE SEEING IS 1272 00:53:43,571 --> 00:53:45,539 A REAL UPTICK IN GENERAL 1273 00:53:45,539 --> 00:53:46,741 APPLICATIONS INCLUDING ALL OF US 1274 00:53:46,741 --> 00:53:47,909 IN THEIR APPLICATION. 1275 00:53:47,909 --> 00:53:51,279 I WOULD SAY THE FIRST THING IS 1276 00:53:51,279 --> 00:53:57,885 ANY RO1 AND R21 ETCETERA YOU 1277 00:53:57,885 --> 00:53:59,620 WANT TO INCLUDE ALL OF US, DO 1278 00:53:59,620 --> 00:53:59,787 IT. 1279 00:53:59,787 --> 00:54:01,222 THERE'S NO REASON NOT TO. 1280 00:54:01,222 --> 00:54:03,291 THERE MAY BE FUTURE 1281 00:54:03,291 --> 00:54:03,624 ANNOUNCEMENTS. 1282 00:54:03,624 --> 00:54:05,092 EVEN IF I KNEW OF THEM YOU KNOW 1283 00:54:05,092 --> 00:54:11,966 I CAN'T TALK ABOUT THEM. 1284 00:54:11,966 --> 00:54:14,735 THERE MIGHT BE THINGS ON THE 1285 00:54:14,735 --> 00:54:14,969 HORIZON. 1286 00:54:14,969 --> 00:54:17,538 >> THAT'S AN EXCELLENT QUESTION 1287 00:54:17,538 --> 00:54:19,240 AND PEOPLE MAY NOT HAVE THOUGHT 1288 00:54:19,240 --> 00:54:20,975 ABOUT WRITING THE RO1 AND USE 1289 00:54:20,975 --> 00:54:24,645 THE DATA AND PAY FOR THE 1290 00:54:24,645 --> 00:54:24,912 ANALYSIS. 1291 00:54:24,912 --> 00:54:26,180 THAT WOULD BE TRUE FOR ALL 1292 00:54:26,180 --> 00:54:28,916 PAPERS AND META-ANALYSES AND 1293 00:54:28,916 --> 00:54:29,517 COMBINATIONS AND MACHINE 1294 00:54:29,517 --> 00:54:30,618 LEARNING AND A.I. AND 1295 00:54:30,618 --> 00:54:31,152 APPLICATIONS. 1296 00:54:31,152 --> 00:54:35,156 IF THEY WANTED MORE DATA 1297 00:54:35,156 --> 00:54:35,990 COLLECTED FOR SPECIMEN CAN YOU 1298 00:54:35,990 --> 00:54:38,459 COMMENT ON THE PROCESS? 1299 00:54:38,459 --> 00:54:42,530 >> THAT'S A GREAT ADDITION. 1300 00:54:42,530 --> 00:54:44,298 RIGHT NOW WE DO NOT HAVE 1301 00:54:44,298 --> 00:54:49,203 INDIVIDUAL ACCESS TO BIO 1302 00:54:49,203 --> 00:54:51,405 SPECIMENS. 1303 00:54:51,405 --> 00:54:52,039 IF YOU WANT ACCESS THAT'S NOT 1304 00:54:52,039 --> 00:54:53,674 SOMETHING YOU CAN REQUEST AS AN 1305 00:54:53,674 --> 00:54:54,408 INDIVIDUAL RESEARCHER. 1306 00:54:54,408 --> 00:54:55,376 IT'S SOMETHING WE'LL DO IN THE 1307 00:54:55,376 --> 00:54:57,611 FUTURE BUT WE'RE STARTING THE 1308 00:54:57,611 --> 00:54:59,480 PARTNERSHIPS WITH INSTITUTES AND 1309 00:54:59,480 --> 00:54:59,714 CENTERS. 1310 00:54:59,714 --> 00:55:03,484 SO THE I.C.s ARE THRIVING 1311 00:55:03,484 --> 00:55:06,087 DEVELOPMENT OF ANCILLARY STUDIES 1312 00:55:06,087 --> 00:55:09,623 AND THEY MAY -- LIKE NPH THE 1313 00:55:09,623 --> 00:55:11,025 NUTRITION FOR PRECISION HEALTH 1314 00:55:11,025 --> 00:55:13,828 IS GETTING ACCESS TO BIO 1315 00:55:13,828 --> 00:55:14,228 SPECIMENS. 1316 00:55:14,228 --> 00:55:15,763 IT WAS THROUGH A PROGRAM 1317 00:55:15,763 --> 00:55:17,164 SPONSORED BY THE COMMON FUND 1318 00:55:17,164 --> 00:55:18,099 THROUGH THE BIG SCALE PROGRAMS 1319 00:55:18,099 --> 00:55:24,805 THAT WOULD HAVE IT COMING AS AN 1320 00:55:25,106 --> 00:55:26,207 RFA THAT WOULD HAVE BIO 1321 00:55:26,207 --> 00:55:26,474 SPECIMENS. 1322 00:55:26,474 --> 00:55:28,642 >> PEOPLE CAN WRITE TO YOU OR 1323 00:55:28,642 --> 00:55:29,744 THE PROGRAM OR THE PROGRAM 1324 00:55:29,744 --> 00:55:31,946 OFFICER AND IF IT RISES TO 1325 00:55:31,946 --> 00:55:32,980 SUFFICIENT PRIORITY AND SOMEONE 1326 00:55:32,980 --> 00:55:34,348 WANTS TO PAY ENOUGH IT MAY 1327 00:55:34,348 --> 00:55:34,582 HAPPEN. 1328 00:55:34,582 --> 00:55:36,617 >> THAT'S TRUE. 1329 00:55:36,617 --> 00:55:37,651 >> FANTASTIC. 1330 00:55:37,651 --> 00:55:39,920 WELL, TO KEEP US RUNNING ON TIME 1331 00:55:39,920 --> 00:55:41,589 FOR THIS MORNING, WE'LL GO AHEAD 1332 00:55:41,589 --> 00:55:44,458 AND WRAP UP THE Q&A FOR THIS KEY 1333 00:55:44,458 --> 00:55:46,594 NOTE TALK AND THANK YOU, 1334 00:55:46,594 --> 00:55:47,828 DR. DENNY AND THERE ARE 1335 00:55:47,828 --> 00:55:50,398 QUESTIONS THAT REMAIN IN THE Q&A 1336 00:55:50,398 --> 00:55:52,933 THAT DR. DENNY CAN HOPEFULLY 1337 00:55:52,933 --> 00:55:54,935 ANSWER AND WE WILL HAVE ANOTHER 1338 00:55:54,935 --> 00:56:00,374 Q&A AT THE END OF THIS SESSION 1339 00:56:00,374 --> 00:56:03,310 FROM 12:10 TO 12:30. 1340 00:56:03,310 --> 00:56:06,113 I'LL INTRODUCE THE SPEAKER FOR 1341 00:56:06,113 --> 00:56:07,548 THE NEXT SESSION. 1342 00:56:07,548 --> 00:56:09,417 DR. PYARAJAN THE DIRECTOR FOR 1343 00:56:09,417 --> 00:56:11,752 THE CENTER FOR DATA AND 1344 00:56:11,752 --> 00:56:13,821 COMPUTATIONAL SCIENCES AT THE 1345 00:56:13,821 --> 00:56:15,890 VETERANS AFFAIR V.A. IN THE 1346 00:56:15,890 --> 00:56:17,324 BOSTON HEALTH CARE SYSTEM. 1347 00:56:17,324 --> 00:56:19,493 DR. PYARAJAN DIRECTS THE CENTER 1348 00:56:19,493 --> 00:56:21,962 AND THE GROUP IS RESPONSIBLE FOR 1349 00:56:21,962 --> 00:56:24,365 THE ACQUISITION, INTEGRATION AND 1350 00:56:24,365 --> 00:56:26,434 ANALYSIS OF THE CLINICAL 1351 00:56:26,434 --> 00:56:28,002 PATIENT-REPORTED AND MULTIOMICS 1352 00:56:28,002 --> 00:56:30,137 DATA FROM THE MILLION VETERANS 1353 00:56:30,137 --> 00:56:31,972 PROGRAM OR MVP. 1354 00:56:31,972 --> 00:56:35,076 WE'LL HEAR ABOUT ANOTHER 1355 00:56:35,076 --> 00:56:36,277 LARGE-SCALE DATA COLLECTION 1356 00:56:36,277 --> 00:56:38,379 INITIATIVE FOR LEARNING MORE 1357 00:56:38,379 --> 00:56:41,215 ABOUT POPULATION-SCALE HEALTH. 1358 00:56:41,215 --> 00:56:43,084 THIS IS ONE OF THE LARGEST 1359 00:56:43,084 --> 00:56:43,818 PRECISION MEDICINE PROGRAMS IN 1360 00:56:43,818 --> 00:56:44,819 THE WORLD. 1361 00:56:44,819 --> 00:56:46,587 WE HEARD ABOUT U.K. BIO BANK AND 1362 00:56:46,587 --> 00:56:49,490 THE "ALL OF US" INITIATIVE. 1363 00:56:49,490 --> 00:56:50,658 THIS IS ANOTHER INITIATIVE WHERE 1364 00:56:50,658 --> 00:56:52,093 LARGE DATA IS ACCESSIBLE FOR 1365 00:56:52,093 --> 00:56:52,993 PEOPLE TO WORK WITH. 1366 00:56:52,993 --> 00:56:55,329 SO WITH THAT I WILL HAND IT OVER 1367 00:56:55,329 --> 00:56:56,764 TO DR. PYARAJAN TO TAKE IT AWAY. 1368 00:56:56,764 --> 00:57:04,405 THANKS. 1369 00:57:04,405 --> 00:57:06,107 >> THANK YOU FOR THE NICE 1370 00:57:06,107 --> 00:57:06,474 INTRODUCTION. 1371 00:57:06,474 --> 00:57:07,741 IT'S GREAT TO BE HERE. 1372 00:57:07,741 --> 00:57:12,146 I'M BRINGING UP THE SLIDE DECK. 1373 00:57:12,146 --> 00:57:13,514 THANKS TO THE ORGANIZERS FOR 1374 00:57:13,514 --> 00:57:17,051 INVITING ME AND GIVING ME AN 1375 00:57:17,051 --> 00:57:18,686 OPPORTUNITY TO TALK ABOUT THE 1376 00:57:18,686 --> 00:57:21,055 MILLION VETERAN PROGRAM. 1377 00:57:21,055 --> 00:57:22,656 IN THE NEXT FEW SLIDES I'M 1378 00:57:22,656 --> 00:57:24,725 HOPING TO GIVE YOU A PREVIEW OF 1379 00:57:24,725 --> 00:57:26,393 WHAT WE'VE BEEN DOING IN THE 1380 00:57:26,393 --> 00:57:30,197 LAST 12 YEARS OR SO. 1381 00:57:30,197 --> 00:57:31,932 SO THE MILLION VETERAN PROGRAM 1382 00:57:31,932 --> 00:57:37,638 WAS INITIATED IN 2010 AND 2011 1383 00:57:37,638 --> 00:57:39,039 AS PART OF THE NATIONAL RESEARCH 1384 00:57:39,039 --> 00:57:43,210 PROGRAM AND BASICALLY AT THAT 1385 00:57:43,210 --> 00:57:45,813 TIME WAS DESIGN TO ADVANCE PRE 1386 00:57:45,813 --> 00:57:47,047 DECISION HEALTH CARE BY LEARNING 1387 00:57:47,047 --> 00:57:49,216 HOW GENES AND LIFESTYLE AND 1388 00:57:49,216 --> 00:57:50,017 EXPOSURE ESSENTIALLY AFFECTS 1389 00:57:50,017 --> 00:57:56,423 HEALTH AND WELLNESS. 1390 00:57:56,423 --> 00:58:00,027 EVERY PARTICIPANT SAY WILL HA 1391 00:58:00,027 --> 00:58:05,399 HAVE -- IS A VOLUNTEER AND GIVES 1392 00:58:05,399 --> 00:58:06,500 SPECIMEN AND ABLE TO INTEGRATE 1393 00:58:06,500 --> 00:58:09,069 THEIR AVAILABLE ON THEM IN THE 1394 00:58:09,069 --> 00:58:11,639 V.A. SYSTEMS, FOR EXAMPLE, AND 1395 00:58:11,639 --> 00:58:12,606 DEVICE SPECIFIC DATA. 1396 00:58:12,606 --> 00:58:15,276 OVER THE LAST 12 OR 13 YEARS 1397 00:58:15,276 --> 00:58:18,846 V.A. HAS INVESTED OVER $550 1398 00:58:18,846 --> 00:58:23,784 MILLION TO BUILD A COHORT FOR 1399 00:58:23,784 --> 00:58:29,056 CURATING THE HEALTH CLINICAL 1400 00:58:29,056 --> 00:58:30,991 DATA AND WE HAVE BUILT A 1401 00:58:30,991 --> 00:58:33,961 RESEARCH PLATFORM SIMILAR TO ALL 1402 00:58:33,961 --> 00:58:44,505 OF US IN THE U.K. BIOBANK AND IT 1403 00:58:46,840 --> 00:58:49,043 WILL BE MORE PRUDENT TO BRING 1404 00:58:49,043 --> 00:58:50,678 THE RESEARCHERS AND COMPUTING TO 1405 00:58:50,678 --> 00:59:00,721 THE DATA WITH MORE AND MORE. 1406 00:59:00,721 --> 00:59:05,726 AND WHAT WE DO IS WE SCHEDULE AN 1407 00:59:05,726 --> 00:59:08,229 APPOINTMENT WITH THEM IF THEY 1408 00:59:08,229 --> 00:59:09,230 ALREADY HAVE A HEALTH CARE 1409 00:59:09,230 --> 00:59:10,731 APPOINTMENT IN ANY OF THE V.A. 1410 00:59:10,731 --> 00:59:16,337 SPREAD ACROSS THE COUNTRY WE 1411 00:59:16,337 --> 00:59:26,814 SORT OF THERE'S AT LEAST 50 1412 00:59:37,725 --> 00:59:39,693 COLLECTION SITES ACROSS THE V.A. 1413 00:59:39,693 --> 00:59:42,062 AND THEY MEAN THAT MOVE FROM ONE 1414 00:59:42,062 --> 00:59:44,732 V.A. TO THE OTHER DEPENDING ON 1415 00:59:44,732 --> 00:59:46,133 THE CRITERIA YOU WANT IT TARGET 1416 00:59:46,133 --> 00:59:48,736 IN ANY CYCLE. 1417 00:59:48,736 --> 00:59:54,074 RECENTLY WE HAVE ALSO ADDED THE 1418 00:59:54,074 --> 00:59:55,542 ONLINE PROCESS WHERE THINGS LIKE 1419 00:59:55,542 --> 00:59:57,311 SIGNING CONSENT AND ANSWERING 1420 00:59:57,311 --> 01:00:03,183 THE SURVEY QUESTIONS CAN BE DONE 1421 01:00:03,183 --> 01:00:04,285 ONLINE. 1422 01:00:04,285 --> 01:00:08,989 AND ENROLLING IN A V.P. INVOLVES 1423 01:00:08,989 --> 01:00:09,823 THE FOLLOWING. 1424 01:00:09,823 --> 01:00:13,661 HAVE YOU A CONSENT PROCESS THAT 1425 01:00:13,661 --> 01:00:16,430 INCLUDES THEIR PERMISSION TO USE 1426 01:00:16,430 --> 01:00:20,167 DATA FROM THE MEDICAL RECORDS 1427 01:00:20,167 --> 01:00:22,403 AND OTHER DATA SOURCES. 1428 01:00:22,403 --> 01:00:26,307 THEY PROVIDE A SPECIMEN OF BLOOD 1429 01:00:26,307 --> 01:00:30,411 AT THE TIME OF ENROLLING AND 1430 01:00:30,411 --> 01:00:33,681 THEN COMPLETE A COUPLE SURVEYS 1431 01:00:33,681 --> 01:00:36,517 WE PROVIDE TO EVERY VETERAN THAT 1432 01:00:36,517 --> 01:00:39,153 JOIN AND I CAN TALK A LITTLE BIT 1433 01:00:39,153 --> 01:00:40,020 MORE ABOUT SURVEYS. 1434 01:00:40,020 --> 01:00:44,958 THEY'RE BASICALLY ONE IS A SHORT 1435 01:00:44,958 --> 01:00:48,295 SURVEY ABOUT FIVE PAGES AND IT 1436 01:00:48,295 --> 01:00:48,929 ASKS QUESTIONS ABOUT THE GENERAL 1437 01:00:48,929 --> 01:00:51,899 HEALTH AND THERE'S A LONGER 1438 01:00:51,899 --> 01:00:56,637 SURVEY ON PERSONAL HEALTH, 1439 01:00:56,637 --> 01:01:04,078 DISEASE AND NUTRITION, A LOT OF 1440 01:01:04,078 --> 01:01:04,812 NUTRITION AND ASSOCIATED 1441 01:01:04,812 --> 01:01:08,148 QUESTIONS. 1442 01:01:08,148 --> 01:01:09,650 THE SAMPLE COLLECTION. 1443 01:01:09,650 --> 01:01:12,553 ONE ISSUE WE THOUGHT OF VERY 1444 01:01:12,553 --> 01:01:13,854 EARLY IN THAT WE'LL BE 1445 01:01:13,854 --> 01:01:15,889 COLLECTING SAMPLES OVER A LONG 1446 01:01:15,889 --> 01:01:17,324 PERIOD OF TIME, TECHNOLOGY WILL 1447 01:01:17,324 --> 01:01:19,026 CHANGE AND IT'S BEING COLLECTED 1448 01:01:19,026 --> 01:01:23,630 FROM MULTIPLE SITES. 1449 01:01:23,630 --> 01:01:24,932 HOW DO WE MAKE SURE MAKE SURE 1450 01:01:24,932 --> 01:01:25,899 THE DATA IS HARMONIZED TO BEGIN 1451 01:01:25,899 --> 01:01:33,140 WITH. 1452 01:01:33,140 --> 01:01:35,275 ESSENTIALLY THE CRITERIA WE HAVE 1453 01:01:35,275 --> 01:01:37,444 IS THE VETERANS SHOULD BE THE 1454 01:01:37,444 --> 01:01:40,080 USER OF THE V.A. HEALTH CARE 1455 01:01:40,080 --> 01:01:40,314 SYSTEM. 1456 01:01:40,314 --> 01:01:45,352 THAT ENSURES THERE'S INFORMATION 1457 01:01:45,352 --> 01:01:55,829 ABOUT THEM IN THE AND IT'S 1458 01:01:57,197 --> 01:01:58,999 SHIPPED OVERNIGHT AND SENT BACK 1459 01:01:58,999 --> 01:02:01,902 TO THE CENTRAL LAB. 1460 01:02:01,902 --> 01:02:08,409 AND WE HAVE ALSO INCLUDED BEING 1461 01:02:08,409 --> 01:02:10,944 SELF-COLLECTION AT THE VETERANS 1462 01:02:10,944 --> 01:02:11,145 HOME. 1463 01:02:11,145 --> 01:02:15,249 ONCE THEY SHOW THEIR INTEREST IN 1464 01:02:15,249 --> 01:02:17,217 JOINING AND PARTICIPANTS WE SEND 1465 01:02:17,217 --> 01:02:19,820 THEM A SELF-COLLECTION KIT TO 1466 01:02:19,820 --> 01:02:21,054 THEIR HOMES THEY CAN COLLECT AND 1467 01:02:21,054 --> 01:02:23,190 USE THE KIT AND SEND IT BACK TO 1468 01:02:23,190 --> 01:02:24,425 OUR LABS. 1469 01:02:24,425 --> 01:02:26,927 MOST OF THE SAMPLES ARRIVE 1470 01:02:26,927 --> 01:02:29,062 WITHIN 24 TO 48 HOURS BUT WE 1471 01:02:29,062 --> 01:02:34,234 KEEP TRACK OF THE COLLECTION 1472 01:02:34,234 --> 01:02:37,905 TIMES AND WHEN IT WAS SHIPPED 1473 01:02:37,905 --> 01:02:40,307 AND RECEIVED AND PROCESSED IN 1474 01:02:40,307 --> 01:02:44,511 THE LAB WITHOUT CLINICAL 1475 01:02:44,511 --> 01:02:45,879 IDENTIFIERS. 1476 01:02:45,879 --> 01:02:51,585 THAT ALLOWS US TO DO THE 1477 01:02:51,585 --> 01:02:55,489 PREPARATIONS IN THE LAB LIKE 1478 01:02:55,489 --> 01:02:57,858 STORING THE MATERIAL WITHOUT 1479 01:02:57,858 --> 01:02:59,726 BIAS AND THE LAB DOESN'T KNOW 1480 01:02:59,726 --> 01:03:04,998 ANYTHING -- ANY OTHER FEATURES 1481 01:03:04,998 --> 01:03:09,303 OF EXAMPLES. 1482 01:03:09,303 --> 01:03:11,138 ONCE THEY MEET THRESHOLD THEY'RE 1483 01:03:11,138 --> 01:03:18,378 SENT OUT FOR MULTIPLE ANALYSIS. 1484 01:03:18,378 --> 01:03:25,252 SO WE HAVE COLLECTED OVER ALMOST 1485 01:03:25,252 --> 01:03:25,986 980,000 NOW AND CLOSING IN ON 1486 01:03:25,986 --> 01:03:30,524 THE MILLION. 1487 01:03:30,524 --> 01:03:31,758 HOPEFULLY IN THE NEXT FEW 1488 01:03:31,758 --> 01:03:31,992 MONTHS. 1489 01:03:31,992 --> 01:03:33,827 WE HAVE ESSENTIALLY BUILD THE 1490 01:03:33,827 --> 01:03:36,330 WORLD'S LARGEST GENOMIC DATABASE 1491 01:03:36,330 --> 01:03:39,500 LINKED TO A HEALTH CARE SYSTEM. 1492 01:03:39,500 --> 01:03:44,438 AND WE SORT OF RELEASE DATA IN 1493 01:03:44,438 --> 01:03:46,473 DIFFERENT TRANCHES FOR THE 1494 01:03:46,473 --> 01:03:47,774 GENOTYPE DATA FOR EXAMPLE. 1495 01:03:47,774 --> 01:03:55,782 WE HAVE OVER 650,000 DATA FROM 1496 01:03:55,782 --> 01:03:56,416 SAMPLES THAT WAS RELEASED LAST 1497 01:03:56,416 --> 01:04:03,790 YEAR. 1498 01:04:03,790 --> 01:04:06,660 SO, I WANT TO GIVE AN IDEA WHAT 1499 01:04:06,660 --> 01:04:09,129 THE M.V.P. DATA UNIVERSE IS. 1500 01:04:09,129 --> 01:04:11,965 YOU CAN IMAGINE THE CENTER IS 1501 01:04:11,965 --> 01:04:14,001 THE M.V.P. PARTICIPANT ITSELF. 1502 01:04:14,001 --> 01:04:21,475 EVERYTHING YOU SEE ABOVE IS 1503 01:04:21,475 --> 01:04:23,043 ACTIVELY COLLECTED AND 1504 01:04:23,043 --> 01:04:29,650 EVERYTHING BELOW IS PASSIVELY 1505 01:04:29,650 --> 01:04:33,086 COLLECTED AT THE TIME OF THE 1506 01:04:33,086 --> 01:04:34,187 PARTICIPANT SIGNING THE CONSENT 1507 01:04:34,187 --> 01:04:36,723 WE COLLECT THE SAMPLE AND HAVE 1508 01:04:36,723 --> 01:04:40,527 TWO SURVEYS THAT THEY COMPLETE 1509 01:04:40,527 --> 01:04:45,132 FOR INFORMATION THAT IS NOT IN 1510 01:04:45,132 --> 01:04:47,467 THE -- TO VALIDATE WHAT IS IN 1511 01:04:47,467 --> 01:04:48,869 THE E.H.R. OR NOT IN THE E.H.R. 1512 01:04:48,869 --> 01:04:54,041 AND FROM THE SAMPLES WE COLLECT 1513 01:04:54,041 --> 01:04:55,042 MOLECULAR DATA. 1514 01:04:55,042 --> 01:04:57,911 AND BELOW THE EQUATOR SO TO 1515 01:04:57,911 --> 01:05:03,183 SPEAK IS THE V.A. CLINICAL DATA. 1516 01:05:03,183 --> 01:05:05,586 SO IT HAS A SYSTEM DATING BACK 1517 01:05:05,586 --> 01:05:06,853 TO THE 1990s. 1518 01:05:06,853 --> 01:05:09,222 MORE THAN 30 YEARS OF 1519 01:05:09,222 --> 01:05:09,856 LONGITUDINAL DATA IS AVAILABLE 1520 01:05:09,856 --> 01:05:18,765 IN THE E.H.R. SYSTEM. 1521 01:05:18,765 --> 01:05:19,733 WITH YOU HAVE 23 MILLION FOLKS 1522 01:05:19,733 --> 01:05:22,903 OF WHICH ABOUT MILLION ARE 1523 01:05:22,903 --> 01:05:30,377 ACTIVE USERS OF THE SYSTEM AND 1524 01:05:30,377 --> 01:05:33,280 THE WAY WE HAVE IS AS THE 1525 01:05:33,280 --> 01:05:38,919 PROJECT GETS APPROVED WE GO AND 1526 01:05:38,919 --> 01:05:46,994 PULL DATA ON AN AS-REQUIRED, 1527 01:05:46,994 --> 01:05:49,229 PROJECT-BY-PROJECT BASIS AND 1528 01:05:49,229 --> 01:05:54,801 INCORPORATE LIKE THE INDEX AND 1529 01:05:54,801 --> 01:05:59,406 CMS AND HAVE DATA FROM THE 1530 01:05:59,406 --> 01:05:59,940 DEPARTMENT OF DEFENSE AND 1531 01:05:59,940 --> 01:06:10,183 EXPOSURE DATA. 1532 01:06:12,953 --> 01:06:16,556 THE DATA IS SORT OF A NESTED 1533 01:06:16,556 --> 01:06:17,391 DESIGN SO TO SPEAK. 1534 01:06:17,391 --> 01:06:20,694 WE REACH OUT TO FOLKS IN THE EMR 1535 01:06:20,694 --> 01:06:23,697 AS I SAID ONE OF THE REQUIREMENT 1536 01:06:23,697 --> 01:06:26,800 TO PARTICIPANT IN MVP IS THEY 1537 01:06:26,800 --> 01:06:30,671 HAVE TO BE USING THE HEALTH CARE 1538 01:06:30,671 --> 01:06:30,971 SYSTEM. 1539 01:06:30,971 --> 01:06:32,139 EVERYBODY IS IN THE EMR SYSTEM 1540 01:06:32,139 --> 01:06:34,841 AND THE SUBSET OF THEM RECOLLECT 1541 01:06:34,841 --> 01:06:36,743 THE SAMPLES WHO ARE PARTICIPANTS 1542 01:06:36,743 --> 01:06:41,481 AND WE COLLECT THE SAMPLES AND 1543 01:06:41,481 --> 01:06:44,851 RUN A CUSTOM GENOTYPING CHIP ON 1544 01:06:44,851 --> 01:06:47,120 ALL THESE SAMPLES. 1545 01:06:47,120 --> 01:06:50,991 THIS IS THE METRICS ARE NOW A 1546 01:06:50,991 --> 01:06:52,993 CHIP SIMILAR TO THE U.K. BIO 1547 01:06:52,993 --> 01:07:00,867 BANK CHIP FOR EXAMPLE. 1548 01:07:00,867 --> 01:07:03,804 AND STARTED DOING ETHNIC FOCUS 1549 01:07:03,804 --> 01:07:07,774 ARRAY TO CAPTURE MORE 1550 01:07:07,774 --> 01:07:12,546 INFORMATION FROM NON-CAUCASIAN 1551 01:07:12,546 --> 01:07:14,715 SAMPLES TO REACH THE GENOTYPE 1552 01:07:14,715 --> 01:07:16,416 DATA WE COLLECT FROM THE SAMPLE. 1553 01:07:16,416 --> 01:07:19,853 WE ARE CLOSING IN ON A MILLION 1554 01:07:19,853 --> 01:07:21,755 SAMPLES TO BE GENOTYPED. 1555 01:07:21,755 --> 01:07:26,526 THE LAST WAS ABOUT 650,000. 1556 01:07:26,526 --> 01:07:30,063 THE WHOLE GENOME WE COMPLETED 1557 01:07:30,063 --> 01:07:35,068 ABOUT 150,000 WHOLE GENOME THE 1558 01:07:35,068 --> 01:07:37,304 FIRST TRANCHE RELEASED ABOUT 1559 01:07:37,304 --> 01:07:40,140 10,000 AND IN THE PROCESS OF 1560 01:07:40,140 --> 01:07:43,477 RELEASING A SECOND TRANCHE THE 1561 01:07:43,477 --> 01:07:45,145 NEXT FEW MONTHS. 1562 01:07:45,145 --> 01:07:51,985 WE HAVE METHYLATION DATA ON 1563 01:07:51,985 --> 01:08:02,462 ABOUT 90,000 WE HAVE ABOUT 1564 01:08:03,930 --> 01:08:08,635 90,000 METABOLOMICS AND CURATE 1565 01:08:08,635 --> 01:08:15,909 AND RELEASE THE DATA AND WE HOPE 1566 01:08:15,909 --> 01:08:16,710 TO DO MORE OF THOSE IN THE 1567 01:08:16,710 --> 01:08:26,953 COMING YEARS. 1568 01:08:50,143 --> 01:08:52,746 AND WE JOKE IF YOU HAVE SEEN ONE 1569 01:08:52,746 --> 01:08:56,683 V.A. YOU HAVE SEEN ONE V.A. 1570 01:08:56,683 --> 01:09:02,022 SYSTEM HAS EVOLVED OVER THE LAST 1571 01:09:02,022 --> 01:09:02,923 30 YEARS. 1572 01:09:02,923 --> 01:09:04,724 AND NOT ONLY HAS IT EVOLVED 1573 01:09:04,724 --> 01:09:07,427 ACROSS ALL THE CENTERS BUT EACH 1574 01:09:07,427 --> 01:09:13,567 OF THE STATIONS IN THE 165 OR 1575 01:09:13,567 --> 01:09:15,101 MORE V.A. HOSPITALS HAVE THEIR 1576 01:09:15,101 --> 01:09:16,570 OWN DATA ELEMENTS THEY USE. 1577 01:09:16,570 --> 01:09:17,704 THEY HAVE A LITTLE BIT OF A 1578 01:09:17,704 --> 01:09:21,541 FREEDOM IN TERMS OF WHAT HOW 1579 01:09:21,541 --> 01:09:24,511 THEY RECORD THEIR DATA AS 1580 01:09:24,511 --> 01:09:30,317 MEDICATIONS, ETCETERA. 1581 01:09:30,317 --> 01:09:36,289 IT'S A CHALLENGE TO MAKE SURE 1582 01:09:36,289 --> 01:09:44,464 THAT WHEN WE DO -- 1583 01:09:44,464 --> 01:09:45,999 >> YOU ACCIDENTALLY PRESSED YOUR 1584 01:09:45,999 --> 01:09:48,902 MUTE BUTTON. 1585 01:09:48,902 --> 01:09:50,003 >> OOPS. 1586 01:09:50,003 --> 01:09:51,771 SORRY, CAN YOU HEAR ME? 1587 01:09:51,771 --> 01:09:51,972 OKAY. 1588 01:09:51,972 --> 01:10:00,647 THANK YOU. 1589 01:10:00,647 --> 01:10:02,849 THERE WAS A QUESTION EARLIER 1590 01:10:02,849 --> 01:10:04,217 DEVELOPING THESE PHENOTYPING 1591 01:10:04,217 --> 01:10:04,517 ALGORITHMS. 1592 01:10:04,517 --> 01:10:06,820 ONE THING WE STARTED DOING FOR 1593 01:10:06,820 --> 01:10:07,921 EXAMPLE IS THAT ANY PHENOTYPE 1594 01:10:07,921 --> 01:10:12,859 THAT IS PUBLISHES WE KIND OF 1595 01:10:12,859 --> 01:10:15,762 CAPTURE THAT ALGORITHM AND THE 1596 01:10:15,762 --> 01:10:17,998 SENSITIVITY AND SPECIFICITY AND 1597 01:10:17,998 --> 01:10:20,300 THE METADATA ABOUT IT AND WE 1598 01:10:20,300 --> 01:10:22,502 HAVE STARTED BUILDING A 1599 01:10:22,502 --> 01:10:24,137 PHENOTYPE OF LIBRARIES SO TO 1600 01:10:24,137 --> 01:10:24,337 SPEAK. 1601 01:10:24,337 --> 01:10:26,673 SO AS I SAID I WAS AT THE 1602 01:10:26,673 --> 01:10:28,441 PREVIOUS SLIDE I WAS TALKING 1603 01:10:28,441 --> 01:10:30,443 ABOUT HOW WE ARE GENERATING ALL 1604 01:10:30,443 --> 01:10:32,579 THESE MULTIOMICS DATA. 1605 01:10:32,579 --> 01:10:36,449 WE DO THAT CENTRALLY AND THAT 1606 01:10:36,449 --> 01:10:38,184 ALLOWS US TO DEVELOP 1607 01:10:38,184 --> 01:10:40,086 STANDARDIZED DATA PROCESSING 1608 01:10:40,086 --> 01:10:42,689 PIPELINES SO WE HAVE SORT OF 1609 01:10:42,689 --> 01:10:45,392 STRICT QUALITY CONTROLS FOR 1610 01:10:45,392 --> 01:10:47,294 EXAMPLE THAT ALLOWS US TO HAVE 1611 01:10:47,294 --> 01:10:48,995 STRICT QUALITY CONTROLS HOW THE 1612 01:10:48,995 --> 01:10:51,932 DATA IS GENERATED, HOW THE DATA 1613 01:10:51,932 --> 01:10:53,800 IS PRE PROCESSED AND ALSO GIVES 1614 01:10:53,800 --> 01:10:55,969 US THE OPPORTUNITY TO GENERATE 1615 01:10:55,969 --> 01:10:57,370 AMPLE METADATA ABOUT THE DATA 1616 01:10:57,370 --> 01:11:00,307 ITSELF THAT CAN THEN ACCOMMODATE 1617 01:11:00,307 --> 01:11:01,107 THE DATA. 1618 01:11:01,107 --> 01:11:03,543 AS YOU CAN IMAGINE THE VOLUME 1619 01:11:03,543 --> 01:11:07,247 AND THE VARIETY OF DATA IS HUGE 1620 01:11:07,247 --> 01:11:09,015 IN M.V.P. 1621 01:11:09,015 --> 01:11:11,017 WE HAVE MORE THAN 30 PETABYTES 1622 01:11:11,017 --> 01:11:17,557 ALREADY AND COUNTING. 1623 01:11:17,557 --> 01:11:20,026 MOST OF OUR DATA INTEGRATION 1624 01:11:20,026 --> 01:11:22,429 HAPPENS ON AN AS-NEEDED BASIS 1625 01:11:22,429 --> 01:11:24,464 BECAUSE WE CAN PULL THE LATEST 1626 01:11:24,464 --> 01:11:26,266 AN GREATEST DATA FROM THE E.H.R. 1627 01:11:26,266 --> 01:11:27,734 FOR EXAMPLE WHEN A PROJECT 1628 01:11:27,734 --> 01:11:28,301 STARTS. 1629 01:11:28,301 --> 01:11:33,106 SO WE HAVE DEVELOPED A SYSTEM 1630 01:11:33,106 --> 01:11:35,108 THAT CAN INTEGRATE DATA ON AN 1631 01:11:35,108 --> 01:11:37,277 AS-NEEDED BASIS. 1632 01:11:37,277 --> 01:11:39,212 I'M NOT GOING TO TALK A WHOLE 1633 01:11:39,212 --> 01:11:41,281 LOT ABOUT IT BUT DATA BEING 1634 01:11:41,281 --> 01:11:42,582 VETERANS DATA THE SECURITY IS 1635 01:11:42,582 --> 01:11:45,719 PARAMOUNT TO US. 1636 01:11:45,719 --> 01:11:51,391 SO WE HAVE OVER THE LAST 12 1637 01:11:51,391 --> 01:11:56,596 YEARS HAVE DEVELOPED A 1638 01:11:56,596 --> 01:11:58,398 MULTIFUNCTIONAL SECURE 1639 01:11:58,398 --> 01:11:59,332 ENVIRONMENT. 1640 01:11:59,332 --> 01:12:01,601 AND COMPUTING TO THE DATA. 1641 01:12:01,601 --> 01:12:07,474 SO EACH STUDY HAS ITS OWN STUDY 1642 01:12:07,474 --> 01:12:11,344 SPACE AND WE HAVE MORE THAN 100 1643 01:12:11,344 --> 01:12:12,045 ANALYTICAL TOOLS AVAILABLE RIGHT 1644 01:12:12,045 --> 01:12:22,389 NOW IN THE PLATFORM. 1645 01:12:25,091 --> 01:12:29,029 TO GIVE YOU AN IDEA ABOUT THE 1646 01:12:29,029 --> 01:12:32,132 M.V.P. COHORT IT'S AVERAGE MALE 1647 01:12:32,132 --> 01:12:36,770 MOST AVERAGE 67 AND MOST THE 1648 01:12:36,770 --> 01:12:39,305 POPULATION IS NOT CAUCASIAN 1649 01:12:39,305 --> 01:12:41,875 WHITE AND SOME RARE 1650 01:12:41,875 --> 01:12:43,176 SELF-REPORTED ANCESTRIES LIKE 1651 01:12:43,176 --> 01:12:46,613 THE NATIVE HAWAIIAN IS .47% OF 1652 01:12:46,613 --> 01:12:50,717 OUR COHORT. 1653 01:12:50,717 --> 01:12:55,388 SO THIS IS AN EXAMPLE WHERE WE 1654 01:12:55,388 --> 01:12:56,122 CONTROL THE DATA QUALITY. 1655 01:12:56,122 --> 01:13:01,261 FOR EXAMPLE, THIS IS THE SAMPLE 1656 01:13:01,261 --> 01:13:05,365 ACROSS 400 AND THE THIRD RELEASE 1657 01:13:05,365 --> 01:13:08,668 OF 450,000 SAMPLES WHERE THE 1658 01:13:08,668 --> 01:13:13,139 MEAN RATE IS 99.36%. 1659 01:13:13,139 --> 01:13:15,341 IF THOSE STRICT CONTROL MEASURES 1660 01:13:15,341 --> 01:13:24,884 ARE NOT MET WE REASSESS. 1661 01:13:24,884 --> 01:13:28,655 THIS ARE SOME OF THE 1662 01:13:28,655 --> 01:13:30,256 OBSERVATIONS WE HAD EARLY ON 1663 01:13:30,256 --> 01:13:32,725 WHERE WE COMPARED THE FREQUENCY 1664 01:13:32,725 --> 01:13:35,829 OF THE M.V.P. DATA SET WITH 1665 01:13:35,829 --> 01:13:38,698 1,000 GENOMES. 1666 01:13:38,698 --> 01:13:41,835 YOU CAN SEE THE M.V.P. CAUCASIAN 1667 01:13:41,835 --> 01:13:44,037 FREQUENCIES IS VERY COMPARABLE 1668 01:13:44,037 --> 01:13:48,141 TO THE GENOME AND THE OTHERS 1669 01:13:48,141 --> 01:13:49,209 DON'T COMPARE. 1670 01:13:49,209 --> 01:13:55,448 AND THIS BASICALLY POINTS US TO 1671 01:13:55,448 --> 01:13:59,185 THE SAMPLES BEING MORE REAL 1672 01:13:59,185 --> 01:14:02,122 WORLD DATA AND A DIVERSE COHORT 1673 01:14:02,122 --> 01:14:06,526 OF TENTATIVE ANCESTRY. 1674 01:14:06,526 --> 01:14:10,096 MULTIPLE ANCESTRY. 1675 01:14:10,096 --> 01:14:12,532 WE'RE SHOWING THE M.V.P. IN ONE 1676 01:14:12,532 --> 01:14:19,439 AND TWO PROJECTED ON TO THE 1677 01:14:19,439 --> 01:14:23,143 POPULATION AND THE M.V.P. 1678 01:14:23,143 --> 01:14:31,684 POPULATION IS DIFFERENT. 1679 01:14:31,684 --> 01:14:34,454 AND THIS LEADS TO SOME ISSUES 1680 01:14:34,454 --> 01:14:36,656 AND CAUTIONARY TALES HOW DATA 1681 01:14:36,656 --> 01:14:38,491 SHOULD BE ANALYZED AND 1682 01:14:38,491 --> 01:14:39,759 INTEGRATED. 1683 01:14:39,759 --> 01:14:41,794 SO WE HAVE THE GENOTYPE DATA WE 1684 01:14:41,794 --> 01:14:45,565 GENERATE FROM THE AND HAVE 1685 01:14:45,565 --> 01:14:48,701 REPEATED IT TO MULTIPLE 1686 01:14:48,701 --> 01:14:49,936 BACKBONES AND REFERENCE THE 1687 01:14:49,936 --> 01:14:51,638 GENOME AND THIS IS WHAT I'M 1688 01:14:51,638 --> 01:14:57,343 SHOWING AS THE QUALITY OF THE 1689 01:14:57,343 --> 01:15:00,713 TOP MED REFERENCE GENOME. 1690 01:15:00,713 --> 01:15:06,519 THE EUROPEAN, AFRICAN AND 1691 01:15:06,519 --> 01:15:10,023 HISPANIC SAMPLES WE HAVE THE Y 1692 01:15:10,023 --> 01:15:13,660 AXIS FOR EACH OF THE FREQUENCY 1693 01:15:13,660 --> 01:15:15,762 BUCKETS ON THE X AXIS BUT THE 1694 01:15:15,762 --> 01:15:17,830 ASIAN FOR EXAMPLE IS LAGGING 1695 01:15:17,830 --> 01:15:22,702 BEHIND IN QUALITY. 1696 01:15:22,702 --> 01:15:25,738 SO THIS IS WE PROVIDE IT TO BE 1697 01:15:25,738 --> 01:15:31,811 CAUTIOUS ABOUT IT. 1698 01:15:31,811 --> 01:15:33,646 I JUST PUT THIS TO SHOW ONE OF 1699 01:15:33,646 --> 01:15:36,382 THE PAPERS PUBLISHED IN 2020 AND 1700 01:15:36,382 --> 01:15:39,085 M.V.P. ENABLED BECAUSE OF THE 1701 01:15:39,085 --> 01:15:40,853 METADATA WE PROVIDE AND THE 1702 01:15:40,853 --> 01:15:43,223 STANDARDIZED DATA QUALITY WE 1703 01:15:43,223 --> 01:15:47,860 HAVE FOR M.V.P., FIRST OF ALL 1704 01:15:47,860 --> 01:15:52,999 THE LARGE PROVIDES LARGER 1705 01:15:52,999 --> 01:15:57,904 ANALYSIS AND THIS GENERATES AND 1706 01:15:57,904 --> 01:16:00,506 A LARGE NUMBER OF NEW 1707 01:16:00,506 --> 01:16:03,710 ASSOCIATIONS. 1708 01:16:03,710 --> 01:16:07,080 THEY WERE ABLE TO DO FOR EXAMPLE 1709 01:16:07,080 --> 01:16:09,549 ANCESTRY SPECIFIC ANALYSIS ON 1710 01:16:09,549 --> 01:16:11,985 ITS OWN TO IDENTIFY ANCESTRIES 1711 01:16:11,985 --> 01:16:19,158 SPECIFIC ASSOCIATIONS. 1712 01:16:19,158 --> 01:16:20,927 THIS IS AN EXAMPLE WHERE ONE OF 1713 01:16:20,927 --> 01:16:25,164 THE EARLY PUBLICATIONS IN 2018 1714 01:16:25,164 --> 01:16:27,900 WHERE WE DISCOVERED 118 NEW 1715 01:16:27,900 --> 01:16:30,036 GENOME LOCI ASSOCIATED WITH 1716 01:16:30,036 --> 01:16:30,370 LIPIDS. 1717 01:16:30,370 --> 01:16:34,474 AT THIS FIGURE I JUST PUT IN 1718 01:16:34,474 --> 01:16:37,110 THERE TO SHOW AND WE LOOKED AT 1719 01:16:37,110 --> 01:16:41,214 THE FREQUENCIES AS WELL AS THE 1720 01:16:41,214 --> 01:16:43,049 ESTIMATES AND ESTIMATES FOR THE 1721 01:16:43,049 --> 01:16:45,685 VARIANTS WHEN WE COMPARE IT TO 1722 01:16:45,685 --> 01:16:49,055 ON THE LEFT IS THE AFRICAN AND 1723 01:16:49,055 --> 01:16:52,125 ON THE RIGHT IS HISPANIC VERSUS 1724 01:16:52,125 --> 01:16:52,392 CAUCASIAN. 1725 01:16:52,392 --> 01:16:54,927 THERE'S A BETTER ALIGNMENT WITH 1726 01:16:54,927 --> 01:17:02,235 THE HISPANIC SAMPLES AND THE 1727 01:17:02,235 --> 01:17:06,606 CAUCASIAN SAMPLES IMPLYING MORE 1728 01:17:06,606 --> 01:17:07,840 GENOME ELEMENT IN HISPANICS THAN 1729 01:17:07,840 --> 01:17:15,014 AFRICAN. 1730 01:17:15,014 --> 01:17:16,349 WE'RE INTERESTED IN DOING 1731 01:17:16,349 --> 01:17:18,084 DISCOVERIES AND TRANSLATING TO 1732 01:17:18,084 --> 01:17:20,253 CLINICAL QUCARE. 1733 01:17:20,253 --> 01:17:24,190 IN A PAPER WE LOOKED AT THE HLA 1734 01:17:24,190 --> 01:17:25,558 FREQUENCIES THAT HAVE LARGE 1735 01:17:25,558 --> 01:17:29,896 PHARMACO GENOMIC AFFECTS ACROSS 1736 01:17:29,896 --> 01:17:32,298 MULTIPLE ANCESTRIES. 1737 01:17:32,298 --> 01:17:37,403 THERE'S QUITE A DIFFERENCE FOR 1738 01:17:37,403 --> 01:17:47,413 SOME OF THESE AND WE CAN PROVIDE 1739 01:17:47,413 --> 01:17:48,548 CLINICAL INTERPRETATION NOT JUST 1740 01:17:48,548 --> 01:17:57,824 AT THE POPULATION LEVEL BUT 1741 01:17:57,824 --> 01:17:58,524 ANCESTRY LEVEL. 1742 01:17:58,524 --> 01:18:02,028 WE HAVE MORE THAN 100 PROJECTS 1743 01:18:02,028 --> 01:18:04,197 WITH 700 RESEARCHERS ACTIVELY 1744 01:18:04,197 --> 01:18:06,032 WORKING WITH THE DATA. 1745 01:18:06,032 --> 01:18:10,603 WE HAVE ABOUT 400 PUBLICATIONS 1746 01:18:10,603 --> 01:18:14,474 THAT HAVE COME OUT -- OUR FIRST 1747 01:18:14,474 --> 01:18:16,576 WAS IN 2015 TO ABOUT EIGHT 1748 01:18:16,576 --> 01:18:22,882 YEARS. 1749 01:18:22,882 --> 01:18:25,184 I WANT TO THANK EVERYONE 1750 01:18:25,184 --> 01:18:27,587 INVOLVED IN THE OFFICE OF 1751 01:18:27,587 --> 01:18:31,023 RESEARCH AND DEVELOPMENT AND THE 1752 01:18:31,023 --> 01:18:41,300 PROGRAM OFFICE. 1753 01:18:41,801 --> 01:18:42,869 THANKS AGAIN. 1754 01:18:42,869 --> 01:18:47,073 I REALLY APPRECIATE THE 1755 01:18:47,073 --> 01:18:48,107 OPPORTUNITY AND THIS TIME I'LL 1756 01:18:48,107 --> 01:18:56,582 TAKE A FEW QUESTIONS. 1757 01:18:56,582 --> 01:18:58,251 >> WE HAVE ONE QUESTION THAT'S 1758 01:18:58,251 --> 01:19:00,586 COME UP FROM MULTIPLE ATTENDEES 1759 01:19:00,586 --> 01:19:05,458 WHICH IS HOW CAN NON-V.A. 1760 01:19:05,458 --> 01:19:06,893 RESEARCHERS ENGAGE WITH THE 1761 01:19:06,893 --> 01:19:07,093 DATA? 1762 01:19:07,093 --> 01:19:08,594 >> SURE. 1763 01:19:08,594 --> 01:19:10,163 SO RIGHT NOW THE WAY WE ARE 1764 01:19:10,163 --> 01:19:14,100 DOING IS WE ARE ENCOURAGING THE 1765 01:19:14,100 --> 01:19:15,501 RESEARCHERS TO FORM CONSORTIA. 1766 01:19:15,501 --> 01:19:20,873 THERE'S A V.A. RESEARCHER THEY 1767 01:19:20,873 --> 01:19:24,944 CAN APPLY FOR THESE AS A 1768 01:19:24,944 --> 01:19:27,880 CONSORTIUM AS THE LED FOR THE 1769 01:19:27,880 --> 01:19:28,648 PRIMARY P.I. 1770 01:19:28,648 --> 01:19:32,285 WE ARE TALKING AND STAY TUNED 1771 01:19:32,285 --> 01:19:34,253 WE'RE MAKING THE DATA AVAILABLE 1772 01:19:34,253 --> 01:19:44,664 MORE WIDELY TO NIH AND. 1773 01:19:50,903 --> 01:19:54,740 THERE'S 1774 01:19:56,142 --> 01:19:57,910 >> THERE'S A POLL COMING UP AND 1775 01:19:57,910 --> 01:20:00,546 THERE'S A QUESTION ABOUT THE 1776 01:20:00,546 --> 01:20:03,049 WORK BENCH. 1777 01:20:03,049 --> 01:20:07,420 AND THE QUESTION IS FOR ALL THE 1778 01:20:07,420 --> 01:20:08,321 DIFFERENT PROGRAMS, U.K. BIO 1779 01:20:08,321 --> 01:20:12,758 BANK, ALL OF US AND HOW DO THE 1780 01:20:12,758 --> 01:20:13,826 WORK BENCHES COMPARE? 1781 01:20:13,826 --> 01:20:15,261 DO THEY HAVE COMMON 1782 01:20:15,261 --> 01:20:22,368 FUNCTIONA 1783 01:20:22,368 --> 01:20:23,269 FUNCTIONAL 1784 01:20:23,269 --> 01:20:23,636 FUNCTIONALITIES. 1785 01:20:23,636 --> 01:20:24,337 >> AS JOSH WAS MENTIONING THE 1786 01:20:24,337 --> 01:20:26,439 U.K. BIO BANK AND THE ALL OF US 1787 01:20:26,439 --> 01:20:30,977 WORK BENCH ARE SIMILAR. 1788 01:20:30,977 --> 01:20:31,644 BUT THE M.V.P. WORK BENCH HAVE 1789 01:20:31,644 --> 01:20:32,745 WE TOOK A DIFFERENT APPROACH 1790 01:20:32,745 --> 01:20:36,349 BECAUSE WE WANTED TO MAKE IT 1791 01:20:36,349 --> 01:20:40,453 MORE EASIER FOR PEOPLE TO BRING 1792 01:20:40,453 --> 01:20:47,059 THEIR TOOLS TO DO THE ANALYSIS 1793 01:20:47,059 --> 01:20:53,900 OUR WORK BENCH IS A LITTLE BIT 1794 01:20:53,900 --> 01:20:57,503 DIFFERENT. 1795 01:20:57,503 --> 01:20:58,237 AP WE HAVE DATA BEEN APPROVED 1796 01:20:58,237 --> 01:21:02,441 FOR. 1797 01:21:02,441 --> 01:21:04,377 AND THEY CAN SHARE TOOLS AN ANY 1798 01:21:04,377 --> 01:21:06,812 PIPELINES THEY HAVE DEVELOPED 1799 01:21:06,812 --> 01:21:10,550 THEY CAN SHARE WITH OTHER STUDY 1800 01:21:10,550 --> 01:21:13,819 PERSONNEL ACROSS THE PLATFORM. 1801 01:21:13,819 --> 01:21:15,187 OUR PLATFORM IS DEVELOPING 1802 01:21:15,187 --> 01:21:18,824 TOOLS, MAKING TOOLS AVAILABLE TO 1803 01:21:18,824 --> 01:21:19,992 OTHERS AND THE ONLY THING STRICT 1804 01:21:19,992 --> 01:21:22,194 WITHIN THE STUDY IS THE DATA 1805 01:21:22,194 --> 01:21:25,731 THAT YOU APPROVED. 1806 01:21:25,731 --> 01:21:27,033 >> WONDERFUL. 1807 01:21:27,033 --> 01:21:27,934 THANKS SO MUCH. 1808 01:21:27,934 --> 01:21:32,204 FOR TIME SAKE WE'LL MOVE ON TO 1809 01:21:32,204 --> 01:21:34,140 ANOTHER SPEAKER AND WE'VE BEEN 1810 01:21:34,140 --> 01:21:37,043 HEARING FROM DR. CORESH AS A 1811 01:21:37,043 --> 01:21:38,844 CONFERENCE CO-CHAIR BUT I'LL 1812 01:21:38,844 --> 01:21:41,180 BRIEFLY INTRODUCE HIM AS THE 1813 01:21:41,180 --> 01:21:47,587 GEORGE W. COMSTOCK PROFESSOR OF 1814 01:21:47,587 --> 01:21:52,525 BIO MEDICINE AT JOHNS HOPKINS 1815 01:21:52,525 --> 01:21:55,261 UNIVERSITY WHO WILL SOON BE AT 1816 01:21:55,261 --> 01:21:58,264 NYU AND HE HAS OVER 150 MILLION 1817 01:21:58,264 --> 01:21:58,764 PROTEOMIC MEASURES. 1818 01:21:58,764 --> 01:22:01,634 DR. CORESH IS AMONG THE MOST 1819 01:22:01,634 --> 01:22:03,502 CITED RESEARCHERS HAVING 1820 01:22:03,502 --> 01:22:06,205 CO-AUTHORED ARTICLES CITED OVER 1821 01:22:06,205 --> 01:22:06,772 100,000 TIMES. 1822 01:22:06,772 --> 01:22:08,641 SO IT WILL BE A THRILL TO HEAR 1823 01:22:08,641 --> 01:22:12,878 FROM DR. CORESH ABOUT THE ARIC 1824 01:22:12,878 --> 01:22:13,879 STUDY AND WITH THAT PLEASE TAKE 1825 01:22:13,879 --> 01:22:14,113 IT AWAY. 1826 01:22:14,113 --> 01:22:24,123 >> WONDERFUL. 1827 01:22:24,123 --> 01:22:26,692 IT'S A PLEASURE AND NICE TO SEE 1828 01:22:26,692 --> 01:22:29,395 ALMOST 200 ATTENDEES AND TALK 1829 01:22:29,395 --> 01:22:31,230 WITH THE ARIC STUDY RENAISSANCE 1830 01:22:31,230 --> 01:22:40,473 IN AN AGING COHORT. 1831 01:22:40,473 --> 01:22:43,643 AGING WITH THE COHORT AN I 1832 01:22:43,643 --> 01:22:46,112 INTRODUCED THE CONCEPT OF A 1833 01:22:46,112 --> 01:22:49,749 RESEARCH STUDY AND ARIC SAY 1834 01:22:49,749 --> 01:22:52,885 COHORT STUDY HOW WE GET INSIGHTS 1835 01:22:52,885 --> 01:23:03,129 FOR AN ACTION. 1836 01:23:05,531 --> 01:23:07,433 ARIC WAS INITIATED IN 1987 AND 1837 01:23:07,433 --> 01:23:10,403 TALKED ABOUT THE FACT IT WAS 1838 01:23:10,403 --> 01:23:13,039 INITIATED BEFORE HE WAS BORN 1839 01:23:13,039 --> 01:23:14,273 SAID DR. WALKER AND YET USING 1840 01:23:14,273 --> 01:23:15,074 THE DATA. 1841 01:23:15,074 --> 01:23:18,577 I WAS BORN BEFORE 1987 BUT I WAS 1842 01:23:18,577 --> 01:23:23,082 A STUDENT AND ON THE LEFT IS A 1843 01:23:23,082 --> 01:23:24,583 CHAIR OF THIS STEERING COMMITTEE 1844 01:23:24,583 --> 01:23:27,820 FROM THE BEGINNING AN RICHIE IS 1845 01:23:27,820 --> 01:23:30,456 87 AND STILL AN ACTIVE 1846 01:23:30,456 --> 01:23:30,923 INVESTIGATOR HIMSELF. 1847 01:23:30,923 --> 01:23:32,692 YOU SEE IT'S A PARTNERSHIP 1848 01:23:32,692 --> 01:23:33,626 BETWEEN INVESTIGATORS, STAFF AND 1849 01:23:33,626 --> 01:23:42,068 PARTICIPANTS. 1850 01:23:42,068 --> 01:23:44,136 AND I WANT TO TALK ABOUT MODERN 1851 01:23:44,136 --> 01:23:46,205 TOOLS AN I'LL SHOW RESULTS. 1852 01:23:46,205 --> 01:23:48,307 SO ARIC HAD A COMMUNITY 1853 01:23:48,307 --> 01:23:48,574 COMPONENT. 1854 01:23:48,574 --> 01:23:49,842 IT'S INTERESTING TO THINK HOW 1855 01:23:49,842 --> 01:23:52,178 YOU CONNECT COMMUNITY, A COHORT 1856 01:23:52,178 --> 01:23:56,515 AND ACTUALLY NOW WE HAVE DONE A 1857 01:23:56,515 --> 01:23:58,984 CLINICAL TRIAL IN A WAY MUCH 1858 01:23:58,984 --> 01:24:00,453 SMALLER THAN THE U.K. BIO BANK 1859 01:24:00,453 --> 01:24:02,488 OR ALL OF US AND VETERANS AND 1860 01:24:02,488 --> 01:24:04,390 STILL LARGER THAN WHAT YOU CAN 1861 01:24:04,390 --> 01:24:06,225 DO IN ONE SITE. 1862 01:24:06,225 --> 01:24:11,030 IT'S BRIDGING THE DIFFERENT 1863 01:24:11,030 --> 01:24:12,798 LEVELS OF COLLABORATION. 1864 01:24:12,798 --> 01:24:17,036 THE ORIGINAL ARIC DESIGN HAD 1865 01:24:17,036 --> 01:24:18,304 THREE VISITS THREE YEARS A PART 1866 01:24:18,304 --> 01:24:21,574 AND IT'S BEEN ADOPTED BY THE 1867 01:24:21,574 --> 01:24:24,110 LEADING NHLBI COHORTS INCLUDING 1868 01:24:24,110 --> 01:24:32,618 MESA, STUDY OF LATINOS AND WE 1869 01:24:32,618 --> 01:24:37,957 STARTED WITH ABOUT 15792 1870 01:24:37,957 --> 01:24:41,494 PARTICIPANTS IN JACKSON, 1871 01:24:41,494 --> 01:24:45,131 MISSISSIPPI AND THE NOVEL EXAM 1872 01:24:45,131 --> 01:24:55,608 WAS A CAROTID INTERMEDIATE 1873 01:24:55,908 --> 01:24:57,443 INTERMEDIAL THICKNESS AND IT'S 1874 01:24:57,443 --> 01:24:58,711 IMPORTANT TO HAVE THE FUTURE 1875 01:24:58,711 --> 01:25:03,682 BANKING EFFORTS. 1876 01:25:03,682 --> 01:25:05,584 THAT BECOMES A SMALL PART OF THE 1877 01:25:05,584 --> 01:25:05,851 STUDY. 1878 01:25:05,851 --> 01:25:10,623 WHEN YOU LOOK AT THE WHOLE DATA 1879 01:25:10,623 --> 01:25:12,525 COLLECTION NOW WE'VE JUST BEEN 1880 01:25:12,525 --> 01:25:14,260 FUNDED FOR VISIT 11. 1881 01:25:14,260 --> 01:25:18,297 WE ARE AT VISIT 10 IN 2023 AND 1882 01:25:18,297 --> 01:25:22,201 OF THE 5200 PARTICIPANTS ALIVE, 1883 01:25:22,201 --> 01:25:24,870 WE'RE DOING SURVEILLANCE ON 4800 1884 01:25:24,870 --> 01:25:28,240 BUT SEEING IN CLINIC BECAUSE OF 1885 01:25:28,240 --> 01:25:30,276 COVID AND OTHER REASONS CLOSER 1886 01:25:30,276 --> 01:25:31,477 TO 1750 PARTICIPANTS. 1887 01:25:31,477 --> 01:25:35,114 SO I THINK THE IDEA OF FOLLOW-UP 1888 01:25:35,114 --> 01:25:37,416 RATES AND COMPLETENESS AND 1889 01:25:37,416 --> 01:25:38,751 INCOMPLETENESS AND HOW YOU DO 1890 01:25:38,751 --> 01:25:43,889 VAL IS INFERENCES IS IMPORTANT. 1891 01:25:43,889 --> 01:25:45,257 AND THE DATA COMPONENTS HAVE 1892 01:25:45,257 --> 01:25:45,724 INCREASED A LOT. 1893 01:25:45,724 --> 01:25:48,627 WE STARTED WITH A HUGE EMPHASIS 1894 01:25:48,627 --> 01:25:49,361 ON VASCULAR RISK FACTORS AND 1895 01:25:49,361 --> 01:25:56,969 MARKERS. 1896 01:25:56,969 --> 01:26:03,542 AND HOMO -- HOMEOSTASIS WAS 1897 01:26:03,542 --> 01:26:05,177 HARDER THAN THEY THOUGHT AND 1898 01:26:05,177 --> 01:26:08,747 STARTED WITH CALCIUM AND NEW 1899 01:26:08,747 --> 01:26:10,449 BRAIN MRI AND PET. 1900 01:26:10,449 --> 01:26:12,484 THE BRAIN MRI AND PET ARE IN 1901 01:26:12,484 --> 01:26:14,386 SUBSETS SO THAT'S AN IMPORTANT 1902 01:26:14,386 --> 01:26:16,956 THING AND IN THE TALK OF HOW TO 1903 01:26:16,956 --> 01:26:19,625 EXPAND SUBSET TO WHOLE GROUPS IS 1904 01:26:19,625 --> 01:26:20,326 INTRIGUING. 1905 01:26:20,326 --> 01:26:21,627 INTERESTINGLY WE HAVE COGNITIVE 1906 01:26:21,627 --> 01:26:24,096 FUNCTION TEST EARLY ON BUT IT 1907 01:26:24,096 --> 01:26:25,698 USED TO BE THREE QUESTIONS, 1908 01:26:25,698 --> 01:26:27,066 THREE MINUTES WORTH OF DATA AND 1909 01:26:27,066 --> 01:26:29,401 NOW WE DO AN HOUR'S WORTH OF 1910 01:26:29,401 --> 01:26:30,836 DATA WHEN WE DO THE FULL 1911 01:26:30,836 --> 01:26:32,571 BATTERY. 1912 01:26:32,571 --> 01:26:34,707 AMAZINGLY THE THREE MINUTES GETS 1913 01:26:34,707 --> 01:26:37,276 YOU QUITE A BIT AND WE CAN GET 1914 01:26:37,276 --> 01:26:40,880 TO UNDERLYING VARIABLES IN 1915 01:26:40,880 --> 01:26:42,248 COGNITIVE GLOBAL COGNITION FROM 1916 01:26:42,248 --> 01:26:45,217 EACH ONE OF THE TESTS WITH 1917 01:26:45,217 --> 01:26:46,552 VARIABLE RELIABILITY. 1918 01:26:46,552 --> 01:26:48,187 WE NOW DO INFORMANT INTERVIEWS 1919 01:26:48,187 --> 01:26:50,322 FOR ACTIVE DEMENTIA 1920 01:26:50,322 --> 01:26:50,656 SURVEILLANCE. 1921 01:26:50,656 --> 01:26:52,191 IT'S IMPORTANT PEOPLE WITH 1922 01:26:52,191 --> 01:26:54,994 DEMENTIA DO NOT COME TO VISITS. 1923 01:26:54,994 --> 01:26:56,428 IF YOU WAIT TO MAKE DIAGNOSIS AT 1924 01:26:56,428 --> 01:26:57,897 VISITS YOU WON'T GET IT. 1925 01:26:57,897 --> 01:26:59,498 YOU HAVE TO DO ACTIVE 1926 01:26:59,498 --> 01:27:00,566 SURVEILLANCE AND IN THE MISS THE 1927 01:27:00,566 --> 01:27:03,168 CASES AND AS WE'VE BEEN TOLD BY 1928 01:27:03,168 --> 01:27:04,803 DR. BOULWARE YOU HAVE TO BE 1929 01:27:04,803 --> 01:27:06,405 AWARE AND MAKE EFFORTS BECAUSE 1930 01:27:06,405 --> 01:27:08,007 OTHERWISE YOU'RE GOING TO GET 1931 01:27:08,007 --> 01:27:10,109 VARIABLE ASCERTAINMENT BY RACE 1932 01:27:10,109 --> 01:27:11,310 AND SOCIAL DETERMINATES OF 1933 01:27:11,310 --> 01:27:11,677 HEALTH. 1934 01:27:11,677 --> 01:27:12,978 WE INTEGRATED HEARING LOSS INTO 1935 01:27:12,978 --> 01:27:14,813 THE STUDY AND I'LL TELL YOU 1936 01:27:14,813 --> 01:27:17,416 ABOUT SOME MAJOR RESULTS FROM 1937 01:27:17,416 --> 01:27:18,384 QUANTITATIVE HEARING AND A NEW 1938 01:27:18,384 --> 01:27:23,055 CLINICAL TRIAL AND WE INTEGRATED 1939 01:27:23,055 --> 01:27:24,023 PHYSICAL FUNCTION ASSESSMENT AND 1940 01:27:24,023 --> 01:27:26,692 LOOKED AT LABS AND BIO BANKING 1941 01:27:26,692 --> 01:27:30,029 WITH A MAJOR FOCUS ON PROTEOMICS 1942 01:27:30,029 --> 01:27:32,164 WITH THE PLATFORM AND YOU HAIRED 1943 01:27:32,164 --> 01:27:34,800 FROM KEENAN WALKER AND I'LL TALK 1944 01:27:34,800 --> 01:27:37,169 ABOUT OTHER FINDINGS AND WE HAVE 1945 01:27:37,169 --> 01:27:40,372 A NEW EMPHASIS ON BLOOD 1946 01:27:40,372 --> 01:27:42,942 ALZHEIMER'S DISEASE AND NEURAL 1947 01:27:42,942 --> 01:27:43,742 DEGENERATION BIOMARKERS. 1948 01:27:43,742 --> 01:27:45,778 IT'S AN EVOLVING FASCINATING 1949 01:27:45,778 --> 01:27:48,213 FIELD AND THERE'S STUDIES ON 1950 01:27:48,213 --> 01:27:48,814 CANCER ON THE LIQUID BYPASS 1951 01:27:48,814 --> 01:27:53,319 CONCEPT FOR CANCER. 1952 01:27:53,319 --> 01:27:56,255 SO THIS IS A DIAGRAM OF ARIC. 1953 01:27:56,255 --> 01:27:57,923 YOU'LL NOTICE THERE WERE NO 1954 01:27:57,923 --> 01:28:00,125 VISITS FOR GREATER THAN 10 YEARS 1955 01:28:00,125 --> 01:28:01,460 AND NIH WAS CONSIDERED ENDING 1956 01:28:01,460 --> 01:28:03,929 THE FUNDING OF ARIC AND 1957 01:28:03,929 --> 01:28:04,964 DECREASING THE FUNDING FOR A LOT 1958 01:28:04,964 --> 01:28:05,831 OF THE COHORTS. 1959 01:28:05,831 --> 01:28:09,902 CLICK AGAIN. 1960 01:28:09,902 --> 01:28:13,639 YOU'LL SEE NOW 1961 01:28:13,639 --> 01:28:15,140 INVESTIGATOR-INITIATED PROPOSALS 1962 01:28:15,140 --> 01:28:16,942 ALLOWED US TO UNCOVER THE 1963 01:28:16,942 --> 01:28:18,077 INCREASING VALUE OF THE COHORT. 1964 01:28:18,077 --> 01:28:19,511 WE HAVE MORE VISITS AND MORE 1965 01:28:19,511 --> 01:28:20,045 DATA COLLECTION THAN EVER 1966 01:28:20,045 --> 01:28:21,347 BEFORE. 1967 01:28:21,347 --> 01:28:25,551 SO THERE'S ACTUALLY A SYNERGY OF 1968 01:28:25,551 --> 01:28:27,219 NEW DATA IN A RICH CONTEXT. 1969 01:28:27,219 --> 01:28:28,320 I THINK THAT'S SOMETHING WE NEED 1970 01:28:28,320 --> 01:28:30,356 TO THINK ABOUT IN THIS WORKSHOP 1971 01:28:30,356 --> 01:28:32,858 ABOUT BRIDGING AND CONNECTING 1972 01:28:32,858 --> 01:28:36,495 HOW DO YOU INCREASE THE VALUE OF 1973 01:28:36,495 --> 01:28:36,695 DATA. 1974 01:28:36,695 --> 01:28:40,499 NOT JUST BIG BUT VALUABLE. 1975 01:28:40,499 --> 01:28:42,267 CONNECTED, INSIGHTFUL, 1976 01:28:42,267 --> 01:28:42,901 INFORMATIVE AND CHANGING 1977 01:28:42,901 --> 01:28:53,379 PRACTICE AND POLICY. 1978 01:28:53,379 --> 01:28:54,613 LIKE EVERYBODY ELSE WE'RE 1979 01:28:54,613 --> 01:28:56,949 ENAMORED OF WEARABLES AND NOW 1980 01:28:56,949 --> 01:28:58,717 THE CHALLENGE IS SUCCEEDED HOW 1981 01:28:58,717 --> 01:29:00,953 WILL WE MANAGE SIX DEVICES? 1982 01:29:00,953 --> 01:29:05,391 THERE'S GOING TO BE TWO 1983 01:29:05,391 --> 01:29:09,361 DEDICATED SLEEP DEVICES OF SLEEP 1984 01:29:09,361 --> 01:29:13,232 PROFILE AND WATCH AND A PHYSICAL 1985 01:29:13,232 --> 01:29:18,470 ACTIVITY DEVICES AND THE LINK 1986 01:29:18,470 --> 01:29:20,539 AND THE COMMERCIAL GRADE DEVICE 1987 01:29:20,539 --> 01:29:23,142 THE FITBIT CHARGE. 1988 01:29:23,142 --> 01:29:25,210 THEY HAVE PEOPLE WEAR FOR FOUR 1989 01:29:25,210 --> 01:29:26,779 YEARS FOREVER. 1990 01:29:26,779 --> 01:29:27,579 WHY SHOULD WE STOP? 1991 01:29:27,579 --> 01:29:33,452 THIS IS MARRYING THE TYPES OF 1992 01:29:33,452 --> 01:29:34,853 THINGS WE'VE DONE ON SMALL SCALE 1993 01:29:34,853 --> 01:29:37,756 TO A LARGE SCALE WITH THE ADDED 1994 01:29:37,756 --> 01:29:40,559 CHALLENGE PARTICIPANTS ARE 80 TO 1995 01:29:40,559 --> 01:29:41,160 100. 1996 01:29:41,160 --> 01:29:42,995 HOW DO YOU GET A 90-YEAR-OLD TO 1997 01:29:42,995 --> 01:29:45,397 WEAR A FITBIT AND CHARGE IT AND 1998 01:29:45,397 --> 01:29:47,332 GET THE DATA TO US? 1999 01:29:47,332 --> 01:29:49,201 THE OTHER THING THAT'S 2000 01:29:49,201 --> 01:29:52,004 FASCINATING IS AS WE'VE DONE THE 2001 01:29:52,004 --> 01:29:54,306 DESIGN THERE'S A NEW DEVICE. 2002 01:29:54,306 --> 01:29:56,875 THEY DISCONTINUE THE LINK AND 2003 01:29:56,875 --> 01:30:01,113 START THE NEWEST DEVICE CALLED 2004 01:30:01,113 --> 01:30:01,313 LEAP. 2005 01:30:01,313 --> 01:30:04,316 IT GETS TO VALIDITY. 2006 01:30:04,316 --> 01:30:06,585 IF YOU CLICK, MY BIG QUESTION IS 2007 01:30:06,585 --> 01:30:08,120 WHAT IS WHAT THEY SAY THEY 2008 01:30:08,120 --> 01:30:08,487 CAUGHT. 2009 01:30:08,487 --> 01:30:10,155 ACTIVITY THEY'VE BEEN DOING FOR 2010 01:30:10,155 --> 01:30:20,599 A WHILE BUT WE KNOW ACCEL 2011 01:30:20,599 --> 01:30:21,600 ACCELEROMETRY IS DIFFERENT AND 2012 01:30:21,600 --> 01:30:23,402 THERE'S ISSUES WITH ACTIVITY 2013 01:30:23,402 --> 01:30:26,738 VERSUS INACTIVITY AND TRANSITION 2014 01:30:26,738 --> 01:30:28,807 AS A POWERFUL THING. 2015 01:30:28,807 --> 01:30:31,910 IT SAYS IT MEASURES SLEEP. 2016 01:30:31,910 --> 01:30:33,011 IT'S ON YOUR WRIST. 2017 01:30:33,011 --> 01:30:37,549 IS IT AS GOOD AS THE 2018 01:30:37,549 --> 01:30:39,518 RESEARCH-GRADE SLEEP DEVICE. 2019 01:30:39,518 --> 01:30:41,687 HEART RATE IS PROBABLY GOOD BUT 2020 01:30:41,687 --> 01:30:45,891 WHEN I USE A FITBIT AND GO ON A 2021 01:30:45,891 --> 01:30:51,463 SPIN CLASS IT TAKES FIVE MINUTES 2022 01:30:51,463 --> 01:30:52,931 TO RECORD AND THEY DO 2023 01:30:52,931 --> 01:30:53,999 INTERESTING THINGS AND WE HAVE 2024 01:30:53,999 --> 01:30:57,469 TO BE AWARE OF WHAT WE'LL GET. 2025 01:30:57,469 --> 01:31:01,273 HEART RATE VARIABILITY AND SKIN 2026 01:31:01,273 --> 01:31:02,307 TEMPERATURE AND BLOOD PRESSURE. 2027 01:31:02,307 --> 01:31:04,042 I SPENT A YEAR TRYING TO 2028 01:31:04,042 --> 01:31:06,512 EVALUATE THE DEVICE THAT WAS FDA 2029 01:31:06,512 --> 01:31:07,546 CLEARED FOR BLOOD PRESSURE AND 2030 01:31:07,546 --> 01:31:12,017 FOUND OUT REALLY WHAT IT WAS 2031 01:31:12,017 --> 01:31:14,253 DOING WAS PARITY HEART RATE WITH 2032 01:31:14,253 --> 01:31:16,488 A CALIBRATION OF BLOOD PRESSURE. 2033 01:31:16,488 --> 01:31:17,823 WE NEED TO KNOW WHAT MEASURES 2034 01:31:17,823 --> 01:31:20,092 ARE VALID AND IF WE CAN GET 2035 01:31:20,092 --> 01:31:22,027 BLOOD PRESSURE IN REAL TIME FROM 2036 01:31:22,027 --> 01:31:24,563 THESE DEVICES, IT WOULD BE 2037 01:31:24,563 --> 01:31:26,698 AMAZING AND TRANSFORMATIVE 2038 01:31:26,698 --> 01:31:27,933 BECAUSE BLOOD PRESSURE IS SO 2039 01:31:27,933 --> 01:31:30,335 IMPORTANT AND YET I WILL KIND OF 2040 01:31:30,335 --> 01:31:33,405 TRUST BUT VERIFY A LOT BEFORE I 2041 01:31:33,405 --> 01:31:33,872 BELIEVE THOSE SIGNALS. 2042 01:31:33,872 --> 01:31:40,479 NEXT SLIDE. 2043 01:31:40,479 --> 01:31:42,981 YOU HAVE TO BE FLEXIBLE WITH 2044 01:31:42,981 --> 01:31:44,116 OLDER AGE PARTICIPANTS. 2045 01:31:44,116 --> 01:31:46,585 WE CAN HAVE BASICALLY A 2046 01:31:46,585 --> 01:31:47,653 SEVEN-HOUR ONE DAY WHICH WE 2047 01:31:47,653 --> 01:31:49,188 THINK IS TOO LONG. 2048 01:31:49,188 --> 01:31:52,224 WE SUGGEST PARTICIPANTS DO TWO 2049 01:31:52,224 --> 01:31:54,493 DAYS AND THAT WOULD BE ABOUT 2050 01:31:54,493 --> 01:31:56,428 THREE TO OUR HOURS EACH DAY OR 2051 01:31:56,428 --> 01:31:57,496 THE PARTICIPANT MAY SAY I DON'T 2052 01:31:57,496 --> 01:32:00,732 WANT TO DO SEVEN HOUR OR TWO 2053 01:32:00,732 --> 01:32:02,868 DAYS, I'M ONLY WILLING TO GIVE 2054 01:32:02,868 --> 01:32:04,536 YOU HALF A DAY OR TWO HOURS OR 2055 01:32:04,536 --> 01:32:06,071 ONLY ANSWER THINGS ON THE PHONE. 2056 01:32:06,071 --> 01:32:09,841 SO WE HAVE TO BE FLEXIBLE TO GET 2057 01:32:09,841 --> 01:32:11,443 HIGH RESPONSE RATES PARTICULARLY 2058 01:32:11,443 --> 01:32:14,213 WHEN PREME OLDER AND HAVE 2059 01:32:14,213 --> 01:32:14,446 DISEASE. 2060 01:32:14,446 --> 01:32:16,048 THINK THERE IS AN INTERESTING 2061 01:32:16,048 --> 01:32:20,886 TENSION BETWEEN LET'S STUDY THE 2062 01:32:20,886 --> 01:32:22,621 WELL WILLING TO WEAR FOUR 2063 01:32:22,621 --> 01:32:25,257 WATCHES AND SEVEN ELECTRODE AND 2064 01:32:25,257 --> 01:32:26,625 LOVE DATA VERSUS THE CHALLENGES 2065 01:32:26,625 --> 01:32:33,165 OF PEOPLE ARE OLDER AND CHRONIC 2066 01:32:33,165 --> 01:32:34,499 DISEASE AND MAY HAVE DEPRESSION, 2067 01:32:34,499 --> 01:32:38,303 OTHER CHALLENGES, FOOD 2068 01:32:38,303 --> 01:32:39,638 INSECURITY AND YET THEY DEVELOP 2069 01:32:39,638 --> 01:32:40,872 THE DISEASES WE CARE ABOUT AND 2070 01:32:40,872 --> 01:32:42,574 NEED TO INCLUDE THEM. 2071 01:32:42,574 --> 01:32:43,742 WE'RE DEVELOPING A WHOLE 2072 01:32:43,742 --> 01:32:46,211 COMPONENT ON CAREGIVING, END OF 2073 01:32:46,211 --> 01:32:48,280 LIFE AND TRAINING FOR THE 2074 01:32:48,280 --> 01:32:50,582 INTERVIEWERS IN HOW TO BE 2075 01:32:50,582 --> 01:32:51,183 EMPATHETIC AND SUPPORTIVE OF 2076 01:32:51,183 --> 01:32:56,555 PARTICIPANTS. 2077 01:32:56,555 --> 01:32:57,756 NOW I'D LIKE TO SWITCH THE 2078 01:32:57,756 --> 01:32:58,790 RESULT. 2079 01:32:58,790 --> 01:32:59,758 METHODS ARE IMPORTANT. 2080 01:32:59,758 --> 01:33:00,859 I'VE BEEN VERY IMPRESSED WITH 2081 01:33:00,859 --> 01:33:02,094 THE BIG STUDIES AND THEIR 2082 01:33:02,094 --> 01:33:02,327 RESULTS. 2083 01:33:02,327 --> 01:33:04,529 I THINK IT'S ACTUALLY A 2084 01:33:04,529 --> 01:33:06,865 CHALLENGE AT LATEST FOR ME IN 2085 01:33:06,865 --> 01:33:09,635 HOW TO PROCESS THE VOLUME AND 2086 01:33:09,635 --> 01:33:11,503 CAPABILITY OF RESEARCH OF THINGS 2087 01:33:11,503 --> 01:33:14,039 LIKE U.K. BIO BANK AND ALL OF US 2088 01:33:14,039 --> 01:33:15,240 AND MILLION VETERANS PROGRAMS. 2089 01:33:15,240 --> 01:33:16,375 IT'S BEEN AN EXCITING PROGRAM 2090 01:33:16,375 --> 01:33:18,110 AND WE ALL NEED TO THINK OF HOW 2091 01:33:18,110 --> 01:33:18,910 TO DO BETTER. 2092 01:33:18,910 --> 01:33:22,581 I WANTED TO SHOW YOU THREE OR 2093 01:33:22,581 --> 01:33:23,682 FOUR EXAMPLES. 2094 01:33:23,682 --> 01:33:25,684 EXAMPLES OF COLLABORATION. 2095 01:33:25,684 --> 01:33:28,487 THIS IS ON THE LEFT A TRAINEE OF 2096 01:33:28,487 --> 01:33:31,657 MINE FOR ABOUT 10 YEARS AN NOW A 2097 01:33:31,657 --> 01:33:34,826 LEADING AUTHORITY ON RESEARCH ON 2098 01:33:34,826 --> 01:33:36,361 OBESITY AND HEART FAILURE 2099 01:33:36,361 --> 01:33:37,896 WORKING ONE THE AMERICAN HEART 2100 01:33:37,896 --> 01:33:38,964 ASSOCIATION LEADING THE CENTER 2101 01:33:38,964 --> 01:33:40,699 AND A POST-DOCTORAL RESEARCH 2102 01:33:40,699 --> 01:33:42,567 FELLOW ABOUT TO START A 2103 01:33:42,567 --> 01:33:46,171 RESIDENCY AND THIS IS HER 2104 01:33:46,171 --> 01:33:46,505 PROJECT. 2105 01:33:46,505 --> 01:33:49,107 IT ADDRESSES THE ISSUE OF THE 2106 01:33:49,107 --> 01:33:51,510 PROTEOMIC ALTERATIONS IN OBESITY 2107 01:33:51,510 --> 01:33:53,111 AND WE FIND OBESE INDIVIDUALS 2108 01:33:53,111 --> 01:33:56,815 HAVE ALTERATIONS AT THE 2109 01:33:56,815 --> 01:33:58,050 SIGNIFICANCE LEVEL OF 700 2110 01:33:58,050 --> 01:33:58,317 PROTEINS. 2111 01:33:58,317 --> 01:33:59,885 WE HAVE THE CHALLENGE OF HOW DO 2112 01:33:59,885 --> 01:34:00,919 YOU INTEGRATE THAT. 2113 01:34:00,919 --> 01:34:04,089 WE WANTED TO LOOK AT HEART 2114 01:34:04,089 --> 01:34:05,590 FAILURE AND SHE FOUND 19 OF 2115 01:34:05,590 --> 01:34:07,459 THESE PROTEINS RELATED TO HEART 2116 01:34:07,459 --> 01:34:08,327 VEIL YOU'RE RISK. 2117 01:34:08,327 --> 01:34:12,564 IF YOU LOOK ON THE RIGHT, YOU 2118 01:34:12,564 --> 01:34:15,701 SEE THE CONCORDANCE ON THE X 2119 01:34:15,701 --> 01:34:16,735 AXIS THE ASSOCIATION WITH 2120 01:34:16,735 --> 01:34:20,138 OBESITY AND ON THE RIGHT THE 2121 01:34:20,138 --> 01:34:21,773 ASSOCIATION WITH HEART FAILURE 2122 01:34:21,773 --> 01:34:23,041 AND THERE'S A CORRELATION. 2123 01:34:23,041 --> 01:34:24,176 NOT PERFECT BUT THING IN RED 2124 01:34:24,176 --> 01:34:25,844 HAVE AN INCREASED LEVEL IN 2125 01:34:25,844 --> 01:34:28,947 OBESITY AND INCREASED LEVEL FOR 2126 01:34:28,947 --> 01:34:31,550 RISK OF HEART FAILURE 10 YEARS 2127 01:34:31,550 --> 01:34:32,751 OR MORE LATER. 2128 01:34:32,751 --> 01:34:34,519 IN BLUE HAVE LOWER LEVELS IN 2129 01:34:34,519 --> 01:34:37,422 OBESITY AND ARE ACTUALLY 2130 01:34:37,422 --> 01:34:38,724 ASSOCIATED WITH A LOWER RISK OF 2131 01:34:38,724 --> 01:34:40,525 HEART FAILURE. 2132 01:34:40,525 --> 01:34:45,197 OVER ALL IT ESTIMATED 72% OF OF 2133 01:34:45,197 --> 01:34:48,200 THE EXCESS HEART FAILURE RISK 2134 01:34:48,200 --> 01:34:50,135 MAY BE EXPLAINED BY THE PROTEOME 2135 01:34:50,135 --> 01:34:51,303 WE'RE MEASURING. 2136 01:34:51,303 --> 01:34:52,270 EXCITING AND INTERESTING AND 2137 01:34:52,270 --> 01:34:53,839 THEN WE HAVE TO TAKE NEXT STEPS 2138 01:34:53,839 --> 01:34:58,243 HOW THAT WOULD CHANGE OUR 2139 01:34:58,243 --> 01:35:00,679 UNDERSTANDING OF BIOLOGY AND 2140 01:35:00,679 --> 01:35:02,214 MOVE TO EXPERIMENTAL SYSTEMS AND 2141 01:35:02,214 --> 01:35:03,348 THINK OF POTENTIAL THERAPEUTICS. 2142 01:35:03,348 --> 01:35:06,017 I WANTED TO TALK ABOUT KIDNEY 2143 01:35:06,017 --> 01:35:06,251 DISEASE. 2144 01:35:06,251 --> 01:35:08,053 IT'S BEEN MY PERSONAL PASSION TO 2145 01:35:08,053 --> 01:35:10,756 LOOK AT KIDNEY DISEASE AND 2146 01:35:10,756 --> 01:35:14,259 KIDNEY FAILURE AND END STAGE 2147 01:35:14,259 --> 01:35:15,494 RENAL DISEASE REQUIRING DIALYSIS 2148 01:35:15,494 --> 01:35:23,168 OR TRANSPLANTATION HAS BEEN AN 2149 01:35:23,168 --> 01:35:26,171 EPIDEMIC AND RATES UNACCEPTABLY 2150 01:35:26,171 --> 01:35:26,805 HIGH IN THE UNITED STATES AND 2151 01:35:26,805 --> 01:35:28,006 OTHER COUNTRIES. 2152 01:35:28,006 --> 01:35:29,107 WE'VE COME TO APPRECIATE ABOUT 2153 01:35:29,107 --> 01:35:31,510 10% OF PEOPLE IN THE U.S. HAVE 2154 01:35:31,510 --> 01:35:32,778 CHRONIC KIDNEY DISEASE. 2155 01:35:32,778 --> 01:35:34,579 WE TOOK THE ARIC DATA AND 2156 01:35:34,579 --> 01:35:37,315 LEARNED METHODS FROM GENOME-WIDE 2157 01:35:37,315 --> 01:35:41,286 ASSOCIATION STUDIES OF HOW TO 2158 01:35:41,286 --> 01:35:45,924 LEVERAGE THAT INTO A CKV 2159 01:35:45,924 --> 01:35:47,859 PROGNOSIS CONSORTIUM. 2160 01:35:47,859 --> 01:35:50,128 A CO-P.I. OF THE INITIATIVE IS 2161 01:35:50,128 --> 01:35:53,331 DIRECTOR OF PRECISION MEDICINE 2162 01:35:53,331 --> 01:35:54,299 AT NYU. 2163 01:35:54,299 --> 01:35:55,934 YOU CAN SEE THE CONSORTIUM HAS 2164 01:35:55,934 --> 01:35:56,301 GROWN. 2165 01:35:56,301 --> 01:35:58,336 WE'RE NOW ON RENEWAL. 2166 01:35:58,336 --> 01:36:08,880 WE HAVE 170 COHORT, 38 MILLION 2167 01:36:09,948 --> 01:36:16,788 AND THERE'S GEISINGER AND YOU 2168 01:36:16,788 --> 01:36:17,355 CAN SEE INFORMATION AT THE 2169 01:36:17,355 --> 01:36:23,462 WEBSITE. 2170 01:36:23,462 --> 01:36:25,130 WE TRIED TO CONTRIBUTE DATA TO 2171 01:36:25,130 --> 01:36:27,833 GUIDELINES AND THE HEAT MAP WITH 2172 01:36:27,833 --> 01:36:30,769 HIGHER RISK AND LOWER GFR AND 2173 01:36:30,769 --> 01:36:33,038 YOU SEE ON THE RIGHT INDICATED 2174 01:36:33,038 --> 01:36:36,141 BY MORE COLOR THAT'S RED AND 2175 01:36:36,141 --> 01:36:37,309 SUGGESTING THAT PATIENTS SHOULD 2176 01:36:37,309 --> 01:36:39,110 BE SEEN MORE OFTEN AT HIGH RISK 2177 01:36:39,110 --> 01:36:42,714 SAY CONCEPT WE HELPED DERIVE 2178 01:36:42,714 --> 01:36:45,817 BASED ON DATA IN 2009 TO 2013. 2179 01:36:45,817 --> 01:36:56,294 WE JUST RE-EXAMINED THIS IN 2180 01:37:05,937 --> 01:37:07,105 CREATININE AND IT WAS CONFIRMED 2181 01:37:07,105 --> 01:37:08,573 ACROSS OUTCOME AND THIS PAPER 2182 01:37:08,573 --> 01:37:11,877 SHOULD BE COMING OUT SHORTLY. 2183 01:37:11,877 --> 01:37:14,446 AND IT CITED IN THE GUIDELINES 2184 01:37:14,446 --> 01:37:16,882 WHICH HAVE BEEN FOR PUBLIC 2185 01:37:16,882 --> 01:37:22,387 COMMENT AND FILED IN 2024. 2186 01:37:22,387 --> 01:37:24,089 SO HOW DO YOU INDIVIDUALIZE 2187 01:37:24,089 --> 01:37:24,289 THIS? 2188 01:37:24,289 --> 01:37:26,157 SO THE HEAT MAP CONCEPT IS THE 2189 01:37:26,157 --> 01:37:29,895 WAY WE THINK OF RISK FACTORS. 2190 01:37:29,895 --> 01:37:33,532 LOWER GFR, HIGHER RISK. 2191 01:37:33,532 --> 01:37:35,734 TO INDIVIDUAL YOU NEED A RISK 2192 01:37:35,734 --> 01:37:37,402 SCORE WITH MORE VARIABLES. 2193 01:37:37,402 --> 01:37:40,906 SO WE'VE NOW PUBLISHED MORE THAN 2194 01:37:40,906 --> 01:37:42,374 HALF A DOZEN DIFFERENT RISK 2195 01:37:42,374 --> 01:37:42,774 SCORES. 2196 01:37:42,774 --> 01:37:45,977 GO TO ARE CDPK RISK TO LOOK AT 2197 01:37:45,977 --> 01:37:47,379 THEM AND MORE IMPORTANT THAN 2198 01:37:47,379 --> 01:37:51,583 KIDNEY DISEASE ITSELF IS THE 2199 01:37:51,583 --> 01:37:52,050 CONCEPT. 2200 01:37:52,050 --> 01:37:54,352 PEOPLE ARE DEVELOPING A.I., 2201 01:37:54,352 --> 01:37:58,690 MACHINE LEARNING RISK SCORES AND 2202 01:37:58,690 --> 01:38:01,293 THEY'LL INDIVIDUALIZE AND WE 2203 01:38:01,293 --> 01:38:02,527 TESTED AND DEVELOPED THEM IN 2204 01:38:02,527 --> 01:38:06,398 DOZENS OF COHORTS AND VALIDATED 2205 01:38:06,398 --> 01:38:08,767 IT IN DOZENS OF COHORTS. 2206 01:38:08,767 --> 01:38:10,468 WE LEARNED IT'S IMPORTANT TO 2207 01:38:10,468 --> 01:38:12,170 TARGET THE POPULATION. 2208 01:38:12,170 --> 01:38:16,207 EACH RISK SCORE THE ARROW STARTS 2209 01:38:16,207 --> 01:38:17,175 IN A DIFFERENT PLACE. 2210 01:38:17,175 --> 01:38:19,711 YOU CAN LOOK AT THE RISK OF 2211 01:38:19,711 --> 01:38:21,680 KIDNEY FAILURE AND DONORS. 2212 01:38:21,680 --> 01:38:23,148 THEY'RE HEALTHY ON AVERAGE AGE 2213 01:38:23,148 --> 01:38:23,381 40. 2214 01:38:23,381 --> 01:38:27,252 YOU NEED TO LOOK AT ESTIMATING A 2215 01:38:27,252 --> 01:38:29,254 30 TO 40 YEAR RISK IN HEALTHY 2216 01:38:29,254 --> 01:38:31,790 PEOPLE THAT'S VERY LOW BECAUSE 2217 01:38:31,790 --> 01:38:32,991 DONORS SHOULDN'T HAVE A HIGH 2218 01:38:32,991 --> 01:38:35,226 RISK AND THE EQUATION IS FOR 2219 01:38:35,226 --> 01:38:36,995 PATIENTS WHO ALREADY HAVE KIDNEY 2220 01:38:36,995 --> 01:38:38,863 DISEASE AND KNOWING THE RISK OF 2221 01:38:38,863 --> 01:38:42,233 GETTING KIDNEY FAILURE AND 2222 01:38:42,233 --> 01:38:43,902 DIALYSIS VERY DIFFERENT. 2223 01:38:43,902 --> 01:38:45,337 WE ALSO UNDERSTAND THAT IN 2224 01:38:45,337 --> 01:38:48,306 DIFFERENT SETTINGS THERE'S 2225 01:38:48,306 --> 01:38:49,240 UNEXPLAINED RISK THAT'S QUITE 2226 01:38:49,240 --> 01:38:50,208 SIGNIFICANT AND WE NEED TO 2227 01:38:50,208 --> 01:38:51,376 UNDERSTAND THAT. 2228 01:38:51,376 --> 01:38:54,212 SO THE TIME HORIZON AND OUTCOME 2229 01:38:54,212 --> 01:38:55,780 AND THRESHOLD AND IMPORTANTLY 2230 01:38:55,780 --> 01:38:59,784 THE DECISIONS YOU NEED TO MAKE. 2231 01:38:59,784 --> 01:39:01,620 SO WHETHER OR NOT YOU DECIDE TO 2232 01:39:01,620 --> 01:39:03,054 START SOMEBODY ON A 2233 01:39:03,054 --> 01:39:04,089 MULTI-SPECIALTY CLINIC WHETHER 2234 01:39:04,089 --> 01:39:06,057 OR NOT YOU HAVE HIGH RISK OF 2235 01:39:06,057 --> 01:39:14,065 BREAST CANCER AND DECIDE TO DO 2236 01:39:14,065 --> 01:39:24,609 AAS EXTREME AS SURGERY TO REMOVE 2237 01:39:31,583 --> 01:39:33,251 THE BREAST AND SOME THOUGHT HOW 2238 01:39:33,251 --> 01:39:34,686 TO USE THE ALGORITHMS BROADLY 2239 01:39:34,686 --> 01:39:36,755 AND SPECIFICALLY AND WE LEARNED 2240 01:39:36,755 --> 01:39:39,391 IN NEW ARTICLES IF WE REALLY 2241 01:39:39,391 --> 01:39:42,394 WANT TO DO A FULL BENEFITS 2242 01:39:42,394 --> 01:39:43,428 ANALYSIS WE DON'T HAVE ENOUGH 2243 01:39:43,428 --> 01:39:48,800 DATA FOR THAT. 2244 01:39:48,800 --> 01:39:50,468 FINALLY I WANT TO TALK ABOUT 2245 01:39:50,468 --> 01:39:52,070 COGNITIVE DECLINE IN THE LAST 2246 01:39:52,070 --> 01:39:53,438 COUPLE EXAMPLES. 2247 01:39:53,438 --> 01:39:57,642 A THREAT TO AN AGING PLANET. 2248 01:39:57,642 --> 01:39:59,177 ALZHEIMER'S DISEASE AND VASCULAR 2249 01:39:59,177 --> 01:39:59,444 DEMENTIA. 2250 01:39:59,444 --> 01:40:01,179 ARE THEY COMPLETELY DIFFERENT? 2251 01:40:01,179 --> 01:40:06,718 WE THINK OF ALZHEIMER'S AS BEING 2252 01:40:06,718 --> 01:40:07,485 NON-PREVENTIBLE. 2253 01:40:07,485 --> 01:40:08,887 WE KNOW VASCULAR DISEASE IF WE 2254 01:40:08,887 --> 01:40:11,022 DID THE RIGHT THINGS MORE THAN 2255 01:40:11,022 --> 01:40:13,158 80% IS PREVENTIBLE AND WHAT 2256 01:40:13,158 --> 01:40:14,426 ABOUT DEMENTIA AND THE 2257 01:40:14,426 --> 01:40:14,726 CONNECTION. 2258 01:40:14,726 --> 01:40:16,628 IN STARTING TO DO THIS RESEARCH 2259 01:40:16,628 --> 01:40:19,197 WE WORKED WITH ALONZO AND 2260 01:40:19,197 --> 01:40:21,299 REALIZED THE VASCULAR RISK 2261 01:40:21,299 --> 01:40:23,468 FACTORS CONTRIBUTE SUBSTANTIALLY 2262 01:40:23,468 --> 01:40:26,471 TO THE RISK OF DEMENTIA BUT THE 2263 01:40:26,471 --> 01:40:27,138 ASSOCIATIONS WERE MEASURED AT 2264 01:40:27,138 --> 01:40:28,673 MID LIFE THAN OLDER AGE. 2265 01:40:28,673 --> 01:40:33,178 THIS IS COUNTER INTUITIVE. 2266 01:40:33,178 --> 01:40:36,347 IF YOU DEVELOP DEMENTIA AT 75 2267 01:40:36,347 --> 01:40:39,384 AND DIABETES GIVES A RISK OF 2268 01:40:39,384 --> 01:40:42,887 2.7, 25 YEARS LATER WHERE 2269 01:40:42,887 --> 01:40:46,091 DIABETES THAT DEVELOPS THAN 60 2270 01:40:46,091 --> 01:40:48,893 GIVES A LOWER AMOUNT OF RISK AND 2271 01:40:48,893 --> 01:40:50,328 SAME FOR HYPERTENSION. 2272 01:40:50,328 --> 01:40:54,332 WE NEED LONG FOLLOW TO 2273 01:40:54,332 --> 01:40:57,001 UNDERSTAND LIFE LONG DISEASE. 2274 01:40:57,001 --> 01:40:59,437 IT'S EXCITING TO HAVE A WEARABLE 2275 01:40:59,437 --> 01:41:02,273 BUT ANYTHING THAT CAN CHANGE IN 2276 01:41:02,273 --> 01:41:07,579 FIVE MINUTES HAS LIMIT TAKES FOR 2277 01:41:07,579 --> 01:41:10,682 PREDICTING -- LIMITATIONS FOR 2278 01:41:10,682 --> 01:41:16,020 PREDICTING HAS RISK DETERMINING 2279 01:41:16,020 --> 01:41:20,658 I'LL BECOME DEPARTMMENTED. 2280 01:41:20,658 --> 01:41:23,661 THIS SHOWS BRAIN AMYLOID IS 2281 01:41:23,661 --> 01:41:24,929 ASSOCIATED WITH MID LIFE 2282 01:41:24,929 --> 01:41:26,731 VASCULAR RISK FACTORS. 2283 01:41:26,731 --> 01:41:31,336 THIS SHOWS NOT ONLY IS 2284 01:41:31,336 --> 01:41:33,071 HYPERTENSION AND DIABETES 2285 01:41:33,071 --> 01:41:34,105 CONNECTED TO DEMENTIA IT CONNECT 2286 01:41:34,105 --> 01:41:37,909 TO THE AMYLOID DEPOSITION IN 2287 01:41:37,909 --> 01:41:39,344 ALZHEIMER'S DISEASE. 2288 01:41:39,344 --> 01:41:40,779 SUGGESTING THAT VASCULAR DISEASE 2289 01:41:40,779 --> 01:41:42,714 TREATMENT WOULD IMPROVE NOT JUST 2290 01:41:42,714 --> 01:41:45,583 VASCULAR DEMENTIA BUT ALSO THE 2291 01:41:45,583 --> 01:41:46,851 DEPOSITION AND POTENTIALLY 2292 01:41:46,851 --> 01:41:52,824 ALZHEIMER'S DISEASE DEMENTIA AS 2293 01:41:52,824 --> 01:41:53,024 WELL. 2294 01:41:53,024 --> 01:41:56,227 NEXT WE WANTED TO ADDRESS 2295 01:41:56,227 --> 01:41:57,629 HEARING AND THE HEARING LOSS IS 2296 01:41:57,629 --> 01:42:00,431 AMONG THE RISK FACTORS FOR 2297 01:42:00,431 --> 01:42:00,698 DEMENTIA. 2298 01:42:00,698 --> 01:42:05,303 NEXT SLIDE AND I ENDED UP 2299 01:42:05,303 --> 01:42:09,207 MEETING FRANK LYNN AT A SEMINAR 2300 01:42:09,207 --> 01:42:10,475 SHOWING HEARING LOSS IS PRESENT 2301 01:42:10,475 --> 01:42:12,277 IN THE MAJORITY OF OLDER ADULTS. 2302 01:42:12,277 --> 01:42:14,579 BY THE TIME YOU GET TO 70 IT'S 2303 01:42:14,579 --> 01:42:16,815 50% BY THE TIME YOU GET TO 90% 2304 01:42:16,815 --> 01:42:20,785 IT'S ALMOST 100%. 2305 01:42:20,785 --> 01:42:24,122 AND BASICALLY WE DID A CLINIC 2306 01:42:24,122 --> 01:42:26,491 TRIAL GOING FROM PILOT TO BEING 2307 01:42:26,491 --> 01:42:29,360 FUNDED TO RANDOMIZE 970 PEOPLE 2308 01:42:29,360 --> 01:42:32,363 RIGHT BEFORE COVID AND WE JUST 2309 01:42:32,363 --> 01:42:33,765 REPORTED THE ANSWER IS IN LANCET 2310 01:42:33,765 --> 01:42:34,966 THIS SUMMER. 2311 01:42:34,966 --> 01:42:35,934 INTERESTING RESULTS. 2312 01:42:35,934 --> 01:42:39,304 BASICALLY THE PRIMARY OUTCOME 2313 01:42:39,304 --> 01:42:41,539 SHOWED NO PROTECTION. 2314 01:42:41,539 --> 01:42:44,609 ON THE OTHER HAND IF YOU 2315 01:42:44,609 --> 01:42:46,444 STRATIFY BY PARTICIPANTS WE 2316 01:42:46,444 --> 01:42:47,846 SHOWED NO REDUCTION IN 2317 01:42:47,846 --> 01:42:50,315 SELF-SELECTED VOLUNTEERS. 2318 01:42:50,315 --> 01:42:52,383 ON THE OTHER HAND ON THE ARIC 2319 01:42:52,383 --> 01:42:53,585 COHORT YOU CAN SEE IF SOMEBODY 2320 01:42:53,585 --> 01:42:54,619 WAS IN THE COHORT AND WE 2321 01:42:54,619 --> 01:42:55,687 APPROACHED THEM AND SAID YOU 2322 01:42:55,687 --> 01:42:58,923 HAVE A HEARING LOSS, DO YOU WANT 2323 01:42:58,923 --> 01:43:00,158 A HEARING AID DEVICE? 2324 01:43:00,158 --> 01:43:05,463 WE GOT A 48% REDUCTION IN 2325 01:43:05,463 --> 01:43:05,864 COGNITIVE DECLINE. 2326 01:43:05,864 --> 01:43:07,532 THIS IS A WHOLE CHALLENGE. 2327 01:43:07,532 --> 01:43:08,766 CLINICAL TRIALS ARE THE BEST BUT 2328 01:43:08,766 --> 01:43:10,969 IF YOU RELY ON VOLUNTEERS, WHICH 2329 01:43:10,969 --> 01:43:12,604 YOU MUST, VOLUNTEERS WILL RUN TO 2330 01:43:12,604 --> 01:43:16,007 YOU SAYING I'M AFRAID OF GETTING 2331 01:43:16,007 --> 01:43:16,541 DEMENTIA OFTEN DON'T GET 2332 01:43:16,541 --> 01:43:18,476 DEMENTIA. 2333 01:43:18,476 --> 01:43:20,511 IT'S A REAL ISSUE. 2334 01:43:20,511 --> 01:43:22,247 THIS IS ONLY OVER THREE YEARS. 2335 01:43:22,247 --> 01:43:24,816 WE'VE BEEN FUNDED TO DO EXTENDED 2336 01:43:24,816 --> 01:43:27,518 FOLLOW AND DEMENTIA IS A 50 YEAR 2337 01:43:27,518 --> 01:43:29,153 PROCESS BUT WE CAN'T WAIT SO 2338 01:43:29,153 --> 01:43:33,691 THIS IS COGNITIVE DECLINE AND 2339 01:43:33,691 --> 01:43:34,993 NEED TO UNDERSTAND SURROGATE 2340 01:43:34,993 --> 01:43:36,861 OUTCOMES AND PROTEOMES AND OTHER 2341 01:43:36,861 --> 01:43:41,065 PEOPLE SHOWING BRAIN IMAGES ARE 2342 01:43:41,065 --> 01:43:41,432 PROMISING. 2343 01:43:41,432 --> 01:43:44,269 OVER ALL I WANTED TO REMIND US 2344 01:43:44,269 --> 01:43:47,205 THAT THE AMERICAN HEART 2345 01:43:47,205 --> 01:43:48,373 ASSOCIATION'S LIFE ESSENTIAL 2346 01:43:48,373 --> 01:43:50,675 EIGHT IF YOU CLICK REALLY TELLS 2347 01:43:50,675 --> 01:43:57,815 US THAT IF YOU ANIMATE THE CLICK 2348 01:43:57,815 --> 01:43:59,284 THAT WE KNOW WHAT TO DO. 2349 01:43:59,284 --> 01:44:00,952 WE WANT TO SAY -- CAN YOU 2350 01:44:00,952 --> 01:44:02,687 ANIMATE THE CLICK? 2351 01:44:02,687 --> 01:44:03,855 WE KNOW WHAT TO DO. 2352 01:44:03,855 --> 01:44:06,357 I THINK ALL OF US WANT TO SAY, 2353 01:44:06,357 --> 01:44:10,595 OH, WELL, WHAT WILL MAKE US 2354 01:44:10,595 --> 01:44:10,828 HEALTHY? 2355 01:44:10,828 --> 01:44:17,502 THE TRUTH IS EATING HEALTHY, 2356 01:44:17,502 --> 01:44:19,137 FITNESS, NOT SMOKING IS HUGE AND 2357 01:44:19,137 --> 01:44:19,637 SLEEPING WELL. 2358 01:44:19,637 --> 01:44:22,674 HOW WE ACHIEVE THAT IS HARD. 2359 01:44:22,674 --> 01:44:25,476 SO HOW WE GET THIS DONE, 2360 01:44:25,476 --> 01:44:27,178 BEHAVIOR CHANGE, PEOPLE I THINK 2361 01:44:27,178 --> 01:44:33,151 ARE THE FINAL FRONTIER OF A LOT 2362 01:44:33,151 --> 01:44:34,886 OF DISEASE BECAUSE A LOT OF 2363 01:44:34,886 --> 01:44:37,288 CHRONIC DISEASE IS BEHAVIORALLY 2364 01:44:37,288 --> 01:44:37,622 ORIENTED. 2365 01:44:37,622 --> 01:44:39,590 THE BIG DATA PROMISE IS HUGELY 2366 01:44:39,590 --> 01:44:42,360 PROMISING FOR UNDERSTANDING 2367 01:44:42,360 --> 01:44:43,094 MECHANISMS AND FOR ME BIO 2368 01:44:43,094 --> 01:44:44,796 MEDICAL INTERVENTION. 2369 01:44:44,796 --> 01:44:47,098 SO ONCE I GET FAR ENOUGH ALONG 2370 01:44:47,098 --> 01:44:49,734 AND I GET A HEART ATTACK THEN I 2371 01:44:49,734 --> 01:44:51,402 NEED DIFFERENT TREATMENT. 2372 01:44:51,402 --> 01:44:52,704 IF I HAVE CANCER, TELLING ME TO 2373 01:44:52,704 --> 01:44:53,771 EAT WELL IS NOT GOING TO BE 2374 01:44:53,771 --> 01:44:56,107 ENOUGH AND WE NEED TO KNOW WHAT 2375 01:44:56,107 --> 01:44:57,342 CANCER, WHAT THERAPY. 2376 01:44:57,342 --> 01:45:01,446 THE SAME THING WITH OTHER 2377 01:45:01,446 --> 01:45:02,513 INFECTIONS AND OTHER CAUSE. 2378 01:45:02,513 --> 01:45:04,782 LAST SLIDE, I WANTED TO THANK 2379 01:45:04,782 --> 01:45:06,317 ALL THE PEOPLE INVOLVED IN THIS 2380 01:45:06,317 --> 01:45:09,420 AND BASICALLY I THINK THERE'S A 2381 01:45:09,420 --> 01:45:10,722 CLICK ANIMATION TOO. 2382 01:45:10,722 --> 01:45:12,290 THE PARTICIPANTS AND 2383 01:45:12,290 --> 01:45:13,257 COLLABORATORS AND STAFF. 2384 01:45:13,257 --> 01:45:15,393 THIS A TEAM SCIENCE ON THE LEFT 2385 01:45:15,393 --> 01:45:18,096 IS OUR DATA COLLECTION TEAM ON 2386 01:45:18,096 --> 01:45:19,130 HALLOWEEN AND YOU KNOW THEY'RE 2387 01:45:19,130 --> 01:45:22,233 GOOD WHEN I SHOWED UP AND GOT A 2388 01:45:22,233 --> 01:45:24,535 COSTUME AND IN THE MIDDLE ARE 2389 01:45:24,535 --> 01:45:25,169 RESEARCHERS INCLUDING MANY 2390 01:45:25,169 --> 01:45:26,571 JUNIOR INVESTIGATORS PRODUCING 2391 01:45:26,571 --> 01:45:34,212 SOME OF THE BEST SCIENCE IN THE 2392 01:45:34,212 --> 01:45:40,084 CARDIOLOGY CONSORTIUM. 2393 01:45:40,084 --> 01:45:41,052 >> THAT WAS WONDERFUL. 2394 01:45:41,052 --> 01:45:42,186 WE HAVE A COUPLE QUESTIONS 2395 01:45:42,186 --> 01:45:44,288 BEFORE WE DIVE IN WE'RE GOING TO 2396 01:45:44,288 --> 01:45:45,757 SHARE THE RESULTS FROM THE FIRST 2397 01:45:45,757 --> 01:45:55,867 POLL. 2398 01:46:24,328 --> 01:46:29,434 >> I THINK IT'S A WONDERFULLY 2399 01:46:29,434 --> 01:46:30,101 INSIGHTFUL PICK UP ON AN ISSUE 2400 01:46:30,101 --> 01:46:31,402 THAT OBSESSES ME. 2401 01:46:31,402 --> 01:46:33,638 PEOPLE IN THIS COUNTRY ARE 2402 01:46:33,638 --> 01:46:35,573 EXPERIENCING FATIGUE. 2403 01:46:35,573 --> 01:46:37,508 WE HAVE TOO MANY PEOPLE AFTER 2404 01:46:37,508 --> 01:46:38,543 US. 2405 01:46:38,543 --> 01:46:40,244 WE CAN NO LONGER GET 95% OF 2406 01:46:40,244 --> 01:46:43,381 PEOPLE TO COME TO CLINIC. 2407 01:46:43,381 --> 01:46:45,983 WHAT WE HAVE TO DO IS PROVIDE 2408 01:46:45,983 --> 01:46:48,853 VALUE TO PEOPLE AND USE MULTIPLE 2409 01:46:48,853 --> 01:46:49,687 LAYERS OF FOLLOW-UP. 2410 01:46:49,687 --> 01:46:52,290 I THINK WE DO IT IN ARIC. 2411 01:46:52,290 --> 01:46:56,127 I'M SURE ALL OF US DO IT AS WELL 2412 01:46:56,127 --> 01:46:57,795 AS AND MILLION VETERANS IS PART 2413 01:46:57,795 --> 01:46:59,263 OF THE SYSTEM. 2414 01:46:59,263 --> 01:47:01,699 IF WE CAN COMBINE PASSIVELY 2415 01:47:01,699 --> 01:47:05,670 SYMPTOMS THAT CAPTURE EVERYBODY 2416 01:47:05,670 --> 01:47:10,308 LIKE THE DEATH INDEX YOU CAN'T 2417 01:47:10,308 --> 01:47:11,542 DIE WITHOUT THE U.S. KNOWING AND 2418 01:47:11,542 --> 01:47:13,077 WE CALL PEOPLE AND ACCEPT THE 2419 01:47:13,077 --> 01:47:16,747 FACT THAT CLINIC VISITS ARE 2420 01:47:16,747 --> 01:47:18,416 ACTUALLY HARDER TO GET. 2421 01:47:18,416 --> 01:47:20,585 I JUST ANSWERED THE POLL. 2422 01:47:20,585 --> 01:47:21,919 I GUESS I'M SENIOR FACULTY. 2423 01:47:21,919 --> 01:47:32,296 EVERYBODY ELSE ANSWER? 2424 01:47:37,235 --> 01:47:40,671 THERE'S A QUESTION WHETHER THE 2425 01:47:40,671 --> 01:47:48,579 AGE OF THE PEOPLE STRATIFIED BY 2426 01:47:48,579 --> 01:47:54,652 DISEASE ONSET OR AND WHETHER 2427 01:47:54,652 --> 01:47:56,921 IT'S LIFE TIME FOR TIME FOR 2428 01:47:56,921 --> 01:47:57,188 INCIDENT. 2429 01:47:57,188 --> 01:47:57,955 >> THIS IS STRATIFIED AT AGE AT 2430 01:47:57,955 --> 01:48:05,429 BASELINE. 2431 01:48:05,429 --> 01:48:06,964 >> THIS WAS STRATIFIED AT THE 2432 01:48:06,964 --> 01:48:08,132 AGE OF BASELINE AND WITHIN THE 2433 01:48:08,132 --> 01:48:12,236 BASELINE WE HAVE A 20-YEAR SPAN 2434 01:48:12,236 --> 01:48:16,207 IN ARIC TO DIVIDE PEOPLE. 2435 01:48:16,207 --> 01:48:17,175 IT'S FORESHADOWING OF OUR WORK. 2436 01:48:17,175 --> 01:48:20,478 NOW WE HAVE 30 YEARS OF 2437 01:48:20,478 --> 01:48:20,745 FOLLOW-UP. 2438 01:48:20,745 --> 01:48:22,747 USING SENSORING WE CAN DO LIFE 2439 01:48:22,747 --> 01:48:24,916 TIME RISK AND WE'RE WORKING ON 2440 01:48:24,916 --> 01:48:26,484 THAT AND I THINK IT'S 2441 01:48:26,484 --> 01:48:27,418 FASCINATING HOW COMPLICATED 2442 01:48:27,418 --> 01:48:28,553 THINGS ARE. 2443 01:48:28,553 --> 01:48:29,854 FOR EXAMPLE, FOR DIABETES WE 2444 01:48:29,854 --> 01:48:34,292 TRIED TO PUBLIC THERE'S RISK 2445 01:48:34,292 --> 01:48:35,693 WITH PRE-DIABETES AND MOST THE 2446 01:48:35,693 --> 01:48:40,464 RISK IS MEDIATED FROM MOVING 2447 01:48:40,464 --> 01:48:41,866 FROM PRE-DIABETES TO DIABETES 2448 01:48:41,866 --> 01:48:44,835 AND IT'S IMPORTANT AND IF YOU 2449 01:48:44,835 --> 01:48:47,805 CAN DELAY DIABETES, EARLY ONSET 2450 01:48:47,805 --> 01:48:51,209 DIABETES IS A HUGE RISK AND 2451 01:48:51,209 --> 01:48:53,644 LATER ONSET DIABETES IS A LOWER 2452 01:48:53,644 --> 01:48:53,878 RISK. 2453 01:48:53,878 --> 01:48:55,680 WITH DEMENTIA MOST OF THAT IS 2454 01:48:55,680 --> 01:48:55,980 LAY. 2455 01:48:55,980 --> 01:48:56,914 NOT MANY CASES FOR US TO LOOK 2456 01:48:56,914 --> 01:48:57,882 AT. 2457 01:48:57,882 --> 01:49:08,059 THANK YOU. 2458 01:49:12,463 --> 01:49:14,298 >> WITH HAVE ONE MORE POLL 2459 01:49:14,298 --> 01:49:15,533 LAUNCHED SO THAT WILL HELP US 2460 01:49:15,533 --> 01:49:17,235 AND THANK YOU CORESH FOR THE 2461 01:49:17,235 --> 01:49:17,802 FANTASTIC TALK. 2462 01:49:17,802 --> 01:49:20,371 AND WE WILL MOVE ON TO THE LAST 2463 01:49:20,371 --> 01:49:23,074 SPEAKER OF THIS SESSION, WHO IS 2464 01:49:23,074 --> 01:49:26,377 DR. PSATY AND HE WILL BE TALKING 2465 01:49:26,377 --> 01:49:28,279 ABOUT THE ORIGINS AND STRUCTURE 2466 01:49:28,279 --> 01:49:30,414 OF THE COHORTS FOR HEART AND 2467 01:49:30,414 --> 01:49:33,317 AGING RESEARCH IN GENOMIC 2468 01:49:33,317 --> 01:49:33,884 EPIDEMIOLOGY OR THE CHARGE 2469 01:49:33,884 --> 01:49:37,888 CONSORTIUM. 2470 01:49:37,888 --> 01:49:40,324 DR. PSATY IS A PROFESSOR AT THE 2471 01:49:40,324 --> 01:49:41,525 UNIVERSITY OF WASHINGTON AND 2472 01:49:41,525 --> 01:49:43,628 EXPERT IN MEDICINE, EPIDEMIOLOGY 2473 01:49:43,628 --> 01:49:45,896 AND HEALTH SYSTEMS. 2474 01:49:45,896 --> 01:49:48,199 AND ALSO CO-DIRECT THE 2475 01:49:48,199 --> 01:49:50,067 CARDIOVASCULAR HEALTH RESEARCH 2476 01:49:50,067 --> 01:49:50,268 UNIT. 2477 01:49:50,268 --> 01:49:54,138 HE EARNED HIS Ph.D. FROM INDIANA 2478 01:49:54,138 --> 01:49:59,143 AND M Ph.D FROM UW AND 2479 01:49:59,143 --> 01:50:00,111 EPIDEMIOLOGY HE'S CONTRIBUTED TO 2480 01:50:00,111 --> 01:50:04,148 MULTIPLE NIH FUNDED STUDIES 2481 01:50:04,148 --> 01:50:04,815 INCLUDING THE ADVISORY COMMITTEE 2482 01:50:04,815 --> 01:50:08,319 HEALTH STUDY AND CHAMPIONS 2483 01:50:08,319 --> 01:50:09,820 INNOVATIVE DATA METHODS AND MULT 2484 01:50:09,820 --> 01:50:13,357 STUDY COLLABORATIONS AND FOUNDED 2485 01:50:13,357 --> 01:50:15,559 THE CHARGE CONSORTIUM TO ADVANCE 2486 01:50:15,559 --> 01:50:17,028 RESEARCH IN GENOMIC 2487 01:50:17,028 --> 01:50:17,361 EPIDEMIOLOGY. 2488 01:50:17,361 --> 01:50:27,905 WITH THAT, PLEASE TAKE IT AWAY. 2489 01:50:38,783 --> 01:50:41,786 >> THANKS FOR THE INTRODUCTION 2490 01:50:41,786 --> 01:50:48,059 AND UP INVITATION. 2491 01:50:48,059 --> 01:50:48,826 OTHER STUDIES WERE INVOLVED 2492 01:50:48,826 --> 01:50:52,563 INCLUDING ARIC AND FRAMING HACK 2493 01:50:52,563 --> 01:50:55,299 AND RODDERDAM AND OTHERS AND 2494 01:50:55,299 --> 01:50:58,436 I'LL FOCUS ON THE STRUCTURE OF 2495 01:50:58,436 --> 01:51:02,907 THE CHARGE CONSORTIUM. 2496 01:51:02,907 --> 01:51:04,909 THIS TALK WILL BE DEVOID OF 2497 01:51:04,909 --> 01:51:05,376 GENETIC DATA. 2498 01:51:05,376 --> 01:51:08,946 YOU WON'T SEE A SINGLE ODDS 2499 01:51:08,946 --> 01:51:09,847 RATIO IN THE STUDY. 2500 01:51:09,847 --> 01:51:13,918 I WANT TO DEFINE A STUDY AS 2501 01:51:13,918 --> 01:51:15,820 PARTICIPANTS AND INVESTIGATORS 2502 01:51:15,820 --> 01:51:19,223 AND JOE'S LAST SLIDE WAS A GOOD 2503 01:51:19,223 --> 01:51:19,557 ILLUSTRATION. 2504 01:51:19,557 --> 01:51:22,560 THERE WERE FIELD CENTER STAFF, 2505 01:51:22,560 --> 01:51:26,230 THERE ARE COLLABORATORS LOCALLY 2506 01:51:26,230 --> 01:51:27,365 AND COLLABORATORS 2507 01:51:27,365 --> 01:51:28,733 INTERNATIONALLY. 2508 01:51:28,733 --> 01:51:33,871 A STUDY REALLY INCLUDES ALL OF 2509 01:51:33,871 --> 01:51:35,506 THOSE TOGETHER. 2510 01:51:35,506 --> 01:51:36,674 A LOT OF THE INTEREST HAS BEEN 2511 01:51:36,674 --> 01:51:39,443 IN AN IN THIS CONFERENCE IN DATA 2512 01:51:39,443 --> 01:51:42,012 SHARING AND THE NIH HAS DATA 2513 01:51:42,012 --> 01:51:43,981 SHARING METHODS THAT PROVIDE 2514 01:51:43,981 --> 01:51:49,954 DATA OPENLY TO PEOPLE. 2515 01:51:49,954 --> 01:51:54,558 THE BIO LINK AND GB GAP PEOPLE 2516 01:51:54,558 --> 01:52:05,102 CAN GO TO THE DATA AND GRAZE. 2517 01:52:05,102 --> 01:52:09,206 WE SUPPORT THAT AND PUBLICLY 2518 01:52:09,206 --> 01:52:11,342 FUNDED DATA OUGHT TO BE PUBLICLY 2519 01:52:11,342 --> 01:52:15,379 AVAILABLE AND CONTRAST THAT WITH 2520 01:52:15,379 --> 01:52:17,181 CHS AND CHARGE AND THAT'S ACCESS 2521 01:52:17,181 --> 01:52:18,749 AND WHAT I'LL DESCRIBE TODAY IN 2522 01:52:18,749 --> 01:52:20,284 PART AND THE GOALS AREN'T JUST 2523 01:52:20,284 --> 01:52:23,154 OF MAKING DATA AVAILABLE IT'S 2524 01:52:23,154 --> 01:52:26,357 PRODUCING HIGH-QUALITY WORK. 2525 01:52:26,357 --> 01:52:28,793 IT'S HIGH LEVELS OF PRODUCTIVITY 2526 01:52:28,793 --> 01:52:29,393 AND TRAINING OF EARLY CAREER 2527 01:52:29,393 --> 01:52:35,433 INVESTIGATORS. 2528 01:52:35,433 --> 01:52:36,734 CHS IS LIKE FRAMINGHAM. 2529 01:52:36,734 --> 01:52:47,077 IT'S A COHORT STUDY. 2530 01:52:52,283 --> 01:53:02,760 WE HAVE 5,588 OLDER ADULTS FOR 2531 01:53:03,093 --> 01:53:06,497 STROKE AND CARDIOVASCULAR 2532 01:53:06,497 --> 01:53:07,932 DISEASE AND THERE WERE SUB 2533 01:53:07,932 --> 01:53:12,970 CLINICAL DISEASE MEASURES AND 2534 01:53:12,970 --> 01:53:14,538 ADVANCED FOLLOW-UP. 2535 01:53:14,538 --> 01:53:17,942 THIS IS A BRIEF SUMMARY OF THE 2536 01:53:17,942 --> 01:53:18,209 MEASURES. 2537 01:53:18,209 --> 01:53:23,113 CAROTID ULTRASOUND, ECHO 2538 01:53:23,113 --> 01:53:25,683 CRANIOLOGY AND MRI AND RETINAL 2539 01:53:25,683 --> 01:53:27,117 PHOTOGRAPHY. 2540 01:53:27,117 --> 01:53:30,020 THIS LOOKS LIKE A LOT LIKE THE 2541 01:53:30,020 --> 01:53:32,490 EXAMINE SCHEDULE THAT WE SAW IN 2542 01:53:32,490 --> 01:53:33,958 ARIC. 2543 01:53:33,958 --> 01:53:35,459 ADDITIONALLY, EVENTS HAVE BEEN 2544 01:53:35,459 --> 01:53:37,528 COLLECTED AND THERE'S BEEN MANY 2545 01:53:37,528 --> 01:53:40,564 MANY ANCILLARY STUDIES THAT 2546 01:53:40,564 --> 01:53:41,732 INCLUDED COGNITIVE FUNCTION, 2547 01:53:41,732 --> 01:53:48,305 OMICS DATA, GENETICS AND FORTH. 2548 01:53:48,305 --> 01:53:50,808 SO THE NEW MODEL OF DATA SHARING 2549 01:53:50,808 --> 01:53:55,813 WAS REALLY DEVELOPED IN THE 2550 01:53:55,813 --> 01:53:58,582 EARLY 2000s AND FORMED THE REAL 2551 01:53:58,582 --> 01:54:01,585 WORKING GROUP IN 2001. 2552 01:54:01,585 --> 01:54:03,621 THEY RECRUITED NEW INVESTIGATORS 2553 01:54:03,621 --> 01:54:07,124 FROM NON-CHS SITES PROVIDED 2554 01:54:07,124 --> 01:54:09,093 INFORMATION ABOUT HOW TO ACCESS 2555 01:54:09,093 --> 01:54:11,695 THE DATA, PROVIDED ANALYTIC 2556 01:54:11,695 --> 01:54:14,431 SUPPORT AND THE RESULT HERE WAS 2557 01:54:14,431 --> 01:54:17,101 A WORKING GROUP THAT PRODUCED 2558 01:54:17,101 --> 01:54:18,936 MULTIPLE GRANTS AND PAPERS AND 2559 01:54:18,936 --> 01:54:28,779 MANY OF THESE FEATURING WORK AND 2560 01:54:28,779 --> 01:54:39,356 CHS WAS REALLY A MODEL IN 2561 01:54:40,591 --> 01:54:42,860 ACTIVE DATA SHARING AND FOLLOWED 2562 01:54:42,860 --> 01:54:45,195 THAT UP IN 2005 AND 2007 WITH 2563 01:54:45,195 --> 01:54:46,664 WORKSHOPS. 2564 01:54:46,664 --> 01:54:52,236 JEANIE OLSON AND DAVID TOOK THE 2565 01:54:52,236 --> 01:55:00,544 LEAD HERE AND THEY IDENTIFIED 2566 01:55:00,544 --> 01:55:05,916 PEOPLE THAT WERE K AWARDEES AND 2567 01:55:05,916 --> 01:55:10,487 IT SPAWNED A HALF DOZEN WORKING 2568 01:55:10,487 --> 01:55:18,562 GROUPS AND STEWARDS OF THE DATA. 2569 01:55:18,562 --> 01:55:20,130 THE BLUE HAVE THE INVESTIGATORS 2570 01:55:20,130 --> 01:55:27,404 FUNDED ON THE GRANT OR CONTRACT 2571 01:55:27,404 --> 01:55:31,976 YOU AND GREEN ARE COLLABORATORS 2572 01:55:31,976 --> 01:55:36,714 AND SEE THE FIRST AUTHORS 2573 01:55:36,714 --> 01:55:41,719 INCREASED MARKEDLY AND AFTER 2574 01:55:41,719 --> 01:55:43,587 2005 AND 2007 THERE WERE FURTHER 2575 01:55:43,587 --> 01:55:44,221 INCREASES. 2576 01:55:44,221 --> 01:55:45,389 THE ADVANTAGE IS THESE YOUNG 2577 01:55:45,389 --> 01:55:45,956 INVESTIGATORS CAN REALLY BE 2578 01:55:45,956 --> 01:55:50,561 CHAMPIONS. 2579 01:55:50,561 --> 01:55:52,162 SO WITH GUIDANCE AND STATISTICAL 2580 01:55:52,162 --> 01:55:53,564 SUPPORT THEY CAN MOVE PAPERS AND 2581 01:55:53,564 --> 01:56:03,941 BE HIGHLY PRODUCTIVE. 2582 01:56:04,842 --> 01:56:09,546 IS LIKE FRAMINGHAM AND ARIC AND 2583 01:56:09,546 --> 01:56:11,749 OTHERS, CHS HAD GWAS ANCILLARY 2584 01:56:11,749 --> 01:56:14,852 STUDY AND HAD GENOME-WIDE DATA 2585 01:56:14,852 --> 01:56:17,187 IN ABOUT 4,000 PARTICIPANTS. 2586 01:56:17,187 --> 01:56:19,356 THE PRIOR AIM WAS CBD EVENTS. 2587 01:56:19,356 --> 01:56:23,761 THERE WERE SECONDARY AIMS. 2588 01:56:23,761 --> 01:56:27,131 THE DATA WERE ALL SHARED 2589 01:56:27,131 --> 01:56:27,665 PUBLICLY WITH GB GAP AS 2590 01:56:27,665 --> 01:56:27,931 REQUIRED. 2591 01:56:27,931 --> 01:56:30,067 AS WE BEGAN TO DO THE ANALYSIS 2592 01:56:30,067 --> 01:56:31,602 WE FOUND LOW POWER FOR THE 2593 01:56:31,602 --> 01:56:35,472 EMERGING EFFECT SIZES. 2594 01:56:35,472 --> 01:56:37,608 THAT WAS THE BEGINNING OF 2595 01:56:37,608 --> 01:56:37,841 CHARGE. 2596 01:56:37,841 --> 01:56:41,145 CHARGE WAS A SIDE EFFECT OF THE 2597 01:56:41,145 --> 01:56:42,079 DISRUPTIVE GOOD WAS TECHNOLOGY. 2598 01:56:42,079 --> 01:56:48,585 IT WAS A MATTER OF A SEARCH FOR 2599 01:56:48,585 --> 01:56:50,387 IMPROVED POWER OR REPLICATION 2600 01:56:50,387 --> 01:56:53,891 AND MANY PEOPLE CONTRIBUTED. 2601 01:56:53,891 --> 01:57:02,099 CHRIS O'DONNELL AND ERIC 2602 01:57:02,099 --> 01:57:03,901 BOERWINKLE WE CAME TOGETHER AND 2603 01:57:03,901 --> 01:57:06,503 THE COHORT DESIGN IS THE 2604 01:57:06,503 --> 01:57:07,471 ORGANIZING PRINCIPAL. 2605 01:57:07,471 --> 01:57:08,706 THAT MEANS ALL THE PHENOTYPES 2606 01:57:08,706 --> 01:57:10,374 YOU SAW EARLIER IN MY SLIDES AND 2607 01:57:10,374 --> 01:57:14,344 THE OTHER PHENOTYPES YOU SAW IN 2608 01:57:14,344 --> 01:57:17,881 JOE'S SLIDES WERE AVAILABLE FOR 2609 01:57:17,881 --> 01:57:22,419 WHOLE GENOME ANALYSIS. 2610 01:57:22,419 --> 01:57:26,290 AND OVER TIME WE ADDED COHORTS, 2611 01:57:26,290 --> 01:57:30,561 MESA HEALTH, ABC, JACKSON, THE 2612 01:57:30,561 --> 01:57:33,130 HISPANIC COMMUNITY HEALTH STUDY 2613 01:57:33,130 --> 01:57:34,198 HAS BEEN INCLUDED. 2614 01:57:34,198 --> 01:57:37,768 AND CHARGE IS A VOLUNTARY 2615 01:57:37,768 --> 01:57:38,202 FEDERATION. 2616 01:57:38,202 --> 01:57:41,038 THE SOURCE OF THE SIEBS IS 2617 01:57:41,038 --> 01:57:44,074 BOTTOM UP. 2618 01:57:44,074 --> 01:57:44,575 AND 2619 01:57:44,575 --> 01:57:47,411 -- THE DESIGN IS BOTTOM UP 2620 01:57:47,411 --> 01:57:50,047 ACROSS MULTIPLE PHENOTYPES. 2621 01:57:50,047 --> 01:57:54,585 SO CHARGE IS REALLY AN EXTENSION 2622 01:57:54,585 --> 01:57:56,920 OF THE NIH APPROACH TO THE 2623 01:57:56,920 --> 01:57:58,956 MULTI-CENTER STUDIES. 2624 01:57:58,956 --> 01:58:01,158 INSTEAD OF A MULTI-SITE STUDY WE 2625 01:58:01,158 --> 01:58:03,393 HAVE A MULTI STUDY CONSORTIUM. 2626 01:58:03,393 --> 01:58:05,162 THE KEY ELEMENT HAS BEEN A 2627 01:58:05,162 --> 01:58:05,763 COORDINATING CENTER. 2628 01:58:05,763 --> 01:58:09,867 IT'S SUPPORTED BY AN 2629 01:58:09,867 --> 01:58:10,334 INFRASTRUCTURE GRANT. 2630 01:58:10,334 --> 01:58:11,902 THERE'S TEN SUBCONTRACTS TO THE 2631 01:58:11,902 --> 01:58:13,103 PARTICIPATING COHORT. 2632 01:58:13,103 --> 01:58:14,838 A LARGE AMOUNT OF THE GRANT GOES 2633 01:58:14,838 --> 01:58:16,073 TO THE COHORT. 2634 01:58:16,073 --> 01:58:19,243 WE ARE NOT ASKING PEOPLE TO 2635 01:58:19,243 --> 01:58:24,481 VOLUNTEER AND HELP RUN THE 2636 01:58:24,481 --> 01:58:24,681 GRANT. 2637 01:58:24,681 --> 01:58:30,621 THEY RECEIVE FUNDING TO 2638 01:58:30,621 --> 01:58:33,157 PARTICIPATE AND WE HAVE HAD TWO 2639 01:58:33,157 --> 01:58:34,958 MEETINGS A YEAR IMPORTANT FOR 2640 01:58:34,958 --> 01:58:35,592 COHESION AND TRAVEL AWARDS FOR 2641 01:58:35,592 --> 01:58:40,764 INVESTIGATORS. 2642 01:58:40,764 --> 01:58:44,034 THE ORGANIZATION IS A MATRIX, 2643 01:58:44,034 --> 01:58:48,438 THREE DIMENSIONAL. 2644 01:58:48,438 --> 01:58:50,741 THE STEERING COMMITTEE 2645 01:58:50,741 --> 01:58:52,342 REPRESENTS EACH OF THE COHORT 2646 01:58:52,342 --> 01:58:54,178 AND THERE'S MEMBERS FROM THE 2647 01:58:54,178 --> 01:58:54,745 STEERING COMMITTEE. 2648 01:58:54,745 --> 01:58:59,416 THERE'S 40 ACTIVE WORKING GROUPS 2649 01:58:59,416 --> 01:59:01,451 RIGHT NOW AND THEY INCLUDE CROSS 2650 01:59:01,451 --> 01:59:02,486 COHORT PHENOTYPE TEAMS. 2651 01:59:02,486 --> 01:59:04,788 OVER TIME SOME OF THESE HAVE 2652 01:59:04,788 --> 01:59:06,156 COME AND SOME HAVE GONE. 2653 01:59:06,156 --> 01:59:07,825 NEW ONES HAVE FORMED UP AND 2654 01:59:07,825 --> 01:59:10,561 THERE'S OTHER COMMITTEES LIKE 2655 01:59:10,561 --> 01:59:13,597 ANALYSIS, GENOTYPING, PROTEOMIC 2656 01:59:13,597 --> 01:59:15,632 AND MENDELIAN RANDOMIZATION THAT 2657 01:59:15,632 --> 01:59:17,935 WORK ACROSS THE COHORTS AND 2658 01:59:17,935 --> 01:59:26,310 WORKING GROUPS. 2659 01:59:26,310 --> 01:59:27,845 THIS WEBSITE INCLUDES THE CHARGE 2660 01:59:27,845 --> 01:59:38,322 PRINCIPLES AND NO SURPRISES. 2661 01:59:45,562 --> 01:59:48,265 THE WORKING GROUP MODELS WITH 2662 01:59:48,265 --> 01:59:50,434 MEMBERS, PRIORITIES, PHENOTYPES, 2663 01:59:50,434 --> 01:59:51,068 COLLABORATIONS, THEY DEVELOP 2664 01:59:51,068 --> 01:59:53,036 GRANT APPLICATIONS. 2665 01:59:53,036 --> 01:59:54,738 THEY CAN INCLUDE MEMBERS FROM 2666 01:59:54,738 --> 01:59:56,273 ANY OTHER STUDY. 2667 01:59:56,273 --> 01:59:59,042 THEY DON'T HAVE TO STAY 2668 01:59:59,042 --> 02:00:02,145 EXCLUSIVELY WITHIN THE CHARGE 2669 02:00:02,145 --> 02:00:02,579 COHORTS. 2670 02:00:02,579 --> 02:00:07,818 THERE ARE EUROPEAN STUDIES, 2671 02:00:07,818 --> 02:00:11,321 ASIAN STUDIES AND MANY OTHERS 2672 02:00:11,321 --> 02:00:12,256 THAT PARTICIPATE IN THE WORKING 2673 02:00:12,256 --> 02:00:12,489 GROUPS. 2674 02:00:12,489 --> 02:00:14,391 THE WORKING GROUPS TRY TO 2675 02:00:14,391 --> 02:00:15,292 IDENTIFY CHAMPIONS. 2676 02:00:15,292 --> 02:00:18,929 AGAIN, I THINK THE CHAMPION IS A 2677 02:00:18,929 --> 02:00:19,997 KEY FEATURE HERE. 2678 02:00:19,997 --> 02:00:23,267 AND THE MANUSCRIPT IS THE UNIT 2679 02:00:23,267 --> 02:00:23,867 OF WORK. 2680 02:00:23,867 --> 02:00:26,703 WE LIKE PROSPECTIVE PROPOSALS 2681 02:00:26,703 --> 02:00:28,071 AND ANALYSIS PLANS. 2682 02:00:28,071 --> 02:00:30,207 IT ESTABLISHES RESPONSIBILITIES 2683 02:00:30,207 --> 02:00:32,442 AND AUTHOR LISTS AND INDIVIDUAL 2684 02:00:32,442 --> 02:00:41,184 GROUPS CAN OPT IN OR OUT. 2685 02:00:41,184 --> 02:00:42,753 THE EARLY CHARGE ANALYSIS 2686 02:00:42,753 --> 02:00:47,324 METHODS WERE PRESPECIFIED 2687 02:00:47,324 --> 02:00:48,892 ANALYSIS PLAN CONDUCTED WITHIN 2688 02:00:48,892 --> 02:00:52,062 STUDY BY LOCAL EXPERTS AND WE 2689 02:00:52,062 --> 02:00:52,963 DID BETWEEN COHORT META-ANALYSIS 2690 02:00:52,963 --> 02:00:55,098 OF THE RESULTS. 2691 02:00:55,098 --> 02:00:57,467 THAT MEANT WE COULD SHARE 2692 02:00:57,467 --> 02:01:00,103 RESULTS ON AN INDIVIDUAL LEVEL 2693 02:01:00,103 --> 02:01:00,304 DATA. 2694 02:01:00,304 --> 02:01:03,140 THIS WAS EFFICIENT AND AVOIDED 2695 02:01:03,140 --> 02:01:05,008 IRB AND DATA MATERIAL ISSUES. 2696 02:01:05,008 --> 02:01:07,177 IT'S ACTUALLY MORE POWERFUL THAT 2697 02:01:07,177 --> 02:01:11,815 BE THE TWO-STAGE DESIGN WITH 2698 02:01:11,815 --> 02:01:12,883 DISCOVERY AND REPLICATION OF 2699 02:01:12,883 --> 02:01:15,986 SUBSET AND IMPORTANTLY IT AVOIDS 2700 02:01:15,986 --> 02:01:19,723 THE CLASS DISTINCTION BETWEEN 2701 02:01:19,723 --> 02:01:21,658 DISCOVERY AND REPLICATION. 2702 02:01:21,658 --> 02:01:24,328 THE META-ANALYSIS METHOD THANKS 2703 02:01:24,328 --> 02:01:29,866 TO OUR BIO STATISTICIANS HAS 2704 02:01:29,866 --> 02:01:31,835 BEEN CULTURALLY POWERFUL FOR 2705 02:01:31,835 --> 02:01:40,010 COLLABORATION. 2706 02:01:40,010 --> 02:01:42,446 SO IN THE OLD DAYS WHEN CHS AND 2707 02:01:42,446 --> 02:01:44,114 OTHERS WERE HUMMING ALONG WE HAD 2708 02:01:44,114 --> 02:01:46,249 SINGLE COHORT PAPERS. 2709 02:01:46,249 --> 02:01:48,385 THERE WERE FIVE TO 10 AUTHORS 2710 02:01:48,385 --> 02:01:52,089 WITH 5,000 OR 15,000 SUBJECTS 2711 02:01:52,089 --> 02:01:53,423 AND THERE WAS POLITE COMPETITION 2712 02:01:53,423 --> 02:01:57,227 IN THE COHORT STUDIES. 2713 02:01:57,227 --> 02:02:00,130 NOWADAYS YOU CAN ACQUIRE DATA 2714 02:02:00,130 --> 02:02:01,965 FROM GB GAP AND BENEFIT FROM THE 2715 02:02:01,965 --> 02:02:03,367 LOCAL KNOWLEDGE AND THE 2716 02:02:03,367 --> 02:02:04,801 COLLABORATION MODEL HAS WORKED 2717 02:02:04,801 --> 02:02:05,702 WELL. 2718 02:02:05,702 --> 02:02:08,872 THE LARGE-SCALE GWAS PAPERS 2719 02:02:08,872 --> 02:02:13,243 OFTEN INCLUDE 50 TO 300 AUTHORS 2720 02:02:13,243 --> 02:02:19,583 WITH 100,000 TO 2.5 MILLION 2721 02:02:19,583 --> 02:02:20,050 PARTICIPANTS. 2722 02:02:20,050 --> 02:02:23,553 IT'S REALLY QUITE EFFICIENT WITH 2723 02:02:23,553 --> 02:02:31,461 A GOOD PARTICIPANT RATIO. 2724 02:02:31,461 --> 02:02:34,564 SOO THE CHARGE MEETINGS HAVE 2725 02:02:34,564 --> 02:02:35,565 BEEN CRITICAL. 2726 02:02:35,565 --> 02:02:39,603 WE STARTED PHONE CALLS FOR 2727 02:02:39,603 --> 02:02:40,704 CHARGE IN 2007. 2728 02:02:40,704 --> 02:02:42,272 HAD A SERIES OF MEETINGS OVER 2729 02:02:42,272 --> 02:02:45,675 THE YEARS. 2730 02:02:45,675 --> 02:02:47,044 A COUPLE WERE VIRTUAL DUE TO THE 2731 02:02:47,044 --> 02:02:51,748 PANDEMIC BUT WE'RE NOW BACK INTO 2732 02:02:51,748 --> 02:02:54,117 UP PERSON MEETINGS WITH THE ONE 2733 02:02:54,117 --> 02:02:58,255 IN MAY WILL BE IN DENVER AND A 2734 02:02:58,255 --> 02:03:00,424 YEAR FROM NOW A CONDITIONAL 2735 02:03:00,424 --> 02:03:08,031 MEETING IN RODDERDAM. 2736 02:03:08,031 --> 02:03:10,400 THE CHARGE PRODUCTS ONE OF THE 2737 02:03:10,400 --> 02:03:13,570 MOST IMPORTANT ONES IS A NOVEL 2738 02:03:13,570 --> 02:03:14,704 RESEARCH STRUCTURE WITH 2739 02:03:14,704 --> 02:03:15,639 INSTITUTIONAL TEAMS AND TRAINING 2740 02:03:15,639 --> 02:03:16,306 EFFORTS. 2741 02:03:16,306 --> 02:03:18,542 CHARGE HAS CONTRIBUTED TO 2742 02:03:18,542 --> 02:03:22,979 PARTICIPATED IN A CULTURAL 2743 02:03:22,979 --> 02:03:26,149 TRANSFORMATION THAT RESULTED IN 2744 02:03:26,149 --> 02:03:28,118 HIGH LEVEL COLLABORATIONS IN THE 2745 02:03:28,118 --> 02:03:28,351 STUDIES. 2746 02:03:28,351 --> 02:03:29,519 ONE OF THE SIDE EFFECTS HAS BEEN 2747 02:03:29,519 --> 02:03:32,522 A NUMBER OF NON-GENETIC 2748 02:03:32,522 --> 02:03:33,090 COLLABORATIONS AMONG THESE 2749 02:03:33,090 --> 02:03:34,758 COHORTS. 2750 02:03:34,758 --> 02:03:39,029 CHARGE HAS MORE THAN 1200 2751 02:03:39,029 --> 02:03:39,830 PUBLICATIONS AND AGE INDEX AT 2752 02:03:39,830 --> 02:03:44,401 ABOUT 163. 2753 02:03:44,401 --> 02:03:46,837 THERE ARE 40 WORKING GROUPS THAT 2754 02:03:46,837 --> 02:03:49,272 REMAIN LARGELY ACTIVE. 2755 02:03:49,272 --> 02:03:53,076 SOME HAVE MERGED WITH PUB MED. 2756 02:03:53,076 --> 02:03:55,679 SOME WORK WITH M.V.P. AND THEY 2757 02:03:55,679 --> 02:03:57,948 HAVE 21 ACTIVE GRANTS. 2758 02:03:57,948 --> 02:04:03,954 WE ALSO HAVE A CHARGE GB GAP 2759 02:04:03,954 --> 02:04:07,190 WITH A SHARING SITE. 2760 02:04:07,190 --> 02:04:09,159 SO SOME OF THE DIRECTIONS HAVE 2761 02:04:09,159 --> 02:04:13,530 BEEN LARGER SAMPLE SIZES 2762 02:04:13,530 --> 02:04:18,535 EMERGING COHORT OF CONSORTIA. 2763 02:04:18,535 --> 02:04:20,370 MULTIETHNIC ANALYSES, BIO 2764 02:04:20,370 --> 02:04:21,071 INFORMATICS WORK. 2765 02:04:21,071 --> 02:04:23,073 SOME WORKING GROUPS INCLUDE 2766 02:04:23,073 --> 02:04:25,675 BASIC SCIENTISTS THAT CONDUCT 2767 02:04:25,675 --> 02:04:26,543 FUNCTIONAL STUDIES. 2768 02:04:26,543 --> 02:04:28,945 NEW PROTEOMIC AND METABOLOMIC 2769 02:04:28,945 --> 02:04:31,748 DATA HAVE HELPED TO REINVIGORATE 2770 02:04:31,748 --> 02:04:32,716 A NUMBER OF THE WORKING GROUPS. 2771 02:04:32,716 --> 02:04:35,552 THE PUBLICATIONS ARE NOW DENSER 2772 02:04:35,552 --> 02:04:38,121 AND MORE COMPLEX THAN THEY WERE 2773 02:04:38,121 --> 02:04:39,689 IN THE EARLY 2000s. 2774 02:04:39,689 --> 02:04:45,795 THERE'S MANY COLLABORATIONS WITH 2775 02:04:45,795 --> 02:04:53,570 PUB MED AND THE AABVAILABILITY 2776 02:04:53,570 --> 02:04:54,771 THE WHOLE GENOME SEQUENCE. 2777 02:04:54,771 --> 02:04:59,509 IT'S NOT REALLY POSSIBLE TO DO 2778 02:04:59,509 --> 02:05:04,714 LOCAL ANALYSIS AND SHARE THE 2779 02:05:04,714 --> 02:05:08,585 RESUL 2780 02:05:08,585 --> 02:05:11,855 RESULTS QUE NEEDED A METHOD FOR 2781 02:05:11,855 --> 02:05:16,226 POOLING DATA AND IF FRAMINGHAM 2782 02:05:16,226 --> 02:05:20,130 WERE TO SHARE DATA SO EACH GROUP 2783 02:05:20,130 --> 02:05:23,800 COULD HAVE IT IT WOULD BE 2784 02:05:23,800 --> 02:05:31,808 TRANSFERS THAT ARE JUST NOT 2785 02:05:31,808 --> 02:05:39,182 FEASIBLE. 2786 02:05:39,182 --> 02:05:42,285 ONCE THE BECAME AVAILABLE CHS 2787 02:05:42,285 --> 02:05:45,021 HELPED CREATE A SINGLE 2788 02:05:45,021 --> 02:05:46,122 CONSORTIUM DOCUMENT THAT STUDIES 2789 02:05:46,122 --> 02:05:48,558 CAN SIGN ON TO AND THEN SHARE 2790 02:05:48,558 --> 02:05:50,927 DATA. 2791 02:05:50,927 --> 02:05:52,395 THIS SOUNDS LIKE AN EASY THING. 2792 02:05:52,395 --> 02:06:02,672 WELL, IT WASN'T. 2793 02:06:03,974 --> 02:06:05,875 AND THERE'S MULTIPLE DIFFERENT 2794 02:06:05,875 --> 02:06:09,246 UNIVERSITIES BUT IT NOW WORKS. 2795 02:06:09,246 --> 02:06:14,451 WE HAVE A DATA SHARING AGREEMENT 2796 02:06:14,451 --> 02:06:16,319 IN CHARGE AND WE SHARED THIS 2797 02:06:16,319 --> 02:06:18,321 WITH OTHERS. 2798 02:06:18,321 --> 02:06:20,357 THE COVID CONSORTIUM ADOPTED 2799 02:06:20,357 --> 02:06:22,492 THIS METHOD AND WITHIN THREE 2800 02:06:22,492 --> 02:06:23,927 MONTHS THEY HAD MOST OF THEIR 2801 02:06:23,927 --> 02:06:25,462 STUDIES SIGNED ON ABLE TO SHARE 2802 02:06:25,462 --> 02:06:35,672 DATA ACROSS ALL SITES. 2803 02:06:35,672 --> 02:06:36,773 SO THE ANALYSIS COMMONS IS THE 2804 02:06:36,773 --> 02:06:40,810 RESULT OF THIS AND THIS IS 2805 02:06:40,810 --> 02:06:45,448 DESCRIBED IN NATURE AND GENETICS 2806 02:06:45,448 --> 02:06:47,384 AND ONE IS SIGNED BY EACH STUDY 2807 02:06:47,384 --> 02:06:48,485 IN THE COLLABORATION. 2808 02:06:48,485 --> 02:06:49,653 THE PRIMARY PURPOSE IS POOLING 2809 02:06:49,653 --> 02:06:51,154 FROM THE WHOLE GENOME SEQUENCE 2810 02:06:51,154 --> 02:06:51,454 DATA. 2811 02:06:51,454 --> 02:06:52,422 THERE'S FEWER ANALYSIS AND 2812 02:06:52,422 --> 02:06:54,991 GREATERESE OF USE. 2813 02:06:54,991 --> 02:06:58,328 -- GREATER EASE OF USE. 2814 02:06:58,328 --> 02:07:00,063 >> TWO-MINUTE WARNING. 2815 02:07:00,063 --> 02:07:04,701 >> OKAY. 2816 02:07:04,701 --> 02:07:06,870 THERE'S MORE POWER AND IT 2817 02:07:06,870 --> 02:07:08,471 REQUIRES MORE CENTRAL 2818 02:07:08,471 --> 02:07:08,805 COORDINATION. 2819 02:07:08,805 --> 02:07:11,941 IT WORK IN CHARGE BUT IT WOULD 2820 02:07:11,941 --> 02:07:21,151 NOT AND DOES NOT SCALE WELL. 2821 02:07:21,151 --> 02:07:25,255 SO I THINK THE NIH HAS BEEN 2822 02:07:25,255 --> 02:07:28,158 ALMOST DISRESPECTFUL OF THE 2823 02:07:28,158 --> 02:07:29,225 INVESTIGATORS' EFFORTS. 2824 02:07:29,225 --> 02:07:31,928 WE HARMONIZED DATA MULTIPLE 2825 02:07:31,928 --> 02:07:33,463 TIMES AND THERE'S NOT A 2826 02:07:33,463 --> 02:07:36,099 MECHANISM FOR EASILY SHARING THE 2827 02:07:36,099 --> 02:07:36,499 HARMONIZED DATA. 2828 02:07:36,499 --> 02:07:38,568 THEY NEED TO GO BACK TO THE 2829 02:07:38,568 --> 02:07:41,071 STUDIES AND IT WOULD BE IDEAL TO 2830 02:07:41,071 --> 02:07:43,273 HAVE A METHOD FOR HARMONIZING 2831 02:07:43,273 --> 02:07:45,408 DATA AND MAKING THAT HARMONIZED 2832 02:07:45,408 --> 02:07:47,677 DATA READILY AVAILABLE. 2833 02:07:47,677 --> 02:07:49,279 AND TO MY KNOWLEDGE THIS DOESN'T 2834 02:07:49,279 --> 02:07:57,887 EXIST. 2835 02:07:57,887 --> 02:07:59,589 I THINK WHAT WE DO IS POPULATION 2836 02:07:59,589 --> 02:07:59,923 BIOLOGY. 2837 02:07:59,923 --> 02:08:02,726 WE DO GENETIC ASSOCIATIONS ON 2838 02:08:02,726 --> 02:08:04,928 LARGE SAMPLES FOR DISCOVERY OF 2839 02:08:04,928 --> 02:08:09,866 NEW BIOLOGY IN HUMANS WITH THE 2840 02:08:09,866 --> 02:08:13,103 NEW OMICS TOOLS AND POWERFUL TO 2841 02:08:13,103 --> 02:08:14,738 IDENTIFY TOPICS. 2842 02:08:14,738 --> 02:08:19,843 I THINK KEENAN WALKER'S PAPER IS 2843 02:08:19,843 --> 02:08:20,910 A NICE EXAMPLE. 2844 02:08:20,910 --> 02:08:21,878 THERE'S PRECISION MEDICINE 2845 02:08:21,878 --> 02:08:26,950 OPPORTUNITIES BUT I THINK IT'S 2846 02:08:26,950 --> 02:08:32,288 IMPORTANT YOU HAVE EVIDENCE OF A 2847 02:08:32,288 --> 02:08:37,627 BENEFIT RATIO. 2848 02:08:37,627 --> 02:08:41,231 CHARGE HAS CONTRIBUTED TO DATA 2849 02:08:41,231 --> 02:08:42,265 SHARING METHODS, TRAINING YOUNG 2850 02:08:42,265 --> 02:08:43,633 INVESTIGATORS AND I THINK THOSE 2851 02:08:43,633 --> 02:08:47,203 ARE IMPORTANT ACHIEVEMENTS. 2852 02:08:47,203 --> 02:08:52,542 IN MY MORE CURMUDGEONLY MOVES 2853 02:08:52,542 --> 02:08:54,844 IT SOMETIMES SEEMS THERE'S TWO 2854 02:08:54,844 --> 02:08:58,815 MANY DATA CHASING TOO FEW GOOD 2855 02:08:58,815 --> 02:08:59,082 QUESTIONS. 2856 02:08:59,082 --> 02:09:00,383 I WOULD ENCOURAGE PEOPLE TO 2857 02:09:00,383 --> 02:09:03,920 THINK ABOUT THE QUESTION. 2858 02:09:03,920 --> 02:09:04,954 GOOD SCIENCE INVOLVES GOOD 2859 02:09:04,954 --> 02:09:06,356 QUESTIONS AND HIGH QUALITY DATA 2860 02:09:06,356 --> 02:09:07,390 AND STRONG METHODS. 2861 02:09:07,390 --> 02:09:09,959 WE NEED THAT COMBINATION AND NOT 2862 02:09:09,959 --> 02:09:19,969 JUST LET'S JUST PREDICT THIS. 2863 02:09:19,969 --> 02:09:22,439 THIS IS THE RESEARCH STEERING 2864 02:09:22,439 --> 02:09:29,879 COMMITTEE INCLUDING EMERITUS 2865 02:09:29,879 --> 02:09:30,880 MEMBERS. 2866 02:09:30,880 --> 02:09:35,018 AND THESE PEOPLE HAVE ALL 2867 02:09:35,018 --> 02:09:35,952 CONTRIBUTED TO CHARGE AND ITS 2868 02:09:35,952 --> 02:09:38,855 VISION AND ACTIVITIES. 2869 02:09:38,855 --> 02:09:44,828 THANK YOU. 2870 02:09:44,828 --> 02:09:48,064 >> FANTASTIC. 2871 02:09:48,064 --> 02:09:50,467 THANK YOU SO MUCH DR. PSATY. 2872 02:09:50,467 --> 02:09:52,268 THERE'S ONE QUESTION ABOUT 2873 02:09:52,268 --> 02:09:56,005 IDENTIFYING THE COHORTS THAT 2874 02:09:56,005 --> 02:09:57,540 BECOME INVOLVED WITH THE CHARGE. 2875 02:09:57,540 --> 02:10:00,577 ISN'T THAT THE CHARGE STEERING 2876 02:10:00,577 --> 02:10:01,344 COMMITTEE IDENTIFIES AND REACHES 2877 02:10:01,344 --> 02:10:05,582 OUT TO EXISTING COHORTS OR IS IT 2878 02:10:05,582 --> 02:10:07,250 THAT EXISTING COHORTS GLOBALLY 2879 02:10:07,250 --> 02:10:08,284 REACH OUT TO CHARGE? 2880 02:10:08,284 --> 02:10:11,421 HOW ARE THE CONNECTIONS MADE? 2881 02:10:11,421 --> 02:10:14,357 SO RIGHT NOW THERE IS A GRANT 2882 02:10:14,357 --> 02:10:16,159 AND THAT GRANT INCLUDES ABOUT 10 2883 02:10:16,159 --> 02:10:18,962 COHORTS AND THEY RECEIVE FUNDING 2884 02:10:18,962 --> 02:10:20,997 AND THEY'RE REPRESENTATIVED ON 2885 02:10:20,997 --> 02:10:22,232 THE STEERING COMMITTEE BUT OTHER 2886 02:10:22,232 --> 02:10:31,274 COHORTS ARE WELCOMED TO JOIN. 2887 02:10:31,274 --> 02:10:33,643 WE DON'T HAVE FUNDING FOR THEM 2888 02:10:33,643 --> 02:10:37,881 AND IN FACT IN THE SAN ANTONIO 2889 02:10:37,881 --> 02:10:38,915 MEETING THERE'S A SESSION WHERE 2890 02:10:38,915 --> 02:10:41,484 SIX NEW COHORTS ARE PRESENTING 2891 02:10:41,484 --> 02:10:45,021 AND HOPING TO WORK WITH CHARGE 2892 02:10:45,021 --> 02:10:46,589 ONE WAY OR ANOTHER. 2893 02:10:46,589 --> 02:10:50,026 THE WAY TO LINK UP WITH CHARGE 2894 02:10:50,026 --> 02:10:51,861 IS THROUGH A WORKING GROUP WHERE 2895 02:10:51,861 --> 02:10:54,797 IF THERE'S A PHENOTYPE THAT THAT 2896 02:10:54,797 --> 02:11:00,637 COHORT REALLY HAS INTEREST IN OR 2897 02:11:00,637 --> 02:11:02,839 TO WE CAN LINK THEM UP WITH THE 2898 02:11:02,839 --> 02:11:05,642 WORKING GROUP AND THEY CAN 2899 02:11:05,642 --> 02:11:06,109 PARTICIPATE IN CHARGE. 2900 02:11:06,109 --> 02:11:11,614 >> EXCELLENT, THANKS. 2901 02:11:11,614 --> 02:11:15,251 AND ONE ADDITIONAL QUESTION IS 2902 02:11:15,251 --> 02:11:15,818 THE ANALYSIS COMMONS MODEL 2903 02:11:15,818 --> 02:11:20,189 DOESN'T SCALE. 2904 02:11:20,189 --> 02:11:25,094 >> IT'S BECAUSE THE GROUP IS 2905 02:11:25,094 --> 02:11:29,532 TREATED AS A STUDY. 2906 02:11:29,532 --> 02:11:30,733 AND IT IS NOT FOR OPEN DATA 2907 02:11:30,733 --> 02:11:33,202 SHARING ACROSS ALL PEOPLE. 2908 02:11:33,202 --> 02:11:36,005 BECAUSE A CENTRAL GROUP HAS TO 2909 02:11:36,005 --> 02:11:42,545 MANAGE WHO GETS ACCESS TO WHICH 2910 02:11:42,545 --> 02:11:43,713 DATA FOR WHICH ANALYSES. 2911 02:11:43,713 --> 02:11:51,187 DOES THAT MAKE SENSE? 2912 02:11:51,187 --> 02:11:51,654 >> GREAT. 2913 02:11:51,654 --> 02:11:53,856 THANK YOU. 2914 02:11:53,856 --> 02:11:59,429 WE'LL NOW MOVE TO Q&A SESSION 2915 02:11:59,429 --> 02:12:00,730 INCLUDE ALL THE SPEAKERS FROM 2916 02:12:00,730 --> 02:12:01,598 THE PREVIOUS SECTION. 2917 02:12:01,598 --> 02:12:03,066 WHILE WE MOVE TO THE Q&A, WE 2918 02:12:03,066 --> 02:12:08,304 HAVE THE RESULTS OF THE TWO POLL 2919 02:12:08,304 --> 02:12:10,506 QUESTIONS THAT ARE RELEASED. 2920 02:12:10,506 --> 02:12:11,174 HOPEFULLY EVERYBODY CAN SEE THE 2921 02:12:11,174 --> 02:12:14,611 RESULTS. 2922 02:12:14,611 --> 02:12:16,312 THE FIRST IS THE PRIMARY 2923 02:12:16,312 --> 02:12:20,350 OBJECTIVE FOR ATTENDING THE 2924 02:12:20,350 --> 02:12:20,683 WORKSHOP. 2925 02:12:20,683 --> 02:12:23,119 WE SEE A VAST MAJORITY OF PEOPLE 2926 02:12:23,119 --> 02:12:23,886 ARE LOOKING TOWARDS FUTURE 2927 02:12:23,886 --> 02:12:25,722 TRENDS AND MANY ARE LOOKING 2928 02:12:25,722 --> 02:12:26,189 TOWARDS NEW TOOLS AND 2929 02:12:26,189 --> 02:12:30,460 TECHNIQUES. 2930 02:12:30,460 --> 02:12:31,628 IF THERE ARE PEOPLE WHO WERE 2931 02:12:31,628 --> 02:12:34,230 LOOKING TO LEARN NEW TOOLS AND 2932 02:12:34,230 --> 02:12:35,198 TECHNIQUES THAT MAY HAVE MISSED 2933 02:12:35,198 --> 02:12:41,871 SOME OF THE TUTORIALS, THOSE 2934 02:12:41,871 --> 02:12:43,072 HAVE MATERIALS AVAILABLE SO 2935 02:12:43,072 --> 02:12:47,510 CHECK THAT OUT AND WE HAD 2936 02:12:47,510 --> 02:12:49,312 ANOTHER QUESTION ABOUT WHO WAS 2937 02:12:49,312 --> 02:12:51,114 IN ATTENDANCE AND GREAT TO SEE 2938 02:12:51,114 --> 02:12:54,117 WE HAVE A DIVERSE SET OF 2939 02:12:54,117 --> 02:12:54,917 ATTENDEES FROM ACROSS DIFFERENT 2940 02:12:54,917 --> 02:12:57,553 STAGES RANGING FROM EARLY CAREER 2941 02:12:57,553 --> 02:13:01,591 ALL THE WAY TO SENIOR FACULTY. 2942 02:13:01,591 --> 02:13:02,358 WELCOME EVERYONE AND PLEASE DO 2943 02:13:02,358 --> 02:13:04,427 ADD ANY QUESTIONS THAT YOU HAVE 2944 02:13:04,427 --> 02:13:05,628 FOR OUR SPEAKERS INTO THE Q&A 2945 02:13:05,628 --> 02:13:14,637 BOX. 2946 02:13:14,637 --> 02:13:16,105 >> AS WE ASSEMBLE THE QUESTIONS 2947 02:13:16,105 --> 02:13:17,807 I WANT TO REMIND PEOPLE WE'LL 2948 02:13:17,807 --> 02:13:22,145 GET A BREAK FROM 12:30 TO 1:00 2949 02:13:22,145 --> 02:13:24,147 AND THINK THE LAST SESSION 2950 02:13:24,147 --> 02:13:27,850 WESTBOUND -- WILL BE EXCITING 2951 02:13:27,850 --> 02:13:30,053 AND INTERESTING STARTING WITH 2952 02:13:30,053 --> 02:13:36,059 ERIC BOERWINKLE EXTREMELY WISE 2953 02:13:36,059 --> 02:13:41,731 AND KNOWLEDGEABLE. 2954 02:13:41,731 --> 02:13:43,466 BRUCE, AMAZING SUCCESS AT 2955 02:13:43,466 --> 02:13:43,700 CHARGE. 2956 02:13:43,700 --> 02:13:44,200 EMPHASIZED THE IDEA OF 2957 02:13:44,200 --> 02:13:50,440 COMMUNITY. 2958 02:13:50,440 --> 02:13:55,812 CAN WE MEASURE COMMUNITIES AND 2959 02:13:55,812 --> 02:14:00,516 MAYBE TALKING TO DR. PYARAJAN IF 2960 02:14:00,516 --> 02:14:02,385 I PRONOUNCED IT CLOSELY, HOW 2961 02:14:02,385 --> 02:14:05,888 DOES A STUDY AS BIG AS ONE 2962 02:14:05,888 --> 02:14:07,924 MILLION VETERANS FOSTER 2963 02:14:07,924 --> 02:14:08,958 COMMUNITY AMONG INVESTIGATORS 2964 02:14:08,958 --> 02:14:11,260 AND MENTORSHIP AND PEOPLE USING 2965 02:14:11,260 --> 02:14:13,696 THE DATA BECAUSE I THINK 2966 02:14:13,696 --> 02:14:16,499 EVENTUALLY IT'S OUR PATIENTS BUT 2967 02:14:16,499 --> 02:14:19,569 ACTUALLY BY PEOPLE SO THE 2968 02:14:19,569 --> 02:14:25,975 ANONYMOUS MODEL I TEND TO VIEW 2969 02:14:25,975 --> 02:14:29,045 HIS SENTIMENT IT NEEDS TO BE 2970 02:14:29,045 --> 02:14:30,747 FREE BUT ANONYMIZED DOESN'T WORK 2971 02:14:30,747 --> 02:14:33,015 FOR SCIENTIFIC RESEARCH. 2972 02:14:33,015 --> 02:14:35,118 >> MY ANSWER ARE THE MEETINGS. 2973 02:14:35,118 --> 02:14:35,952 THEY'RE EXCITING. 2974 02:14:35,952 --> 02:14:37,754 PEOPLE CAN TALK ON THE SIDE. 2975 02:14:37,754 --> 02:14:41,157 THEY CAN FORM COLLABORATIONS. 2976 02:14:41,157 --> 02:14:44,727 WE HAVE WORKSHOPS THAT GO ALONG 2977 02:14:44,727 --> 02:14:55,171 WITH THE MEN -- MANDELIAN 2978 02:14:58,541 --> 02:14:58,841 RANDOMIZATIONS. 2979 02:14:58,841 --> 02:15:05,047 IF IT WAS JUST CALLS I DON'T 2980 02:15:05,047 --> 02:15:06,783 THINK IT WOULD HAVE LASTED. 2981 02:15:06,783 --> 02:15:09,886 >> I WAS THINKING ABOUT THIS 2982 02:15:09,886 --> 02:15:16,092 WORKSHOP FOR SOME PARTICIPANTS 2983 02:15:16,092 --> 02:15:19,796 TO FULLY BENEFIT IT'S GREAT TO 2984 02:15:19,796 --> 02:15:21,197 GET CAUGHT UP. 2985 02:15:21,197 --> 02:15:23,132 QUESTIONS FOR THE V.A.? 2986 02:15:23,132 --> 02:15:28,604 >> WE HAVE -- ONE OF THE THINGS 2987 02:15:28,604 --> 02:15:38,214 WE HAVE BEEN A PERSON THAT'S 2988 02:15:38,214 --> 02:15:47,056 ENDED UP AT THE V.A. TOO WE 2989 02:15:47,056 --> 02:15:50,259 TRIED TO PROMOTE AND ONE THING 2990 02:15:50,259 --> 02:15:51,661 WE'RE BEING CRITICAL AND THIS IS 2991 02:15:51,661 --> 02:15:55,698 SORT OF CRITICISM FOR THE V.A. 2992 02:15:55,698 --> 02:15:59,335 NOT RELEASING THE DATA 2993 02:15:59,335 --> 02:16:08,711 COMPLETELY OPEN AND AVAILABLE 2994 02:16:08,711 --> 02:16:11,147 EVERYWHERE AND THE UNSTRUCTURED 2995 02:16:11,147 --> 02:16:14,150 DATA WE WANT TO ENSURE WE 2996 02:16:14,150 --> 02:16:19,922 RELEASE IT IN A RESPONSIBLE WAY 2997 02:16:19,922 --> 02:16:25,061 THAT KEEPS THE DATA SECURE AND 2998 02:16:25,061 --> 02:16:33,469 THE PARTICIP PARTICIPANTS THE V 2999 02:16:33,469 --> 02:16:36,038 SECURE AND WE HAVE EXAMPLES AND 3000 02:16:36,038 --> 02:16:37,506 WE HAVE BEEN ENCOURAGING 3001 02:16:37,506 --> 02:16:38,908 RESEARCHERS TO GO AND 3002 02:16:38,908 --> 02:16:40,376 PARTICIPATE AND PRESENT AND TALK 3003 02:16:40,376 --> 02:16:41,043 TO FOLKS. 3004 02:16:41,043 --> 02:16:46,582 THE OTHER THING WE HAVE BEEN 3005 02:16:46,582 --> 02:16:48,784 DOING FOR THE NEW PROJECTS 3006 02:16:48,784 --> 02:16:52,655 COMING THROUGH WE'RE ENCOURAGE 3007 02:16:52,655 --> 02:16:55,258 CONSORTIUMS TO BE FORMED. 3008 02:16:55,258 --> 02:16:59,395 WE HAVE STUDIES WITH MORE THAN 3009 02:16:59,395 --> 02:17:02,498 40, 50 RESEARCH GROUPS MORE THAN 3010 02:17:02,498 --> 02:17:08,170 40, 50 FOLKS COLLABORATING FROM 3011 02:17:08,170 --> 02:17:12,575 ACROSS THE COUNTRY AND AS I SAID 3012 02:17:12,575 --> 02:17:14,210 EARLIER ACADEMIC RESEARCHERS 3013 02:17:14,210 --> 02:17:16,646 PARTICIPATING WITH THEIR 3014 02:17:16,646 --> 02:17:19,282 COLLEAGUES WITH A V.A. 3015 02:17:19,282 --> 02:17:20,416 APPOINTMENT TO WRITE GRANTS AND 3016 02:17:20,416 --> 02:17:21,217 REALLY PROMOTING THAT. 3017 02:17:21,217 --> 02:17:26,622 >> THANK YOU. 3018 02:17:26,622 --> 02:17:30,293 >> AND ALONG THOSE LINES, ALL OF 3019 02:17:30,293 --> 02:17:35,431 US ARE AWARE THAT THE RISK OF 3020 02:17:35,431 --> 02:17:36,933 RE-IDENTIFICATION OF STUDY 3021 02:17:36,933 --> 02:17:38,501 PARTICIPANTS IS NEVER ZERO. 3022 02:17:38,501 --> 02:17:39,936 SO WE HAVE THIS TRADE-OFF THAT 3023 02:17:39,936 --> 02:17:41,704 WE HAVE TO THINK ABOUT OF THE 3024 02:17:41,704 --> 02:17:43,139 BALANCE BETWEEN THE RISKS AND 3025 02:17:43,139 --> 02:17:45,174 BENEFITS TO STUDY PARTICIPANTS. 3026 02:17:45,174 --> 02:17:48,577 AND I'M CURIOUS FOR ALL OF THE 3027 02:17:48,577 --> 02:17:50,112 SPEAKERS OF THIS SESSION MAYBE 3028 02:17:50,112 --> 02:17:53,115 IT START WITH DR. DENNY ON THE 3029 02:17:53,115 --> 02:17:57,820 QUESTION OF HOW DO YOU SOMEONE 3030 02:17:57,820 --> 02:18:00,122 INDICATE THE TRADE-OFF OF RISK 3031 02:18:00,122 --> 02:18:03,659 AND BENEFIT TO PARTICIPANTS AND 3032 02:18:03,659 --> 02:18:05,227 THE POTENTIAL FOR 3033 02:18:05,227 --> 02:18:06,228 RE-IDENTIFICATION BALANCED WITH 3034 02:18:06,228 --> 02:18:09,865 THE POTENTIAL FOR DOING GOOD? 3035 02:18:09,865 --> 02:18:13,703 >> IT'S A GREAT QUESTION. 3036 02:18:13,703 --> 02:18:17,006 I CAN GO BACK TO THE WORK AT 3037 02:18:17,006 --> 02:18:20,009 VANDERBILT AND BUILDING HIPAA 3038 02:18:20,009 --> 02:18:23,479 DE-IDENTIFIED REPOSITORY LINKED 3039 02:18:23,479 --> 02:18:24,413 TO DNA. 3040 02:18:24,413 --> 02:18:28,684 THE DIFFERENCE WITH ALL OF US IS 3041 02:18:28,684 --> 02:18:31,287 IT STARTED WITH 17 CITIES AND 3042 02:18:31,287 --> 02:18:35,024 ASKED ABOUT THE SCENARIO WITH 3043 02:18:35,024 --> 02:18:36,492 THE POPULATION AND BUILT THE 3044 02:18:36,492 --> 02:18:38,694 PROGRAM UP FROM WHAT AT THAT 3045 02:18:38,694 --> 02:18:39,795 TIME WOULD HAVE BEEN POTENTIAL 3046 02:18:39,795 --> 02:18:42,198 PARTICIPANTS BECAUSE WE DIDN'T 3047 02:18:42,198 --> 02:18:43,466 HAVE A PROGRAM. 3048 02:18:43,466 --> 02:18:47,670 OFF WHAT THEY TOLD US WAS 3049 02:18:47,670 --> 02:18:47,937 IMPORTANT. 3050 02:18:47,937 --> 02:18:49,705 SO WE TRY TO MAKE IT CLEAR IN 3051 02:18:49,705 --> 02:18:52,908 THE CONSENT THAT WE'RE NOT GOING 3052 02:18:52,908 --> 02:18:54,443 TO BE SHARING YOUR DIRECT 3053 02:18:54,443 --> 02:18:55,978 IDENTIFIERS AND THINGS LIKE THAT 3054 02:18:55,978 --> 02:18:58,514 BUT IT DOESN'T MEAN IT'S 3055 02:18:58,514 --> 02:18:59,515 IMPOSSIBLE FOR YOU TO 3056 02:18:59,515 --> 02:18:59,815 REIDENTIFY. 3057 02:18:59,815 --> 02:19:01,050 WE'LL DO THE BEST WE CAN AND 3058 02:19:01,050 --> 02:19:03,819 HAVE VIDEOS ON CONSENT AND 3059 02:19:03,819 --> 02:19:05,054 PRIVACY AND THINGS LIKE THIS 3060 02:19:05,054 --> 02:19:05,321 SECURITY. 3061 02:19:05,321 --> 02:19:07,757 THAT'S ONE OF THE RISKS OF THE 3062 02:19:07,757 --> 02:19:07,990 PROGRAM. 3063 02:19:07,990 --> 02:19:11,127 IN ADDITION I'M PRETTY SURE IT'S 3064 02:19:11,127 --> 02:19:13,596 LIKE THE QUESTIONS THAT WE ASK 3065 02:19:13,596 --> 02:19:15,564 THE PARTICIPANT TO MAKE SURE 3066 02:19:15,564 --> 02:19:26,108 THEY UNDERSTAND CORRECTLY WHAT 3067 02:19:33,682 --> 02:19:35,017 THE PARTICIPANTS SAY AND AT THE 3068 02:19:35,017 --> 02:19:37,286 SAME TIME PEOPLE WANT US TO 3069 02:19:37,286 --> 02:19:37,787 DISCOVER STUFF. 3070 02:19:37,787 --> 02:19:40,089 THEY WANT US TO MAKE A 3071 02:19:40,089 --> 02:19:40,389 DIFFERENCE. 3072 02:19:40,389 --> 02:19:43,325 THAT'S WHY THEY'RE JOINING AND I 3073 02:19:43,325 --> 02:19:44,660 THINK A LOT OF TIMES WE MIGHT BE 3074 02:19:44,660 --> 02:19:45,995 MORE WORRIED ABOUT THAT THAN 3075 02:19:45,995 --> 02:19:52,068 SOME OF OUR PARTICIPANTS ARE. 3076 02:19:52,068 --> 02:19:53,869 LOTS OF PEOPLE ARE GIVING 3077 02:19:53,869 --> 02:19:56,372 INFORMATION TO CREDIT CARD AND 3078 02:19:56,372 --> 02:19:57,706 NETFLIX AND OTHER COMPANIES OUT 3079 02:19:57,706 --> 02:19:59,608 THERE THAT IS SOLD TO OTHER 3080 02:19:59,608 --> 02:20:02,144 PEOPLE VERSUS WHAT THEY GIVE TO 3081 02:20:02,144 --> 02:20:05,881 US. 3082 02:20:05,881 --> 02:20:16,192 SO IT'S IMPORTANT. 3083 02:20:18,227 --> 02:20:19,328 >> WHAT'S PRIVATE AND WHAT 3084 02:20:19,328 --> 02:20:22,998 CANNON SHARED WITH THE ADVENT OF 3085 02:20:22,998 --> 02:20:26,302 SOCIAL MEDIA SO TO SAY. 3086 02:20:26,302 --> 02:20:28,871 BACK IN 2009, 2008 WHEN WE WERE 3087 02:20:28,871 --> 02:20:30,606 DOING A LITTLE SURVEY THE 3088 02:20:30,606 --> 02:20:36,412 VETERANS WERE VERY ALTRUISTIC IN 3089 02:20:36,412 --> 02:20:43,552 SAYING TAY HAVE NO HESITATION TO 3090 02:20:43,552 --> 02:20:44,620 SHARE DATA WITH ACADEMIC 3091 02:20:44,620 --> 02:20:51,093 INSTITUTIONS. 3092 02:20:51,093 --> 02:20:52,928 THEY WERE NOT KEEN ON SHARING 3093 02:20:52,928 --> 02:20:54,263 FOR PROFIT AND THAT'S EVOLVED 3094 02:20:54,263 --> 02:20:55,865 OVER THE TIME IN TERMS OF WHAT 3095 02:20:55,865 --> 02:20:59,902 THEY ARE WILLING TO SHARE AS 3096 02:20:59,902 --> 02:21:02,505 PART OF THE LARGE BIO BANK. 3097 02:21:02,505 --> 02:21:05,207 IN GENERAL I AGREE THE V.A. HAS 3098 02:21:05,207 --> 02:21:07,243 TAKEN THE IDEA TO ERROR ON THE 3099 02:21:07,243 --> 02:21:12,148 SIDE OF CAUTION AND WE HAVE BEEN 3100 02:21:12,148 --> 02:21:20,589 FIGURING OUT THE NUANCES OF AS A 3101 02:21:20,589 --> 02:21:22,658 QUESTION IT DEPENDS ON THE 3102 02:21:22,658 --> 02:21:27,496 NUANCES IN TERMS OF WHAT CAN BE 3103 02:21:27,496 --> 02:21:29,865 REIDENTIFIED AND WHAT CAN BE 3104 02:21:29,865 --> 02:21:33,636 TRULY ANONYMIZED. 3105 02:21:33,636 --> 02:21:34,403 >> THAT'S GREAT. 3106 02:21:34,403 --> 02:21:38,140 LOOKS LIKE WE HAVE A QUESTION 3107 02:21:38,140 --> 02:21:39,708 FROM DR. BOERWINKLE IF YOU WANT 3108 02:21:39,708 --> 02:21:41,010 TO JUMP IN. 3109 02:21:41,010 --> 02:21:43,045 >> THERE'S A LOT OF WISDOM IN 3110 02:21:43,045 --> 02:21:45,514 THIS SESSION BUT I'LL PICK ON 3111 02:21:45,514 --> 02:21:46,849 YOU, BRUCE, FOR FUN. 3112 02:21:46,849 --> 02:21:48,551 YOU BROUGHT UP THE IMPORTANCE OF 3113 02:21:48,551 --> 02:21:52,655 ASKING A GOOD QUESTION. 3114 02:21:52,655 --> 02:21:55,291 HOW DO WE MENTOR -- FIRST 3115 02:21:55,291 --> 02:21:58,961 OURSELVES AND HOW DO WE TALK TO 3116 02:21:58,961 --> 02:22:00,996 THE FIELD ABOUT THE IMPORTANCE 3117 02:22:00,996 --> 02:22:02,398 OF A GOOD QUESTION BUT KEEPING 3118 02:22:02,398 --> 02:22:06,468 IN MIND THAT THE WORLD RIGHT NOW 3119 02:22:06,468 --> 02:22:13,008 IS GA-GA ABOUT THE POSSIBLE OF 3120 02:22:13,008 --> 02:22:13,576 HYPOTHESIS-FREE, ARTIFICIAL 3121 02:22:13,576 --> 02:22:15,044 INTELLIGENCE ETCETERA. 3122 02:22:15,044 --> 02:22:16,312 THERE'S A GROWING SENTIMENT WHAT 3123 02:22:16,312 --> 02:22:18,480 YOU REALLY NEED IS NOT TO BE 3124 02:22:18,480 --> 02:22:20,683 VERY SMART BUT RATHER TO HAVE A 3125 02:22:20,683 --> 02:22:23,619 REALLY BIG AND CLIMB A LADDER 3126 02:22:23,619 --> 02:22:25,821 AND DUMP THE DATA AT THE TOP AND 3127 02:22:25,821 --> 02:22:28,290 PUSH THE ON BUTTON AND THE NEXT 3128 02:22:28,290 --> 02:22:30,593 DAY INSIGHT WILL COME OUT THE 3129 02:22:30,593 --> 02:22:30,826 BOTTOM. 3130 02:22:30,826 --> 02:22:40,803 HOW DO WE BALANCE THOSE IN 2023? 3131 02:22:40,803 --> 02:22:42,605 WELL, THANKS, ERIC FOR THAT 3132 02:22:42,605 --> 02:22:42,972 QUESTION. 3133 02:22:42,972 --> 02:22:44,640 IN THE OLD DAYS WHEN WE HAD TO 3134 02:22:44,640 --> 02:22:46,242 WRITE GRANTS AND COLLECT THE 3135 02:22:46,242 --> 02:22:48,844 DATA AND GET FUNDING FOR THE 3136 02:22:48,844 --> 02:22:51,480 DATA COLLECTION TO ANSWER A 3137 02:22:51,480 --> 02:22:53,882 QUESTION, THE QUESTION USED TO 3138 02:22:53,882 --> 02:22:55,417 BE CRITICALLY IMPORTANT. 3139 02:22:55,417 --> 02:22:56,785 AND SO I THINK THE METHOD THERE 3140 02:22:56,785 --> 02:23:01,257 WAS TO LOOK AT THE LITERATURE, 3141 02:23:01,257 --> 02:23:02,925 KNOW THE LITERATURE WELL AND ASK 3142 02:23:02,925 --> 02:23:05,494 WHAT THE NEXT ANSWERABLE 3143 02:23:05,494 --> 02:23:07,763 QUESTION MIGHT BE. 3144 02:23:07,763 --> 02:23:09,064 THINGS HAVE SHIFTED A BIT WITH 3145 02:23:09,064 --> 02:23:13,269 THE BIG DATA BUT I THINK FOR BIG 3146 02:23:13,269 --> 02:23:19,275 DATA ANALYSIS I TEND TO PREFER 3147 02:23:19,275 --> 02:23:19,875 ETIOLOGIC QUESTIONS. 3148 02:23:19,875 --> 02:23:21,477 WHAT WHERE THE CAUSES OF DISEASE 3149 02:23:21,477 --> 02:23:23,946 AND HOW CAN WE USE OMICS TO 3150 02:23:23,946 --> 02:23:27,182 VERIFY THE VARIANTS AND ARE THEY 3151 02:23:27,182 --> 02:23:37,893 TARGETABLE AND DOES MENDEL IIAN 3152 02:23:41,263 --> 02:23:42,965 SYSTEMS HELP AND JOE MADE A 3153 02:23:42,965 --> 02:23:46,969 POINT IN EMPHASIZING WE NEED TO 3154 02:23:46,969 --> 02:23:48,637 THINK WITH THE POSITIVE 3155 02:23:48,637 --> 02:23:50,906 PREDICTIVE VALUE AND THE 3156 02:23:50,906 --> 02:23:52,675 INCREASE OF .02 IS REALLY 3157 02:23:52,675 --> 02:23:57,946 NOTHING TO WRITE HOME ABOUT. 3158 02:23:57,946 --> 02:24:00,582 AND PREDICTION IS IMPORTANT FOR 3159 02:24:00,582 --> 02:24:02,484 INSTANCE IF A THERAPY THAT MIGHT 3160 02:24:02,484 --> 02:24:05,854 BE OFFERED IS TOXIC OR 3161 02:24:05,854 --> 02:24:09,058 EXPENSIVE. 3162 02:24:09,058 --> 02:24:10,759 BUT FOR MANY THERAPIES THAT'S 3163 02:24:10,759 --> 02:24:12,328 NOT AN ISSUE. 3164 02:24:12,328 --> 02:24:14,663 I TEND TO FAVOR ETIOLOGIC 3165 02:24:14,663 --> 02:24:16,598 QUESTIONS OFFER PREDICTIVE ONES. 3166 02:24:16,598 --> 02:24:18,267 THERE'S SETTINGS WHERE 3167 02:24:18,267 --> 02:24:19,802 PREDICTION WORKS AND IS KEY BUT 3168 02:24:19,802 --> 02:24:21,870 I THINK THEY'RE MORE LIMITED. 3169 02:24:21,870 --> 02:24:23,772 >> THANKS. 3170 02:24:23,772 --> 02:24:28,277 >> I THINK TO EXPAND A LITTLE 3171 02:24:28,277 --> 02:24:29,878 BIT YOUR QUESTION IS PROFOUND 3172 02:24:29,878 --> 02:24:32,314 BUT IT'S ANY EXCITING TIME BUT I 3173 02:24:32,314 --> 02:24:35,250 THINK THE PUBLIC INTERESTED IN 3174 02:24:35,250 --> 02:24:36,618 NUMBERS. 3175 02:24:36,618 --> 02:24:37,853 THE PUBLIC IS INTERESTED IN WHAT 3176 02:24:37,853 --> 02:24:42,891 ALGORITHMS CAN DO. 3177 02:24:42,891 --> 02:24:44,993 FOR ME IT MEANS EDUCATION HAS AN 3178 02:24:44,993 --> 02:24:45,894 OPPORTUNITY BECAUSE I THINK WE 3179 02:24:45,894 --> 02:24:47,696 CAN'T ANSWER THE WORLD WITH A 3180 02:24:47,696 --> 02:24:48,630 TWEET OR AN X, WHATEVER THAT IS 3181 02:24:48,630 --> 02:24:50,032 NOW. 3182 02:24:50,032 --> 02:24:53,569 AND FOR ME THE KEY CONCEPT I 3183 02:24:53,569 --> 02:24:55,771 STRUGGLED WITH FOR A LONG TIME 3184 02:24:55,771 --> 02:24:57,005 IS THE BAYESIAN PRINCIPLE THEY 3185 02:24:57,005 --> 02:24:58,440 THINK APPLIES TO EVERYTHING THAT 3186 02:24:58,440 --> 02:25:04,146 DATA GIVES YOU A LIKELIHOOD 3187 02:25:04,146 --> 02:25:04,346 RATIO. 3188 02:25:04,346 --> 02:25:10,786 BUT THERE IS A PRIOR AND IF YOU 3189 02:25:10,786 --> 02:25:14,289 START WITH INSANE THINGS WITH A 3190 02:25:14,289 --> 02:25:19,294 MILLION POSSIBLE THINGS YOU KNOW 3191 02:25:19,294 --> 02:25:25,167 NOTHING ABOUT IT'S DIFFICULT TO 3192 02:25:25,167 --> 02:25:25,968 GET THE MEAN. 3193 02:25:25,968 --> 02:25:36,445 >> THE KEY IS TO BRING THEM 3194 02:25:38,847 --> 02:25:39,915 TOGETHER AND HAVEN'T DONE ENOUGH 3195 02:25:39,915 --> 02:25:42,618 OF BRINGING BOTH APPROACHES 3196 02:25:42,618 --> 02:25:43,752 TOGETHER TRYING TO UNDERSTAND 3197 02:25:43,752 --> 02:25:46,422 WHAT'S GOING ON WHEN THEY AGREE 3198 02:25:46,422 --> 02:25:47,523 AND TRYING TO UNDER UNDERSTAND 3199 02:25:47,523 --> 02:25:49,625 WHAT'S IT GOING ON WHEN THEY 3200 02:25:49,625 --> 02:25:51,026 DON'T AGREE. 3201 02:25:51,026 --> 02:25:54,229 BUT RIGHT NOW WE'RE SORT OF 3202 02:25:54,229 --> 02:25:55,531 ENMANIERED BY THE TECHNOLOGY, 3203 02:25:55,531 --> 02:25:56,698 RIGHTFULLY SO. 3204 02:25:56,698 --> 02:25:59,835 SO I'M NOT BEING CRITICAL BUT 3205 02:25:59,835 --> 02:26:01,303 WONDER IF WE NEED TO SPEND MORE 3206 02:26:01,303 --> 02:26:05,040 TIME BRINGING THESE TWO 3207 02:26:05,040 --> 02:26:08,277 APPROACHES INTO A SEMI COHESIVE 3208 02:26:08,277 --> 02:26:09,711 ALGORITHM OR WORK FLOW. 3209 02:26:09,711 --> 02:26:12,114 >> I'D LOVE YOUR ANSWER. 3210 02:26:12,114 --> 02:26:13,115 I'VE BEEN STRUCK SOME OF THE 3211 02:26:13,115 --> 02:26:16,919 MOST EXCITING THINGS ARE 3212 02:26:16,919 --> 02:26:20,622 ANECDOTES OF ONE. 3213 02:26:20,622 --> 02:26:21,457 SEQUENCE IS BETTER. 3214 02:26:21,457 --> 02:26:26,195 HOW DO WE CONNECT THAT ANECDOTE 3215 02:26:26,195 --> 02:26:30,265 TO SCIENCE AND AT A PERSONAL 3216 02:26:30,265 --> 02:26:31,800 LEVEL IT'S A LOT OF DATA BUT WE 3217 02:26:31,800 --> 02:26:33,869 NEED THE PRINCIPLES OF ACCURACY 3218 02:26:33,869 --> 02:26:35,771 AND PREDICTIVE VALUE, ETCETERA. 3219 02:26:35,771 --> 02:26:39,508 >> I THINK TO ADD TO THAT, 3220 02:26:39,508 --> 02:26:40,576 THERE'S AN INTERESTING POINT ON 3221 02:26:40,576 --> 02:26:43,412 TOP OF ERIC TOPOL'S TALK 3222 02:26:43,412 --> 02:26:47,082 YESTERDAY ABOUT THE IDEA OF THE 3223 02:26:47,082 --> 02:26:48,484 ANECDOTES IS THERE A WAY TO 3224 02:26:48,484 --> 02:26:51,086 BRING THEM TO ACTUALLY LEARN 3225 02:26:51,086 --> 02:26:52,721 FROM THE END OF ONE STUDIES. 3226 02:26:52,721 --> 02:26:55,057 IT SEEMS LIKE THERE MAY BE 3227 02:26:55,057 --> 02:26:56,992 POTENTIAL IF SOME TRAINEES ARE 3228 02:26:56,992 --> 02:26:58,260 INTERESTED IN PURSUING THAT 3229 02:26:58,260 --> 02:27:01,797 ROUTE OF COMING UP WITH A WAY TO 3230 02:27:01,797 --> 02:27:02,798 AGGREGATE THESE ANECDOTAL 3231 02:27:02,798 --> 02:27:05,901 STORIES SO WE CAN START TO LEARN 3232 02:27:05,901 --> 02:27:07,536 ON A LARGER SCALE HOW EFFECTIVE 3233 02:27:07,536 --> 02:27:15,744 THESE METHODS ARE. 3234 02:27:15,744 --> 02:27:17,279 >> THERE'S AN INTERESTING 3235 02:27:17,279 --> 02:27:18,547 QUESTION DIRECTED TO DR. CORESH 3236 02:27:18,547 --> 02:27:20,582 BUT I THINK IS RELEVANT TO ALL 3237 02:27:20,582 --> 02:27:23,385 THE FOLKS RUNNING THESE STUDIES 3238 02:27:23,385 --> 02:27:24,720 WHICH IS ABOUT PARTICIPANT 3239 02:27:24,720 --> 02:27:25,087 FATIGUE. 3240 02:27:25,087 --> 02:27:26,588 SO WHEN WE HAVE THESE 3241 02:27:26,588 --> 02:27:29,491 LONGITUDINAL STUDIES, HOW DO YOU 3242 02:27:29,491 --> 02:27:30,726 THINK ABOUT PARTICIPANT FATIGUE. 3243 02:27:30,726 --> 02:27:33,495 ARE THERE WAYS TO KEEP PEOPLE 3244 02:27:33,495 --> 02:27:35,163 ENGAGED IN WAYS TO ADDRESS FROM 3245 02:27:35,163 --> 02:27:38,600 THE OUTSET EXPECTED DROP OFF? 3246 02:27:38,600 --> 02:27:41,670 >> YEAH, I'M HAPPY TO START AND 3247 02:27:41,670 --> 02:27:42,771 INTERESTED TO HEAR FROM OTHER 3248 02:27:42,771 --> 02:27:43,972 PEOPLE HAVE DONE THIS. 3249 02:27:43,972 --> 02:27:47,609 I THINK HAVE SHIFTED OUR 3250 02:27:47,609 --> 02:27:49,378 INVESTIGATOR GROUP TO THINK MORE 3251 02:27:49,378 --> 02:27:53,515 INSTEAD OF OFTEN WE WERE 3252 02:27:53,515 --> 02:27:54,583 QUANTIFYING PARTICIPANT BURDEN 3253 02:27:54,583 --> 02:27:55,684 IN THE NUMBER OF MINUTES THEY 3254 02:27:55,684 --> 02:27:57,352 HAVE TO PUT UP WITH US 3255 02:27:57,352 --> 02:27:59,488 ESPECIALLY IN ARIC WITH THE 3256 02:27:59,488 --> 02:28:00,656 COHORT IS OLDER I THINK A LOT IS 3257 02:28:00,656 --> 02:28:10,766 VALUE. 3258 02:28:20,175 --> 02:28:22,711 WHAT ARE THEY GETTING AND THE 3259 02:28:22,711 --> 02:28:25,547 PERCIEVED VALUE AND IF THEY LIKE 3260 02:28:25,547 --> 02:28:27,149 US THEY'LL LIKE SPENDING TIME 3261 02:28:27,149 --> 02:28:29,484 WITH US AND SOME OF US PREFER A 3262 02:28:29,484 --> 02:28:31,887 FOUR-HOUR VISIT AND TAKE A 3263 02:28:31,887 --> 02:28:33,255 SEVEN-HOUR VISIT THE BURDEN IS 3264 02:28:33,255 --> 02:28:35,657 THEN ON US AND THERE'S PROOF 3265 02:28:35,657 --> 02:28:38,093 WHERE IN THE ARIC STUDY WE'RE 3266 02:28:38,093 --> 02:28:40,262 STRUGGLING TO GET THE RIGHT 3267 02:28:40,262 --> 02:28:42,197 RESPONSE RATE BUT IN THE 3268 02:28:42,197 --> 02:28:43,699 PARTICIPANTS WHERE WE WENT FROM 3269 02:28:43,699 --> 02:28:45,300 TWO TO SIX VISITS A YEAR WE GOT 3270 02:28:45,300 --> 02:28:53,742 AT THE END OF THREE YEARS THE 3271 02:28:53,742 --> 02:28:55,210 90% RESPONSE RATE BECAUSE WE 3272 02:28:55,210 --> 02:28:57,279 GIVE THEM FREE HEARING AIDS AND 3273 02:28:57,279 --> 02:28:59,481 SOME GOT AN AGING 3274 02:28:59,481 --> 02:28:59,881 INTERDEVELOPINGS. 3275 02:28:59,881 --> 02:29:02,184 IT'S AN ENGAGEMENT AND MAKING 3276 02:29:02,184 --> 02:29:07,823 SURE THAT WE AS SCIENTISTS SEE 3277 02:29:07,823 --> 02:29:09,992 THE TWO-WAY STREET AND SOME 3278 02:29:09,992 --> 02:29:11,627 LISTEN TO WHAT THE PARTICIPANTS 3279 02:29:11,627 --> 02:29:13,261 WANT IT STUDY. 3280 02:29:13,261 --> 02:29:19,067 I THINK THAT'S USEFUL BUT FOR ME 3281 02:29:19,067 --> 02:29:23,872 EVEN MORE IMPORTANT IS WHAT 3282 02:29:23,872 --> 02:29:25,841 PARTICIPANTS SEE AS IMPACTFUL 3283 02:29:25,841 --> 02:29:28,710 AND ENGAGING BUT DIFFERENT. 3284 02:29:28,710 --> 02:29:30,879 WE ARE INVESTIGATORS, THEY ARE 3285 02:29:30,879 --> 02:29:31,213 PARTICIPANTS. 3286 02:29:31,213 --> 02:29:32,881 THEY'RE NOT GOING TO BE ALLIES 3287 02:29:32,881 --> 02:29:37,919 IN THE GWAS DATA BUT THEY HAVE 3288 02:29:37,919 --> 02:29:39,287 THEIR OWN NEEDS. 3289 02:29:39,287 --> 02:29:40,822 I HOPE THAT HELPS. 3290 02:29:40,822 --> 02:29:43,225 >> WOULD ANYONE LIKE TO ADD ON 3291 02:29:43,225 --> 02:29:47,863 TOP OF THAT? 3292 02:29:47,863 --> 02:29:50,699 >> THE ONLY THING I AGREE I WANT 3293 02:29:50,699 --> 02:29:52,768 TO ADD IS THAT THE VETERANS IN 3294 02:29:52,768 --> 02:29:55,037 GENERAL ARE MORALE TRUISTIC 3295 02:29:55,037 --> 02:29:57,205 BECAUSE THEY'RE MORE WILLING TO 3296 02:29:57,205 --> 02:29:58,807 CONTRIBUTE ANYTHING THAT HELPS. 3297 02:29:58,807 --> 02:30:02,544 THEY KNOW IT MAY NOT HELP THEM 3298 02:30:02,544 --> 02:30:06,848 BUT MIGHT HELP THEIR FELLOW 3299 02:30:06,848 --> 02:30:07,115 VETERANS. 3300 02:30:07,115 --> 02:30:12,421 WHAT WE ARE LEARNING THE 3301 02:30:12,421 --> 02:30:17,392 ENGAGEMENT IS VERY IMPORTANT. 3302 02:30:17,392 --> 02:30:20,429 THEY NEED TO KNOW WHAT IS COMING 3303 02:30:20,429 --> 02:30:21,630 AND WHAT ARE THE CONTRIBUTIONS 3304 02:30:21,630 --> 02:30:24,666 THE DATA HAS MADE TO THE SOCIETY 3305 02:30:24,666 --> 02:30:26,702 AND TO OTHER VETERANS AND HOW IT 3306 02:30:26,702 --> 02:30:32,841 HAS HELPED. 3307 02:30:32,841 --> 02:30:43,385 WE HAVE SORT OF TAKEN ENGAGEMENT 3308 02:30:44,486 --> 02:30:46,188 AND TALKING AT THE FIELD LEVEL 3309 02:30:46,188 --> 02:30:56,565 TO KEEP THEM ENGAGED. 3310 02:30:58,734 --> 02:31:01,369 >> IT'S WONDERFUL WE AGREE. 3311 02:31:01,369 --> 02:31:03,505 CAN YOU GIVE PEOPLE BALLPARK 3312 02:31:03,505 --> 02:31:04,539 ESTIMATES TO CALIBRATE MAY BE 3313 02:31:04,539 --> 02:31:06,842 HARD TO DO ON THE TOP OF YOUR 3314 02:31:06,842 --> 02:31:09,911 HEAD WHAT ARE REASONABLE 3315 02:31:09,911 --> 02:31:12,881 RESPONSE RATES TO A 3316 02:31:12,881 --> 02:31:17,953 QUESTIONNAIRE, TO AN EXAM, TO A 3317 02:31:17,953 --> 02:31:19,888 BLOOD, TO A TEST AND THEN AS A 3318 02:31:19,888 --> 02:31:21,890 REMINDER TO EVERYBODY, YOUR 3319 02:31:21,890 --> 02:31:23,925 FOLLOW UP IS 100%. 3320 02:31:23,925 --> 02:31:24,926 FOR A LOT OF THINGS THEY DON'T 3321 02:31:24,926 --> 02:31:26,561 HAVE A CHOICE. 3322 02:31:26,561 --> 02:31:29,865 THEY'RE IN YOUR SYSTEM. 3323 02:31:29,865 --> 02:31:30,799 >> EXACTLY. 3324 02:31:30,799 --> 02:31:33,235 I CAN TACKLE A FEW. 3325 02:31:33,235 --> 02:31:36,738 FOR WHEN WE REACH OUT LIKE THE 3326 02:31:36,738 --> 02:31:42,744 OLD SNAIL MAIL LETTER TO FOLKS 3327 02:31:42,744 --> 02:31:46,414 YOU SEND OUT A LETTER AND IF 3328 02:31:46,414 --> 02:31:47,949 THEY DON'T RESPOND WE SEND A 3329 02:31:47,949 --> 02:31:49,584 SECOND AND THIRD. 3330 02:31:49,584 --> 02:31:53,488 BETWEEN THE THREE WE GET 3331 02:31:53,488 --> 02:31:57,459 SOMEWHERE BETWEEN 50% TO 80% 3332 02:31:57,459 --> 02:32:02,898 RATES AND SINCE WE HAVE GONE TO 3333 02:32:02,898 --> 02:32:04,466 THE ONLINE THING FOR THEM DOING 3334 02:32:04,466 --> 02:32:07,702 THE CONSENT AND GIVING THE BLOOD 3335 02:32:07,702 --> 02:32:10,305 IS MORE IMPORTANT THAN ANSWERING 3336 02:32:10,305 --> 02:32:10,972 THE SURVEY ACQUISITION AND 3337 02:32:10,972 --> 02:32:21,383 THEY'RE LOWER THAN THAT. 3338 02:32:22,384 --> 02:32:25,220 WE'RE GEARING UP TO DO A SECOND 3339 02:32:25,220 --> 02:32:29,825 SURVEY AND AS YOU SAID THE 3340 02:32:29,825 --> 02:32:31,426 E.H.R. DATA IS AVAILABLE ONCE 3341 02:32:31,426 --> 02:32:35,764 THE CONSENT IS SIGNED BUT WE'RE 3342 02:32:35,764 --> 02:32:39,401 LOOKING INTO COLLECTING A SECOND 3343 02:32:39,401 --> 02:32:41,703 SURVEY AND LONGITUDINAL SAMPLE 3344 02:32:41,703 --> 02:32:42,270 COLLECTION. 3345 02:32:42,270 --> 02:32:48,276 >> IT'S A HELPFUL CALCULATION. 3346 02:32:48,276 --> 02:32:51,213 GOD'S GIFT TO COHORTS IS ONCE 3347 02:32:51,213 --> 02:32:53,148 ENROLL, FOLLOW-UP IS WHAT 3348 02:32:53,148 --> 02:32:54,449 MATTERS AN THAT'S IN YOUR SYSTEM 3349 02:32:54,449 --> 02:32:58,320 BUT NOT THE WORLD ONE OF MY 3350 02:32:58,320 --> 02:33:00,922 SENIOR MENTORS DID HOUSEHOLD 3351 02:33:00,922 --> 02:33:08,997 ENUMERATION GOT 99% OF 3352 02:33:08,997 --> 02:33:11,600 HOUSEHOLDS AND IN CHINA YOU CAN 3353 02:33:11,600 --> 02:33:12,868 STILL GET HUGE RATES BUT WE HAVE 3354 02:33:12,868 --> 02:33:15,670 TO LIVE WITH THE SYSTEMS WE 3355 02:33:15,670 --> 02:33:15,871 HAVE. 3356 02:33:15,871 --> 02:33:16,872 PASSIVE MAY HELP A LOT. 3357 02:33:16,872 --> 02:33:17,672 THANK YOU VERY MUCH. 3358 02:33:17,672 --> 02:33:23,311 I THINK WE MAY BE ON TIME, 3359 02:33:23,311 --> 02:33:23,678 RIGHT? 3360 02:33:23,678 --> 02:33:24,479 >> 3361 02:33:24,479 --> 02:33:27,382 >> IT'S A PERFECT TIME TO WRAP 3362 02:33:27,382 --> 02:33:30,619 AND RETURNING AT 1:00 P.M. 3363 02:33:30,619 --> 02:33:34,689 ENOUGH TIME TO GRAB A QUICK 3364 02:33:34,689 --> 02:33:36,958 LUNCH AND KICK OFF WITH DR. BOUR 3365 02:33:36,958 --> 02:33:39,461 WINKLE AND THEN WE'LL HAVE AN 3366 02:33:39,461 --> 02:33:41,062 AFTERNOON SESSION ON FUTURE 3367 02:33:41,062 --> 02:33:42,430 TRENDS, INNOVATIONS APPLICATIONS 3368 02:33:42,430 --> 02:33:51,177 OF BIG DATA AND EPIDEMIOLOGY. 3369 02:33:51,177 --> 02:33:55,181 IT'SA PLEASURE TO INTRODUCING 3370 02:33:55,181 --> 02:34:01,321 DR. BOERWINKLE IS THE DEAN OF 3371 02:34:01,321 --> 02:34:09,529 SCHOOL OF PUBLIC HEALTH IN 3372 02:34:09,529 --> 02:34:15,468 HOUSTON WITH AN EMPHASIS ON 3373 02:34:15,468 --> 02:34:17,737 LARGE TEAM SCIENCE AND THEY'VE 3374 02:34:17,737 --> 02:34:23,276 MADE GROUNDBREAKING DISCOVERIES 3375 02:34:23,276 --> 02:34:25,078 WITH CHRONIC DISEASE AND 3376 02:34:25,078 --> 02:34:27,080 DEMENTIA AND RARE SINGLE GENE 3377 02:34:27,080 --> 02:34:27,714 DISORDERS. 3378 02:34:27,714 --> 02:34:30,149 HE'S CO-AUTHORED OVER 1,000 3379 02:34:30,149 --> 02:34:35,021 PAPERS AND VERY HIGH IMPACT 3380 02:34:35,021 --> 02:34:35,421 PAE 3381 02:34:35,421 --> 02:34:36,689 PAPERS AND HAS BEEN A WONDERFUL 3382 02:34:36,689 --> 02:34:39,692 COLLEAGUE AND MENTOR AND IT'S A 3383 02:34:39,692 --> 02:34:40,994 PLEASURE MYSELF TO HAVE BEEN 3384 02:34:40,994 --> 02:34:42,695 MENTORED AND LEARNED FROM HIS 3385 02:34:42,695 --> 02:34:45,698 AMAZING WORK AND THOUGHTFUL 3386 02:34:45,698 --> 02:34:47,567 INSIGHTS AND BROAD WISDOM. 3387 02:34:47,567 --> 02:34:49,936 THANK YOU FOR TAKING ON THIS 3388 02:34:49,936 --> 02:34:52,739 SLIGHTLY IMPOSSIBLE TASK. 3389 02:34:52,739 --> 02:34:53,573 >> THANK YOU. 3390 02:34:53,573 --> 02:34:59,012 ORE THE ORGANIZERS IT'S BEEN A 3391 02:34:59,012 --> 02:35:07,887 GREAT MEETING AND FUN MEETING. 3392 02:35:07,887 --> 02:35:11,057 I'LL TALK ABOUT THE LARGE AMOUNT 3393 02:35:11,057 --> 02:35:12,892 OF DATA FOR THE PROGRAM AND 3394 02:35:12,892 --> 02:35:19,265 FOCUS MULON MULTIOMICS DATA AND 3395 02:35:19,265 --> 02:35:20,600 TALK ABOUT TOOLS AND TECHNIQUES 3396 02:35:20,600 --> 02:35:22,569 IN A TWO OF DAY MEETING TOWARDS 3397 02:35:22,569 --> 02:35:24,837 THE END THAT COULD BE RATHER DRY 3398 02:35:24,837 --> 02:35:30,643 SO I'LL TRY TO WEAVE IN 3399 02:35:30,643 --> 02:35:35,648 INTERESTING STORIES IS ALONG 3400 02:35:35,648 --> 02:35:38,184 WITH BROAD DISCUSSION AND TAKE 3401 02:35:38,184 --> 02:35:40,587 ADVANTAGE OF THE FACT OF BEING A 3402 02:35:40,587 --> 02:35:42,488 KEY NOTE SPEAKER TOWARDS THE 3403 02:35:42,488 --> 02:35:43,923 AFTERNOON OF THE SECOND DAY I 3404 02:35:43,923 --> 02:35:49,429 CAN DO COLOR COMMENTARY OF SOME 3405 02:35:49,429 --> 02:35:59,973 OF THE THINGS WE'VE HEARD AN I I 3406 02:36:03,710 --> 02:36:06,379 RUN OUT OF TIME I THINK IT'S 3407 02:36:06,379 --> 02:36:08,848 MORE INTERESTING. 3408 02:36:08,848 --> 02:36:13,586 WE'VE ALL SEEN A NUMBER OF 3409 02:36:13,586 --> 02:36:14,954 VERSIONS OF THIS KIND OF SLIDE 3410 02:36:14,954 --> 02:36:19,726 WHERE WE HAVE LEVELS OF 3411 02:36:19,726 --> 02:36:20,860 INFORMATION UP THIS CASE AS I 3412 02:36:20,860 --> 02:36:24,364 SAID ALREADY IN MY CHARGE IT'S 3413 02:36:24,364 --> 02:36:26,132 LEVELS OF MULTIOMIC INFORMATION 3414 02:36:26,132 --> 02:36:28,334 BUT I THINK IT'S IMPORTANT TO 3415 02:36:28,334 --> 02:36:29,035 PAUSE AND THINK ABOUT THESE 3416 02:36:29,035 --> 02:36:33,539 KINDS OF FIGURES. 3417 02:36:33,539 --> 02:36:38,511 THE FIRST IS IT'S NOT JUST A 3418 02:36:38,511 --> 02:36:39,278 RANDOM ORDER. 3419 02:36:39,278 --> 02:36:43,983 WE THINK WE'RE SMART AND THAT 3420 02:36:43,983 --> 02:36:45,718 INFORMATION IS TRANSMITTED IN 3421 02:36:45,718 --> 02:36:51,024 SOME ORDER IN GENOMICS AND 3422 02:36:51,024 --> 02:36:53,993 METHYLATION WITH TRANSCRIPTOMICS 3423 02:36:53,993 --> 02:36:58,031 AND IT'S LIKELY CORRELATED WITH 3424 02:36:58,031 --> 02:37:01,167 PROTEIN LEVELS AND SOMEHOW THE 3425 02:37:01,167 --> 02:37:03,736 PROTEINS ARE INTERACTING IN 3426 02:37:03,736 --> 02:37:06,305 PATHWAYS AND WE CAN MEASURE 3427 02:37:06,305 --> 02:37:06,939 METABOLOMICS AND IT'S A 3428 02:37:06,939 --> 02:37:07,507 PHENOTYPE AND ORDER WE PUT 3429 02:37:07,507 --> 02:37:17,617 THERE. 3430 02:37:21,487 --> 02:37:26,926 AND THERE'S A LONGITUDINAL 3431 02:37:26,926 --> 02:37:29,562 COHORT STUDY. 3432 02:37:29,562 --> 02:37:31,831 AND IT WAS MENTIONED I THINK JOE 3433 02:37:31,831 --> 02:37:35,334 OR DR. CORESH MENTIONED THAT 3434 02:37:35,334 --> 02:37:37,270 THESE THINGS CAN CHANGE WITH 3435 02:37:37,270 --> 02:37:37,470 DIET. 3436 02:37:37,470 --> 02:37:38,604 THEY CHANGE WHEN I STAND UP 3437 02:37:38,604 --> 02:37:44,644 VERSUS SITTING DOWN. 3438 02:37:44,644 --> 02:37:45,812 SO TIME IS INCREDIBLY IMPORTANT 3439 02:37:45,812 --> 02:37:47,714 AND WHEN WE THINK OF DATA 3440 02:37:47,714 --> 02:37:48,681 INTEGRATION WHICH IS AN 3441 02:37:48,681 --> 02:37:53,820 IMPORTANT PART AND IN THE 3442 02:37:53,820 --> 02:37:57,590 MARQUEE OF THIS MEETING IS YOU 3443 02:37:57,590 --> 02:37:58,825 HAVE TO KEEP TRACK OF TIME AND 3444 02:37:58,825 --> 02:38:02,695 MAKE SURE YOU KNOW WHAT TIME 3445 02:38:02,695 --> 02:38:06,032 EACH OF THESE LEVELS BIOLOGIC 3446 02:38:06,032 --> 02:38:11,170 HIERARCHY WERE MENTIONED. 3447 02:38:11,170 --> 02:38:21,514 AND FINALLY TISSUE. 3448 02:38:24,817 --> 02:38:26,419 IN TISSUES WE'RE ALL IN LOVE 3449 02:38:26,419 --> 02:38:29,155 WITH OUR SOLID TISSUES SO WE'RE 3450 02:38:29,155 --> 02:38:31,557 LIMITED IN WHAT WE CAN GET BUT 3451 02:38:31,557 --> 02:38:35,862 ON THE OTHER HAND WE'VE GOTTEN 3452 02:38:35,862 --> 02:38:40,333 CLEVER I WOULD SAY ABOUT GETTING 3453 02:38:40,333 --> 02:38:41,768 INFORMATION FOR EXAMPLE FROM 3454 02:38:41,768 --> 02:38:42,135 STOOL SAMPLES. 3455 02:38:42,135 --> 02:38:45,972 WE'VE GOTTEN CLEVER WHAT WE CAN 3456 02:38:45,972 --> 02:38:48,174 GET WITH SMALL BIOPSIES OR 3457 02:38:48,174 --> 02:38:50,376 SAMPLES FOR EXAMPLE IN THE 3458 02:38:50,376 --> 02:38:57,350 CANCER ARENA SO IF WE CAN NEST 3459 02:38:57,350 --> 02:39:07,827 SOME OF THOSE SOME OF THAT 3460 02:39:13,933 --> 02:39:15,735 ABILITY IS INFORMATIVE AND 3461 02:39:15,735 --> 02:39:21,274 DR. PSATY TEE UP THE BALL NICELY 3462 02:39:21,274 --> 02:39:23,743 BUT MAYBE IT'S A SIGN OF OLD AGE 3463 02:39:23,743 --> 02:39:25,978 I LIKE UNDERSTANDING OF A 3464 02:39:25,978 --> 02:39:31,017 QUESTION EVEN THOUGH I 3465 02:39:31,017 --> 02:39:41,527 UNDERSTAND MODERN DAY SCIENCE 3466 02:39:43,763 --> 02:39:48,000 CAN FIND RELATIONSHIPS THE MERE 3467 02:39:48,000 --> 02:39:50,136 MORTAL COULDN'T HAVE SEEN BUT 3468 02:39:50,136 --> 02:39:52,004 IT'S STILL IMPORTANT TO PUT THE 3469 02:39:52,004 --> 02:39:53,072 OBSERVATIONS IN THE CONTEXT OF 3470 02:39:53,072 --> 02:39:55,408 WHAT'S DRIVING YOU TO DO THIS. 3471 02:39:55,408 --> 02:39:59,979 IT GOES BACK TO FOR THOSE WHO 3472 02:39:59,979 --> 02:40:01,781 HEARD THE WELCOME AND THERE WAS 3473 02:40:01,781 --> 02:40:07,086 A NICE DISCUSSION OF BRINGING 3474 02:40:07,086 --> 02:40:08,688 TOGETHER HYPOTHESIS QUESTION 3475 02:40:08,688 --> 02:40:11,524 DRIVEN VERSUS HYPOTHESIS FREE OR 3476 02:40:11,524 --> 02:40:13,326 A.I. SCIENCE AND I THINK A 3477 02:40:13,326 --> 02:40:14,627 CHALLENGE WE'RE GOING TO HAVE AS 3478 02:40:14,627 --> 02:40:16,295 A FIELD THE NEXT FEW YEARS SHOW 3479 02:40:16,295 --> 02:40:26,839 WE BRING THOSE THINGS TOGETHER. 3480 02:40:46,859 --> 02:40:48,527 WOULD TALKED ABOUT PARTICIPATING 3481 02:40:48,527 --> 02:40:51,831 RATES AND WHAT PERCENTAGE OF 3482 02:40:51,831 --> 02:40:52,531 INDIVIDUALS TAKE PART IN THE 3483 02:40:52,531 --> 02:40:54,433 SURVEY AND THERE'S THE CONCEPT 3484 02:40:54,433 --> 02:41:04,710 OF MISSING OR INCOMPLETE DATA. 3485 02:41:04,710 --> 02:41:06,012 IT'S IMPORTANT TO UNDERSTAND 3486 02:41:06,012 --> 02:41:08,281 WHAT IS UNDERLYING THE 3487 02:41:08,281 --> 02:41:09,548 MISSINGNESS AND WHETHER IT'S 3488 02:41:09,548 --> 02:41:12,285 RANDOM OR NOT RANDOM. 3489 02:41:12,285 --> 02:41:13,686 THAT'S AN OBVIOUS THING TO SAY 3490 02:41:13,686 --> 02:41:20,593 BUT HOW YOU HANDLE AND INTERPRET 3491 02:41:20,593 --> 02:41:31,137 THE MISSINGNESS IT'S BECAUSE THE 3492 02:41:31,137 --> 02:41:35,608 FIELD BUILT TOOLS IN THE CONTEXT 3493 02:41:35,608 --> 02:41:37,443 AND UNDERSTAND WHERE THE ANSWER 3494 02:41:37,443 --> 02:41:41,314 FITS IN AND WHEN IS IT WISE TO 3495 02:41:41,314 --> 02:41:43,582 IMPUTE AND NOT IMPUTE. 3496 02:41:43,582 --> 02:41:44,183 MAYBE WE'RE SMARTER THAN WE 3497 02:41:44,183 --> 02:41:50,256 REALLY ARE. 3498 02:41:50,256 --> 02:41:56,662 I WORK IN A FIELD WITH 3499 02:41:56,662 --> 02:42:03,569 METABOLOMICS DATA WE KNOW SOME 3500 02:42:03,569 --> 02:42:05,671 LEVELS ARE NOT BELOW THE 3501 02:42:05,671 --> 02:42:07,173 DETECTION LIMIT AND NEED TO 3502 02:42:07,173 --> 02:42:17,717 UNDERSTAND WHAT'S DRIVING THAT. 3503 02:42:23,789 --> 02:42:26,926 COMPUTING HAS GROWN ENORMOUSLY 3504 02:42:26,926 --> 02:42:32,198 IN THE LAST 10 OR FIVE YEARS 3505 02:42:32,198 --> 02:42:37,536 CERTAINLY BUT THERE'S A PROBLEM 3506 02:42:37,536 --> 02:42:43,576 EMERGING WE'RE PART OF THE 3507 02:42:43,576 --> 02:42:43,809 PROBLEM. 3508 02:42:43,809 --> 02:42:45,177 WE BUILT DATA ENCLAVES WHERE 3509 02:42:45,177 --> 02:42:49,448 DATA IS HELD AND BECAUSE IT'S 3510 02:42:49,448 --> 02:42:50,850 LARGE, SOMETIMES PETABYTES OF 3511 02:42:50,850 --> 02:42:52,151 DATA IN A CLOUD ENVIRONMENT 3512 02:42:52,151 --> 02:42:53,319 BECAUSE OF COMPUTATIONAL 3513 02:42:53,319 --> 02:42:58,491 EFFICIENCY BUT YOU CAN'T 3514 02:42:58,491 --> 02:43:00,960 DOWNLOAD IT AND CAN'T COMBINE IT 3515 02:43:00,960 --> 02:43:07,133 WITH OTHER SOURCES AND NIGMS HAS 3516 02:43:07,133 --> 02:43:10,669 ANOTHER PLATFORM AND NHGRI HAS 3517 02:43:10,669 --> 02:43:15,241 PLANVILLE AND AGING HAS NIGADS. 3518 02:43:15,241 --> 02:43:19,211 THE "ALL OF US" DATA AND THEY'RE 3519 02:43:19,211 --> 02:43:25,751 EACH IN ENCLAVES, ONE, YOU CAN'T 3520 02:43:25,751 --> 02:43:33,059 BRING THE DATA TOGETHER IS THAT 3521 02:43:33,059 --> 02:43:34,260 BEST FOR THE SCIENCE IN THE 3522 02:43:34,260 --> 02:43:34,627 UNITED STATES. 3523 02:43:34,627 --> 02:43:35,628 NUMBER ONE. 3524 02:43:35,628 --> 02:43:36,762 NUMBER TWO, THERE'S AN 3525 02:43:36,762 --> 02:43:40,699 OPPORTUNITY FOR DATA SCIENTISTS 3526 02:43:40,699 --> 02:43:46,105 TO THINK ABOUT MAYBE YOU DON'T 3527 02:43:46,105 --> 02:43:48,974 NEED IT BRING THE DATA TOGETHER 3528 02:43:48,974 --> 02:43:49,875 THERE'S THE SUFFICIENT STATISTIC 3529 02:43:49,875 --> 02:43:55,748 IS THERE A WAY TO SUMMARIZE AND 3530 02:43:55,748 --> 02:44:06,292 NOT LOSE INFORMATION BRING THAT 3531 02:44:09,095 --> 02:44:11,764 STATISTIC DOWN AND IN SYMPOSIUMS 3532 02:44:11,764 --> 02:44:14,400 LIKE THIS WE NEED TO THINK ABOUT 3533 02:44:14,400 --> 02:44:15,901 ENCLAVING DATA. 3534 02:44:15,901 --> 02:44:17,703 WE'RE SHARING IT BUT ONLY IN 3535 02:44:17,703 --> 02:44:19,872 PARTICULAR COMPUTE ENVIRONMENTS 3536 02:44:19,872 --> 02:44:21,006 AND YOU CAN'T CROSS COMPUTE 3537 02:44:21,006 --> 02:44:25,478 ENVIRONMENTS. 3538 02:44:25,478 --> 02:44:35,988 NEED TO BRING THE TOOLS AND 3539 02:44:37,656 --> 02:44:38,224 APPRO 3540 02:44:38,224 --> 02:44:43,429 APPROA 3541 02:44:43,429 --> 02:44:45,264 PROXIMAL AND IT WAS DONE WITHIN 3542 02:44:45,264 --> 02:44:47,032 THE CONTEXT WITHIN BUILDING 3543 02:44:47,032 --> 02:44:52,138 COMMUNITIES OF INVESTIGATORS AND 3544 02:44:52,138 --> 02:44:55,508 THEN THERE'S THE DISTRIBUTION OF 3545 02:44:55,508 --> 02:44:57,643 DATA WE'RE NOT DOING A GOOD JOB 3546 02:44:57,643 --> 02:45:08,187 OR ENOUGH THOUGHT IN IT FOR ONE. 3547 02:45:11,891 --> 02:45:15,494 HERE'S A LIST OF METHODS AND 3548 02:45:15,494 --> 02:45:16,629 PRETTY DRY STUFF. 3549 02:45:16,629 --> 02:45:18,197 WHEN WE HAVE DATA OFTEN ONE 3550 02:45:18,197 --> 02:45:19,632 CHALLENGE IS INDIVIDUALS TRYING 3551 02:45:19,632 --> 02:45:25,704 TO THINK OF DATA REDUCTION 3552 02:45:25,704 --> 02:45:33,846 TECHNIQUES. 3553 02:45:33,846 --> 02:45:35,514 THE FIRST TWO ARE CLUSTER AND 3554 02:45:35,514 --> 02:45:38,117 FACTOR ANALYSIS AND TAKING LARGE 3555 02:45:38,117 --> 02:45:40,452 VARIABLES AND TRYING TO EXTRACT 3556 02:45:40,452 --> 02:45:45,724 A PRINCIPLE COMPONENT, IF YOU 3557 02:45:45,724 --> 02:45:52,765 WILL, AND WORK WITH THE SMALLER 3558 02:45:52,765 --> 02:45:54,700 NUMBER AND THERE'S ADVANTAGES IN 3559 02:45:54,700 --> 02:45:56,869 TERMS OF COMPUTATIONAL 3560 02:45:56,869 --> 02:45:57,169 EFFICIENCY. 3561 02:45:57,169 --> 02:45:58,404 THERE'S ADVANTAGES WHEN WE THINK 3562 02:45:58,404 --> 02:46:00,172 WE UNDERSTAND WHAT'S HAPPENING 3563 02:46:00,172 --> 02:46:06,078 TO INTERPRET THE PRINCIPLE 3564 02:46:06,078 --> 02:46:15,187 COMPONENTS IN SOME WAY. 3565 02:46:15,187 --> 02:46:17,289 WITH BIOLOGY AND THERE'S ONE NOW 3566 02:46:17,289 --> 02:46:18,691 PARTICIPANTS AND FOR SOME WHO 3567 02:46:18,691 --> 02:46:20,392 HAD SOME FORMAL TRAINING YOU 3568 02:46:20,392 --> 02:46:25,631 HAVE PROBABLY RAN ACROSS THE 3569 02:46:25,631 --> 02:46:26,365 CANONICAL CORRELATION BUT 3570 02:46:26,365 --> 02:46:31,270 THERE'S GROWING INTEREST THIS 3571 02:46:31,270 --> 02:46:32,238 CONCEPT OF ANALYSIS. 3572 02:46:32,238 --> 02:46:42,781 THINKING BACK TO MY SECOND SLIDE 3573 02:46:46,385 --> 02:46:52,391 LAYERS OF OMICS AND THINK OF THE 3574 02:46:52,391 --> 02:46:53,025 CANONICAL CORRELATIONS WITHIN 3575 02:46:53,025 --> 02:46:54,693 THE LAYER AND RELATE THEM ACROSS 3576 02:46:54,693 --> 02:46:59,164 LAYERS. 3577 02:46:59,164 --> 02:47:05,871 IT'S A METHOD THAT IS GROWING IN 3578 02:47:05,871 --> 02:47:16,415 THE FIELD GROWING AND TRUST AND 3579 02:47:18,317 --> 02:47:19,852 OMICS AND THIS I DON'T HAVE 3580 02:47:19,852 --> 02:47:22,021 ASSOCIATION WITH WHICH PROBABLY 3581 02:47:22,021 --> 02:47:23,322 GIVES IT MORE CREDIBILITY. 3582 02:47:23,322 --> 02:47:26,759 IT'S WORK IN BRAIN IMAGING AND 3583 02:47:26,759 --> 02:47:27,960 FUNCTIONAL BRAIN ANALYSIS BY 3584 02:47:27,960 --> 02:47:30,362 WANG ET AL. AND PUBLISHED IN 3585 02:47:30,362 --> 02:47:32,164 NEURO IMAGING AND WANT TO 3586 02:47:32,164 --> 02:47:34,767 COMPLEMENT THE JOURNAL THAT GAVE 3587 02:47:34,767 --> 02:47:37,536 THESE AUTHORS A LOT OF LICENSE. 3588 02:47:37,536 --> 02:47:42,608 WHAT THEY'VE DONE IS WALKED 3589 02:47:42,608 --> 02:47:53,152 THROUGH COMPLICATED ANALYSIS AND 3590 02:47:54,453 --> 02:47:56,422 EXPLAINED WHAT THEY WERE DOING 3591 02:47:56,422 --> 02:48:03,429 AT EACH STEP AND TOOK TIME 3592 02:48:03,429 --> 02:48:04,697 SERIES DATA OF SIGNALS AND 3593 02:48:04,697 --> 02:48:07,066 THAT'S ONE MEASURE AND ACROSS 3594 02:48:07,066 --> 02:48:10,436 TIME AND THEN THEY ALSO HAD BY 3595 02:48:10,436 --> 02:48:12,104 QUESTIONNAIRE AMONG A NUMBER OF 3596 02:48:12,104 --> 02:48:14,740 PSYCHO METRIC MEASURES THEY 3597 02:48:14,740 --> 02:48:16,842 AGAIN USED CANONICAL 3598 02:48:16,842 --> 02:48:17,943 CORRELATIONS TO BOIL DOWN TO 3599 02:48:17,943 --> 02:48:20,579 SOMETHING THEY PUT LABELS ON, 3600 02:48:20,579 --> 02:48:23,182 MOOD, PSYCHOSIS, FEAR AND 3601 02:48:23,182 --> 02:48:33,592 EXTERNALIZING BEHAVIOR. 3602 02:48:42,234 --> 02:48:44,903 THEY TOOK THE SURVEY DATA AND 3603 02:48:44,903 --> 02:48:46,171 BROUGHT THEM TOGETHER ON THE 3604 02:48:46,171 --> 02:48:46,538 LOWER RIGHT. 3605 02:48:46,538 --> 02:48:47,539 I WASN'T GOING TO GO THROUGH THE 3606 02:48:47,539 --> 02:48:50,342 SCIENCE OR RESULTS OF THIS BUT I 3607 02:48:50,342 --> 02:48:58,183 DO THINK AND ENCOURAGE FOR THOSE 3608 02:48:58,183 --> 02:49:03,088 WHERE THIS IS A RELATIVELY NEW 3609 02:49:03,088 --> 02:49:05,858 PAPER YOU CAN READ THE GO, THE 3610 02:49:05,858 --> 02:49:08,093 BAD, THE LOGIC OF THE WORK AND 3611 02:49:08,093 --> 02:49:10,229 IT'S A MARVELOUS EXAMPLE OF 3612 02:49:10,229 --> 02:49:10,863 PRESENTING SCIENCE AND LEARNING 3613 02:49:10,863 --> 02:49:21,173 AT THE SAME TIME. 3614 02:49:29,381 --> 02:49:30,849 IT'S IMPORTANT TO THINK ABOUT 3615 02:49:30,849 --> 02:49:33,152 WHEN YOU EXERCISE CERTAIN 3616 02:49:33,152 --> 02:49:35,421 STATISTICS AND CAME UP DURING 3617 02:49:35,421 --> 02:49:37,523 THE MEETING, WHY ARE WE DOING 3618 02:49:37,523 --> 02:49:37,723 THIS? 3619 02:49:37,723 --> 02:49:39,892 AT THE END OF THE DAY YOU SIT 3620 02:49:39,892 --> 02:49:43,295 DOWN ON THE PORCH WITH YOUR ICE 3621 02:49:43,295 --> 02:49:45,230 TEA, ARE WE TRYING TO IMPROVE 3622 02:49:45,230 --> 02:49:46,665 PREDICTION OR MECHANISTIC 3623 02:49:46,665 --> 02:49:57,109 UNDERSTANDING OR ETIOLOGY? 3624 02:50:01,046 --> 02:50:02,881 THINK BACK TO THE LAYERS AND THE 3625 02:50:02,881 --> 02:50:04,349 QUESTION IS WHEN DO I EXERCISE 3626 02:50:04,349 --> 02:50:06,418 THE STATISTICAL METHODS TO DO 3627 02:50:06,418 --> 02:50:07,085 DATA REDUCTION? 3628 02:50:07,085 --> 02:50:09,288 WHEN DO I DO THE PRINCIPLE 3629 02:50:09,288 --> 02:50:09,621 COMPONENTS? 3630 02:50:09,621 --> 02:50:13,625 WHEN DO I DO THE CANONICAL 3631 02:50:13,625 --> 02:50:19,164 CORRELATION AND THOSE ARE TWO 3632 02:50:19,164 --> 02:50:29,741 AREAS ONE IS YOU DO THE 3633 02:50:29,741 --> 02:50:30,809 CANONICAL REDUCTION OR DATA 3634 02:50:30,809 --> 02:50:33,579 ANALYSIS AT EACH LEVEL AND THEN 3635 02:50:33,579 --> 02:50:34,780 LOOK AT THE RELATIONSHIP BETWEEN 3636 02:50:34,780 --> 02:50:35,180 LEVELS. 3637 02:50:35,180 --> 02:50:41,153 I THINK PROBABLY YOU CAN SEE OR 3638 02:50:41,153 --> 02:50:43,055 FEEL THE METHOD HELPS IMPROVE 3639 02:50:43,055 --> 02:50:44,790 UNDERSTANDING. 3640 02:50:44,790 --> 02:50:46,825 IF YOU'RE TRYING TO UNDERSTAND A 3641 02:50:46,825 --> 02:50:50,262 GIVEN PROBLEM OR WHY THERE MAY 3642 02:50:50,262 --> 02:50:52,364 BE A RELATIONSHIP THIS IS A 3643 02:50:52,364 --> 02:50:53,365 PREFERRED METHOD. 3644 02:50:53,365 --> 02:50:57,102 IN ALL YOU'RE TRYING TO DO IS 3645 02:50:57,102 --> 02:50:59,238 IMPROVE PREDICTION AND REALLY 3646 02:50:59,238 --> 02:51:01,773 DON'T CARE ABOUT UNDERSTANDING, 3647 02:51:01,773 --> 02:51:03,509 WHICH IS PROBABLY UNFORTUNATELY 3648 02:51:03,509 --> 02:51:06,411 MOST OF US WANT IT DO BOTH AT 3649 02:51:06,411 --> 02:51:07,613 THE SAME TIME PROBABLY, YOU 3650 02:51:07,613 --> 02:51:09,481 DON'T NEED TO WORRY ABOUT THE 3651 02:51:09,481 --> 02:51:09,715 LAYERS. 3652 02:51:09,715 --> 02:51:11,350 YOU'RE THE ONE WHO DEFINED THE 3653 02:51:11,350 --> 02:51:20,859 LAYERS AND PUT THEM IN ORDER. 3654 02:51:20,859 --> 02:51:31,403 YOU CAN CAPA -- CANCAPANATE ALL 3655 02:51:37,409 --> 02:51:38,877 THE DATA AND YOU CHOOSE WHEN TO 3656 02:51:38,877 --> 02:51:49,388 DO THE DATA REDUCTION METHODS. 3657 02:51:50,889 --> 02:51:56,261 IS THEN ALL THE EXAMPLES WE 3658 02:51:56,261 --> 02:51:57,896 HEARD AND THEY ALL HAD SOME SORT 3659 02:51:57,896 --> 02:52:01,767 OF GENETICS WITH OMICS WITH 3660 02:52:01,767 --> 02:52:02,167 OTHER PHENOTYPIC 3661 02:52:02,167 --> 02:52:09,841 CHARACTERIZATION. 3662 02:52:09,841 --> 02:52:11,543 THAT ALLOWS US TO ASK WHAT IS 3663 02:52:11,543 --> 02:52:14,179 SPECIAL ABOUT GENETIC DATA AND 3664 02:52:14,179 --> 02:52:16,014 HOW DO WE LEVERAGE THAT. 3665 02:52:16,014 --> 02:52:18,617 AND WHAT'S SPECIAL ABOUT IT IS 3666 02:52:18,617 --> 02:52:29,161 THERE'S ELEMENT OR LITTLE CHANCE 3667 02:52:30,929 --> 02:52:35,901 FOR REVERSE CAUSATION AND IN 3668 02:52:35,901 --> 02:52:37,235 CANCER IN PARTICULAR WHERE THE 3669 02:52:37,235 --> 02:52:37,803 OUTCOME OR PHENOTYPE WILL 3670 02:52:37,803 --> 02:52:40,405 INFLUENCE THE GENOTYPE. 3671 02:52:40,405 --> 02:52:44,176 AND SO THIS ALLOWS ONE AND BRUCE 3672 02:52:44,176 --> 02:52:52,651 USED THIS WORD OF MENDELIAN 3673 02:52:52,651 --> 02:52:56,521 RANDOMIZATION UNDERSTANDING THE 3674 02:52:56,521 --> 02:52:58,824 RELATIONSHIP BETWEEN THE 3675 02:52:58,824 --> 02:53:00,926 PARTICULAR OMIC IS IT CAUSAL OR 3676 02:53:00,926 --> 02:53:01,827 INFLUENCING IS THERE A 3677 02:53:01,827 --> 02:53:06,665 DIRECTIONALITY IN THE OUTCOME OR 3678 02:53:06,665 --> 02:53:09,935 IS THERE POSSIBLE REVERSE 3679 02:53:09,935 --> 02:53:10,202 CAUSATION. 3680 02:53:10,202 --> 02:53:11,570 OVER THE LAST 10 YEARS IT'S 3681 02:53:11,570 --> 02:53:14,673 GROWN TO A RELATIVELY SIMPLE 3682 02:53:14,673 --> 02:53:19,411 CONCEPT TO AN EXTREMELY 3683 02:53:19,411 --> 02:53:25,150 COMPLICATED MEDIATION SET OF 3684 02:53:25,150 --> 02:53:26,118 ANALYSIS. 3685 02:53:26,118 --> 02:53:27,719 I'M NOT GOING TO WALK THROUGH 3686 02:53:27,719 --> 02:53:28,186 IT. 3687 02:53:28,186 --> 02:53:30,355 IT GETS TEDIOUS BUT BASICALLY 3688 02:53:30,355 --> 02:53:33,558 EVERYONE CAN SEE AT THE SIMPLE 3689 02:53:33,558 --> 02:53:36,061 LEVEL HOW THE INSTRUMENTAL 3690 02:53:36,061 --> 02:53:38,630 VARIABLES AND MENDELIAN 3691 02:53:38,630 --> 02:53:39,531 RANDOMIZATION AND UNDERSTAND 3692 02:53:39,531 --> 02:53:43,869 WHETHER A GIVEN ASSOCIATION 3693 02:53:43,869 --> 02:53:45,904 BETWEEN AN OMIC MEASURE 3694 02:53:45,904 --> 02:53:48,073 PROTEOMIC OR METABOLOMIC MEASURE 3695 02:53:48,073 --> 02:53:54,513 IS LIKELY OR POSSIBLY CAUSAL OR 3696 02:53:54,513 --> 02:53:55,981 IS THERE REVERSE CAUSATION. 3697 02:53:55,981 --> 02:54:04,790 USUALLY WE HAVE MANY MEASURES. 3698 02:54:04,790 --> 02:54:08,427 AND YOU CAN LOOK AT HIGH 3699 02:54:08,427 --> 02:54:10,562 DIMENSIONAL METHODS OF REALLY 3700 02:54:10,562 --> 02:54:18,904 IT'S THE FIRST FUNDAMENTAL 3701 02:54:18,904 --> 02:54:23,175 MENDELIAN RANDOMIZATION BUT ON 3702 02:54:23,175 --> 02:54:26,011 STEROIDS AND THERE'S THE CONCEPT 3703 02:54:26,011 --> 02:54:28,346 OF LATENT MEDIATION THERE'S A 3704 02:54:28,346 --> 02:54:32,551 PUB MED I.D. ALONG WITH THE TOOL 3705 02:54:32,551 --> 02:54:35,620 TO HELP IN THOSE ANALYSES. 3706 02:54:35,620 --> 02:54:37,556 IF YOU'RE A PERSON THAT HAS A 3707 02:54:37,556 --> 02:54:40,158 LOT OF OMICS DATA WITH 3708 02:54:40,158 --> 02:54:44,696 METABOLOMICS IT POSSIBLEY IS A 3709 02:54:44,696 --> 02:54:55,240 METHOD YOU WOULD BE EXERCISING. 3710 02:55:06,051 --> 02:55:09,921 THERE'S OMICS DATA AND IT'S BEEN 3711 02:55:09,921 --> 02:55:12,124 A LOT OF FUN TO SEE THE 3712 02:55:12,124 --> 02:55:14,860 EVOLUTION OF THE OMICS DATA 3713 02:55:14,860 --> 02:55:17,429 BEGINNING WITH GENETIC MARKERS 3714 02:55:17,429 --> 02:55:17,963 MOVING INTO WHOLE GENOME 3715 02:55:17,963 --> 02:55:22,934 SEQUENCE. 3716 02:55:22,934 --> 02:55:27,172 ADDING ON METHYLATION BUT 3717 02:55:27,172 --> 02:55:30,509 RECENTLY METABOLOMICS AND 3718 02:55:30,509 --> 02:55:32,744 PROTEOMICS AND IT'S A CHALLENGE 3719 02:55:32,744 --> 02:55:37,816 AND OPPORTUNITY. 3720 02:55:37,816 --> 02:55:42,821 ONE, EXPAND LOOKING AT MARKERS 3721 02:55:42,821 --> 02:55:53,231 OF DISEASE PROGRESSION. 3722 02:55:57,335 --> 02:55:59,671 WARE VERY GOOD IN AT LEAST IN MY 3723 02:55:59,671 --> 02:56:02,474 CAL AWAY THINK WE'RE GOOD AT 3724 02:56:02,474 --> 02:56:04,476 MEASURING THE GENOME BUT NOT AS 3725 02:56:04,476 --> 02:56:07,312 >> GOOD AS WE SHOULD BE IN 3726 02:56:07,312 --> 02:56:08,079 MEASURING ENVIRONMENTAL 3727 02:56:08,079 --> 02:56:08,346 EXPOSURE. 3728 02:56:08,346 --> 02:56:10,615 SOME OF THE OTHER OMICS ARE 3729 02:56:10,615 --> 02:56:14,853 EITHER GOOD MEASURES OF 3730 02:56:14,853 --> 02:56:17,355 ENVIRONMENTAL EXPOSURES OR GOOD 3731 02:56:17,355 --> 02:56:20,158 MEASURES OF GENE INTERACTION AND 3732 02:56:20,158 --> 02:56:23,128 I ENCOURAGE THINKING ABOUT THE 3733 02:56:23,128 --> 02:56:23,662 ENVIRONMENT. 3734 02:56:23,662 --> 02:56:26,097 I MADE A LIVING IN GENETIC 3735 02:56:26,097 --> 02:56:29,367 EPIDEMIOLOGY BUT I DO THINK IT'S 3736 02:56:29,367 --> 02:56:30,535 AN OPPORTUNITY HERE TO EXPAND 3737 02:56:30,535 --> 02:56:33,171 BEYOND JUST SIMPLE GENOMICS AND 3738 02:56:33,171 --> 02:56:34,439 THINK OF GENE ENVIRONMENT 3739 02:56:34,439 --> 02:56:35,740 INTERACTION WITH THIGHS OTHER 3740 02:56:35,740 --> 02:56:35,941 OMICS. 3741 02:56:35,941 --> 02:56:38,810 I'M GOING TO GIVE YOU A COUPLE 3742 02:56:38,810 --> 02:56:40,345 EXAMPLES OF TOUCHING ON A 3743 02:56:40,345 --> 02:56:48,053 VARIETY OF THINGS. 3744 02:56:48,053 --> 02:56:50,989 MOST OF THE DATA I'M GOING TO 3745 02:56:50,989 --> 02:56:52,424 PRESENT SO I DON'T BOUNCE AROUND 3746 02:56:52,424 --> 02:56:55,560 WILL BE FROM THE EXAMPLE -- WE 3747 02:56:55,560 --> 02:56:59,264 CALL VISIT 5 TO PUT A DATE ON IT 3748 02:56:59,264 --> 02:57:00,832 IS 2011. 3749 02:57:00,832 --> 02:57:07,439 ARIC IS A STUDY AND THIS ONE IS 3750 02:57:07,439 --> 02:57:09,507 ABOUT 5,500 WHERE WE HAVE GOOD 3751 02:57:09,507 --> 02:57:13,511 MEASURES OF GENOMICS, WE HAVE 3752 02:57:13,511 --> 02:57:14,646 TRANSCRIPT OMICS AND METHYLATION 3753 02:57:14,646 --> 02:57:17,082 DATA AND PROTEOMIC DATA AND 3754 02:57:17,082 --> 02:57:17,749 METABOLOMIC DATA AT THE ONE TIME 3755 02:57:17,749 --> 02:57:20,886 POINT. 3756 02:57:20,886 --> 02:57:23,321 THAT ALLOWS US TO DO A LOT OF 3757 02:57:23,321 --> 02:57:27,692 WORK IN TERMS OF LEVELS OF SOME 3758 02:57:27,692 --> 02:57:29,361 BIOLOGIC HIERARCHY AND LOOKING 3759 02:57:29,361 --> 02:57:32,163 FORWARD TO PREDICT DISEASE THAT 3760 02:57:32,163 --> 02:57:32,797 I THINK JOE NICELY SET UP FOR 3761 02:57:32,797 --> 02:57:41,072 US. 3762 02:57:41,072 --> 02:57:43,074 I'LL GIVE A COUPLE EXAMPLES. 3763 02:57:43,074 --> 02:57:44,376 THE FIRST COMES FROM HEART 3764 02:57:44,376 --> 02:57:44,609 FAILURE. 3765 02:57:44,609 --> 02:57:50,815 I WANT TO GIVE A SHOUT OUT THE 3766 02:57:50,815 --> 02:57:53,151 U.K. BIO BANK HAS HAD 3767 02:57:53,151 --> 02:57:58,290 PUBLICATIONS ONE IN NATURE AND 3768 02:57:58,290 --> 02:58:03,662 MEDICINE IN 2022 AND WE HAVE THE 3769 02:58:03,662 --> 02:58:05,730 OPPORTUNITY AND SHUNT FORGET 3770 02:58:05,730 --> 02:58:08,533 GOOD EPIDEMIOLOGY NOT GOOD, 3771 02:58:08,533 --> 02:58:09,668 GREAT EPIDEMIOLOGY THAT'S COME 3772 02:58:09,668 --> 02:58:11,136 BEFORE US. 3773 02:58:11,136 --> 02:58:15,607 BEFORE YOU GO NUTS AND START 3774 02:58:15,607 --> 02:58:20,378 DOING A LOT OF MULE OMIC -- 3775 02:58:20,378 --> 02:58:21,947 MULTIOMIC AND PREDICTION LET'S 3776 02:58:21,947 --> 02:58:25,116 NOT FORGET AGE, GENDER AND 3777 02:58:25,116 --> 02:58:26,117 COMORBIDITIES PARTICULARLY IF 3778 02:58:26,117 --> 02:58:28,420 YOU'RE STUDYING HEART FAILURE, 3779 02:58:28,420 --> 02:58:31,790 HYPERTENSION, DIABETES. 3780 02:58:31,790 --> 02:58:33,625 THERE'S A GOOD BIOMEDICAL AND 3781 02:58:33,625 --> 02:58:39,464 MOST ARE AWARE OF PRO V NP A 3782 02:58:39,464 --> 02:58:41,333 MARKER OF CARDIAC INJURY. 3783 02:58:41,333 --> 02:58:49,774 I WANT TO MAKE A PLUG AND GIVE 3784 02:58:49,774 --> 02:58:51,810 CREDIT TO THOSE WHO CAME BEFORE 3785 02:58:51,810 --> 02:58:57,582 US AND INCORPORATE THE 3786 02:58:57,582 --> 02:59:00,218 FUNDAMENTAL EPIDEMIOLOGIC RISK 3787 02:59:00,218 --> 02:59:06,691 FACTORS AND GOING FORWARD. 3788 02:59:06,691 --> 02:59:09,194 THIS IS A RATHER NOISY SLIDE. 3789 02:59:09,194 --> 02:59:12,230 IT'S BASICALLY LOOKING AT 3790 02:59:12,230 --> 02:59:15,200 METABOLOMICS AND INCIDENT HEART 3791 02:59:15,200 --> 02:59:24,943 FAILURE. 3792 02:59:24,943 --> 02:59:27,178 THERE'S ALL-CAUSE HEART FAILURE 3793 02:59:27,178 --> 02:59:37,889 AND FOR THE OAFICIONADOS IN THE 3794 02:59:38,323 --> 02:59:40,859 GROUP YOU'LL SEE ON THE PATHWAYS 3795 02:59:40,859 --> 02:59:42,427 BY METABOLOMICS AND IT'S 3796 02:59:42,427 --> 02:59:44,062 INTERESTING TO NOTE AND THESE 3797 02:59:44,062 --> 02:59:47,699 ARE NOT IN ANY ORDER TO MAKE THE 3798 02:59:47,699 --> 02:59:49,934 DOTS LOOK A CERTAIN WAY AND LOOK 3799 02:59:49,934 --> 02:59:54,472 AT THE AMINO ACIDS AND SOME ARE 3800 02:59:54,472 --> 02:59:55,073 POSITIVELY ASSOCIATED WITH 3801 02:59:55,073 --> 02:59:57,876 DISEASE AND WHEN YOU GET TO THE 3802 02:59:57,876 --> 02:59:59,210 LIPIDS, THE GREEN IN THE MIDDLE 3803 02:59:59,210 --> 03:00:08,319 THERE'S A CLASS OF LIPIDS FATTY 3804 03:00:08,319 --> 03:00:10,088 ACIDS POSITIVELY AND NEGATIVELY 3805 03:00:10,088 --> 03:00:10,822 ASSOCIATED WITH DISEASE. 3806 03:00:10,822 --> 03:00:12,557 IT'S INTERESTING TO SEE THE 3807 03:00:12,557 --> 03:00:22,967 PATTERNS GOING FORWARD. 3808 03:00:22,967 --> 03:00:24,636 AND WHAT WE'VE DONE WE HEARD 3809 03:00:24,636 --> 03:00:28,940 ABOUT GENETIC RISK SCORES. 3810 03:00:28,940 --> 03:00:31,209 YOU CAN CREATE BASICALLY 3811 03:00:31,209 --> 03:00:36,314 METABOLOMIC RISK SCORES AND YOU 3812 03:00:36,314 --> 03:00:39,417 CAN ASK WHETHER THESE ARE ROC 3813 03:00:39,417 --> 03:00:40,718 CURVES YOU'RE ALL USED TO AND 3814 03:00:40,718 --> 03:00:42,454 LOOK AT THE ONES ON THE LEFT AND 3815 03:00:42,454 --> 03:00:45,256 THE TRADITIONAL RISK FACTORS OR 3816 03:00:45,256 --> 03:00:49,694 THE TRADITIONAL RISK FACTORS 3817 03:00:49,694 --> 03:00:52,230 PLUS PRO VNP IN BLUE AND I GUESS 3818 03:00:52,230 --> 03:00:55,934 IT'S LAVENDER AND YOU SEE THE 3819 03:00:55,934 --> 03:00:59,771 INCREASE IN PREDICTABILITY WHEN 3820 03:00:59,771 --> 03:01:02,440 YOU ADD METABOLOMIC RISK SCORES. 3821 03:01:02,440 --> 03:01:04,142 I'M GOING THROUGH THIS BECAUSE 3822 03:01:04,142 --> 03:01:06,744 IT'S ANOTHER WAY OF DATA 3823 03:01:06,744 --> 03:01:07,779 REDUCTION TAKING ALL THE 3824 03:01:07,779 --> 03:01:11,015 COMPLICATED THINGS ON THE 3825 03:01:11,015 --> 03:01:12,050 PREVIOUS SLIDE FOR EACH 3826 03:01:12,050 --> 03:01:13,818 INDIVIDUAL COMING UP WITH A 3827 03:01:13,818 --> 03:01:15,120 NUMBER AND USING THAT NUMBER IN 3828 03:01:15,120 --> 03:01:23,428 A PREDICTION ANALYSIS. 3829 03:01:23,428 --> 03:01:24,562 AND LIKEWISE THERE'S TWO 3830 03:01:24,562 --> 03:01:25,597 CONCEPTS ON THE SLIDE. 3831 03:01:25,597 --> 03:01:32,170 ONE IS TAKING THE RESULTS FROM 3832 03:01:32,170 --> 03:01:34,906 U.K. BIO BANK AND ADDING THEM IN 3833 03:01:34,906 --> 03:01:37,342 AND SEEING IF THE ARIC 3834 03:01:37,342 --> 03:01:39,611 METABOLOMIC RISK SCORE IMPROVES 3835 03:01:39,611 --> 03:01:39,911 PREDICTION. 3836 03:01:39,911 --> 03:01:43,014 THAT'S ONE QUESTION. 3837 03:01:43,014 --> 03:01:46,951 THE SECOND IS IF YOU HAVE SERUM 3838 03:01:46,951 --> 03:01:48,586 METABOLOMICS, DOES ADDING 3839 03:01:48,586 --> 03:01:53,224 URINARY METABOLOMICS TO YOUR 3840 03:01:53,224 --> 03:01:54,626 REPERTOIRE DOES IT IMPROVE YOUR 3841 03:01:54,626 --> 03:01:55,793 ABILITY TO PREDICT. 3842 03:01:55,793 --> 03:01:57,128 I'LL CUT TO THE CHASE MAYBE ALL 3843 03:01:57,128 --> 03:02:00,298 THE WAY TO THE RIGHT, THOSE ARE 3844 03:02:00,298 --> 03:02:03,535 STATISTICS ON THE Y AXIS AND 3845 03:02:03,535 --> 03:02:05,904 NOTICE THE STEP WISE INCREASE 3846 03:02:05,904 --> 03:02:08,173 AND I WAS A BIT SURPRISED TO BE 3847 03:02:08,173 --> 03:02:18,683 HONEST WITH YOU THAT URINARY 3848 03:02:21,386 --> 03:02:31,696 METABOLOMICS IMPROVED. 3849 03:02:31,696 --> 03:02:33,464 TRANSITION BEING FROM ONE STUDY 3850 03:02:33,464 --> 03:02:35,667 AND THIS PROGRAM HAS BEEN 3851 03:02:35,667 --> 03:02:37,635 MENTIONED OF THE TOP MED 3852 03:02:37,635 --> 03:02:37,869 PROGRAM. 3853 03:02:37,869 --> 03:02:40,872 IT'S UNIQUE IN A NUMBER OF WAYS. 3854 03:02:40,872 --> 03:02:44,108 ONE IS VERY SPECIFICALLY TRYING 3855 03:02:44,108 --> 03:02:46,911 TO GET MULTIOMIC DATA IN NOT 3856 03:02:46,911 --> 03:02:48,079 ONLY A LARGE SAMPLE BUT A 3857 03:02:48,079 --> 03:02:53,318 DIVERSE SAMPLE. 3858 03:02:53,318 --> 03:02:56,688 IT CONTAINS THE LARGE COHORT 3859 03:02:56,688 --> 03:02:58,656 STUDIES MENTIONED MULTIPLE 3860 03:02:58,656 --> 03:03:00,124 TIMES. 3861 03:03:00,124 --> 03:03:03,127 ARIC, FRAMINGHAM, THE STUDY OF 3862 03:03:03,127 --> 03:03:04,262 LATINOS, ETCETERA AND ALSO 3863 03:03:04,262 --> 03:03:05,897 INCLUDES A NUMBER OF DISEASE 3864 03:03:05,897 --> 03:03:08,499 SPECIFIC PARTICULARLY IN THE 3865 03:03:08,499 --> 03:03:08,700 LUNG. 3866 03:03:08,700 --> 03:03:15,173 A NUMBER OF DISEASE SPECIFIC AND 3867 03:03:15,173 --> 03:03:17,575 WHAT'S SHOWN IN THE PIE DIAGRAM 3868 03:03:17,575 --> 03:03:19,877 IS THE ETHNICITY BUT THE 3869 03:03:19,877 --> 03:03:21,879 MAJORITY TODAY IS STILL 3870 03:03:21,879 --> 03:03:22,347 NON-HISPANIC WHITES. 3871 03:03:22,347 --> 03:03:25,250 THERE'S A LOT OF EFFORT TO MAKE 3872 03:03:25,250 --> 03:03:29,220 SURE WE HAVE GOOD REPRESENTATION 3873 03:03:29,220 --> 03:03:30,755 OF AFRICAN AMERICANS, LATINOS. 3874 03:03:30,755 --> 03:03:35,493 I CAN'T REMEMBER WHO IT WAS. 3875 03:03:35,493 --> 03:03:39,998 WE'RE STILL NOT DOING AS WELL AS 3876 03:03:39,998 --> 03:03:42,400 WE SHOULD IN ASIAN ANCESTRY. 3877 03:03:42,400 --> 03:03:45,803 I KNOW THERE'S AN ASIAN COHORT 3878 03:03:45,803 --> 03:03:53,144 BEING LAUNCHED AND IT'S OVER 3879 03:03:53,144 --> 03:03:53,311 DUE. 3880 03:03:53,311 --> 03:04:01,119 IT IS BY ITSELF A DIVERSE GROUP. 3881 03:04:01,119 --> 03:04:03,621 >> YOU WARNED THAT WAS GOOD 3882 03:04:03,621 --> 03:04:06,391 WISDOM AT THE BEGINNING BUT AT 3883 03:04:06,391 --> 03:04:07,859 THE COST OF THE LATE SLIDES BUT 3884 03:04:07,859 --> 03:04:10,128 WE'RE AT THE WRAP-UP, PHASE. 3885 03:04:10,128 --> 03:04:10,595 THANK YOU. 3886 03:04:10,595 --> 03:04:14,832 >> IT'S A GOOD TIME TO WRAP UP 3887 03:04:14,832 --> 03:04:17,402 AND SHOWS METABOLOMICS IN A 3888 03:04:17,402 --> 03:04:18,069 GWAS. 3889 03:04:18,069 --> 03:04:28,346 I'LL SKIP THAT. 3890 03:04:31,983 --> 03:04:34,118 I WANT TO PAUSE. 3891 03:04:34,118 --> 03:04:36,287 THIS IS DRILLING DOWN ON A GWAS 3892 03:04:36,287 --> 03:04:39,424 OF THE ENTIRE HUMAN PROTEOME. 3893 03:04:39,424 --> 03:04:41,759 BUT SPECIFICALLY THEN LOOKING AT 3894 03:04:41,759 --> 03:04:45,129 THE RESULTS OF THE FINDINGS HOW 3895 03:04:45,129 --> 03:04:47,031 THEY RELATE TO VARIOUS DISEASES 3896 03:04:47,031 --> 03:04:48,833 IN THIS CASE SLEEP. 3897 03:04:48,833 --> 03:04:51,502 SO IT'S A NICE EXAMPLE BASICALLY 3898 03:04:51,502 --> 03:04:54,839 AGAIN OF A WELL CHARACTERIZED 3899 03:04:54,839 --> 03:04:58,009 COHORT OF THE ABILITY TO DO 3900 03:04:58,009 --> 03:05:00,678 DISCOVERY WORK IN A LAYER THAT'S 3901 03:05:00,678 --> 03:05:02,714 CLOSE TO THE GENE LEVEL AND THEN 3902 03:05:02,714 --> 03:05:04,949 TAKE THOSE FINDINGS AND RELATE 3903 03:05:04,949 --> 03:05:06,417 IT TO A PHENOTYPE AS I SAID THIS 3904 03:05:06,417 --> 03:05:16,661 IS WITH SLEEP. 3905 03:05:17,929 --> 03:05:25,937 IT SHOWS THE APOE ASSOCIATED A 3906 03:05:25,937 --> 03:05:30,108 LEUCINE RICH PROTEIN ASSOCIATED 3907 03:05:30,108 --> 03:05:31,409 WITH SLEEP PATTERNS. 3908 03:05:31,409 --> 03:05:34,712 THIS IS A FUN SLIDE AND MY LAST. 3909 03:05:34,712 --> 03:05:37,582 I CALL THIS A VIRTUOUS CYCLE AND 3910 03:05:37,582 --> 03:05:39,283 IT'S WORK -- I DON'T KNOW IF 3911 03:05:39,283 --> 03:05:40,651 JOSH DENNY IS STILL ON. 3912 03:05:40,651 --> 03:05:42,520 IT'S WORK I TRIED TO PROMOTE 3913 03:05:42,520 --> 03:05:47,725 PARTICULARLY WITHIN THE ALL OF 3914 03:05:47,725 --> 03:05:49,894 US IS TRYING TO CREATE A 3915 03:05:49,894 --> 03:05:51,763 VIRTUOUS CYCLE WHERE WE HAVE 3916 03:05:51,763 --> 03:05:54,098 POPULATION DATA AND COHORT DATA. 3917 03:05:54,098 --> 03:05:59,804 WE DO A LOT OF DISCOVERY WORK ON 3918 03:05:59,804 --> 03:06:02,140 THE YELLOW AND GREEN AND CREATE 3919 03:06:02,140 --> 03:06:04,142 MOLECULAR PROFILES OF INDIVIDUAL 3920 03:06:04,142 --> 03:06:05,243 PATIENTS AND FEED IT BACK TO 3921 03:06:05,243 --> 03:06:07,445 CLINICAL CARE AND HAVE THE 3922 03:06:07,445 --> 03:06:09,380 CLINICAL CARE THEN INFORM THE 3923 03:06:09,380 --> 03:06:11,616 COHORT STUDIES IN THE SAME 3924 03:06:11,616 --> 03:06:11,949 POPULATION. 3925 03:06:11,949 --> 03:06:15,086 I THINK IT'S AN IDEAL WE SHOULD 3926 03:06:15,086 --> 03:06:17,488 ALL STRIVE FOR THOSE WHO ARE 3927 03:06:17,488 --> 03:06:21,392 EMBEDDED WITHIN UNIVERSITIES OR 3928 03:06:21,392 --> 03:06:22,026 INSTITUTIONS. 3929 03:06:22,026 --> 03:06:23,294 THEY'RE ASSOCIATED WITH HEALTH 3930 03:06:23,294 --> 03:06:24,429 CARE AND IT'S A NICE SYSTEM TO 3931 03:06:24,429 --> 03:06:29,500 PROMOTE THIS WORK. 3932 03:06:29,500 --> 03:06:31,569 A WONDERFUL THANK YOU AND THE 3933 03:06:31,569 --> 03:06:34,439 PARTICIPANTS AND STAFF AND THE 3934 03:06:34,439 --> 03:06:35,840 INVESTIGATORS AND I WANT TO 3935 03:06:35,840 --> 03:06:37,742 THANK NHLBI BOTH FOR THIS 3936 03:06:37,742 --> 03:06:44,749 MEETING AND FOR OTHERS AT NIH 3937 03:06:44,749 --> 03:06:48,453 AND THE CHANCE TO BE HERE. 3938 03:06:48,453 --> 03:06:49,353 >> WONDERFUL ERIC. 3939 03:06:49,353 --> 03:06:49,754 BEAUTIFUL TALK. 3940 03:06:49,754 --> 03:06:52,089 I HOPE PEOPLE APPRECIATED THE 3941 03:06:52,089 --> 03:06:53,291 WORDS OF WISDOM BROUGHT ABOUT 3942 03:06:53,291 --> 03:06:53,925 ANALYSIS AND THINKING HOW TO DO 3943 03:06:53,925 --> 03:07:00,097 LAYERS. 3944 03:07:00,097 --> 03:07:03,334 I'LL ASK ONE QUESTION FOR THE 3945 03:07:03,334 --> 03:07:05,069 SAKE OF TIME. 3946 03:07:05,069 --> 03:07:06,337 MENTIONED CLOUD CAUSED SILE 3947 03:07:06,337 --> 03:07:07,638 OWING FOR ENCLAVES. 3948 03:07:07,638 --> 03:07:08,940 CAN THE CLOUD BE PART OF THE 3949 03:07:08,940 --> 03:07:09,207 SOLUTION? 3950 03:07:09,207 --> 03:07:15,513 >> IT CAN BE. 3951 03:07:15,513 --> 03:07:18,115 I'LL GIVE YOU AN OBSERVATION I 3952 03:07:18,115 --> 03:07:24,021 THINK OVER TIME SCIENTISTS AND 3953 03:07:24,021 --> 03:07:29,327 INVESTIGATORS HAVE BECOME 3954 03:07:29,327 --> 03:07:31,762 WONDERFULLY IMPROVE AT 3955 03:07:31,762 --> 03:07:32,096 COLLABORATING. 3956 03:07:32,096 --> 03:07:33,931 WE LEARNED HOW TO COLLABORATE 3957 03:07:33,931 --> 03:07:36,167 WITH ONE ANOTHER AND WE MIGHT BE 3958 03:07:36,167 --> 03:07:38,002 SOMETIMES COMPETITORS ON TUESDAY 3959 03:07:38,002 --> 03:07:40,137 AND ON THURSDAY WE'RE 3960 03:07:40,137 --> 03:07:40,705 COLLABORATORS. 3961 03:07:40,705 --> 03:07:41,939 SCIENTISTS HAVE LEARNED TO DO 3962 03:07:41,939 --> 03:07:51,115 THAT VERY WELL. 3963 03:07:51,115 --> 03:07:53,751 NIH INSTITUTES LEARNED TO DO 3964 03:07:53,751 --> 03:07:55,253 THAT AND WE NEED MORE 3965 03:07:55,253 --> 03:07:56,087 COLLABORATION AND FIGURE OUT HOW 3966 03:07:56,087 --> 03:07:56,354 TO SHARE. 3967 03:07:56,354 --> 03:08:00,224 THAT'S ONE OBSERVATION. 3968 03:08:00,224 --> 03:08:02,193 THE OTHER IS THE CLOUD CAN BE 3969 03:08:02,193 --> 03:08:06,664 THE SOLUTION. 3970 03:08:06,664 --> 03:08:13,137 THERE'S A LOT HAPPENING IN THE 3971 03:08:13,137 --> 03:08:14,906 PRIVATE SECTOR AND FEES ARE VERY 3972 03:08:14,906 --> 03:08:15,306 HIGH. 3973 03:08:15,306 --> 03:08:25,850 THE OTHERS ARE BUILDING TUNNELS. 3974 03:08:26,984 --> 03:08:28,386 IF WE HAD BETTER TUNNELLING 3975 03:08:28,386 --> 03:08:30,087 AVAILABLE TO THE PUBLIC OR 3976 03:08:30,087 --> 03:08:31,556 INVESTIGATORS LIKE US WOULD 3977 03:08:31,556 --> 03:08:31,756 HELP. 3978 03:08:31,756 --> 03:08:32,423 YES, THEY'RE PART OF THE 3979 03:08:32,423 --> 03:08:33,124 SOLUTION. 3980 03:08:33,124 --> 03:08:33,925 >> WONDERFUL. 3981 03:08:33,925 --> 03:08:34,392 THANK YOU. 3982 03:08:34,392 --> 03:08:37,061 AND YOU KNOW PEOPLE CAN SUBMIT 3983 03:08:37,061 --> 03:08:43,668 QUESTIONS AND YOU CAN ANSWER. 3984 03:08:43,668 --> 03:08:46,771 SO CAN YOU QUEUE UP THE NEXT SET 3985 03:08:46,771 --> 03:08:51,042 OF SLIDES AND I'LL INTRODUCE 3986 03:08:51,042 --> 03:08:52,009 DR. MOFFITT AN ASSOCIATE 3987 03:08:52,009 --> 03:08:53,744 PROFESSOR IN THE DEPARTMENT OF 3988 03:08:53,744 --> 03:08:59,183 HEMATOLOGY AND MEDICAL ONTOLOGY 3989 03:08:59,183 --> 03:09:00,217 THE SECONDARY APPOINTMENT IN 3990 03:09:00,217 --> 03:09:03,387 BIOMEDICAL INFORMATICS AT EMORY 3991 03:09:03,387 --> 03:09:06,090 UNIVERSITY AND I SEE YOU ON 3992 03:09:06,090 --> 03:09:06,591 CAMERA. 3993 03:09:06,591 --> 03:09:08,492 WONDERFUL, THANK YOU. 3994 03:09:08,492 --> 03:09:09,994 HIS EARLY WORK APPLIED MAJOR 3995 03:09:09,994 --> 03:09:18,402 TECHNIQUES TO DISCOVER CANONICAL 3996 03:09:18,402 --> 03:09:21,606 SUB TYPES OF CANCER AND HE'S 3997 03:09:21,606 --> 03:09:27,278 BEEN PART OF THE NATIONAL COVID 3998 03:09:27,278 --> 03:09:28,412 COHORT COLLABORATE WHICH CREATES 3999 03:09:28,412 --> 03:09:31,148 A COMMUNITY OF OVER 4,000 USERS 4000 03:09:31,148 --> 03:09:34,752 WORKING WITH HEALTH RECORDS OF 4001 03:09:34,752 --> 03:09:39,156 OVER 20 MILLION PATIENTS AND 4002 03:09:39,156 --> 03:09:39,991 BACK IT COLLABORATION. 4003 03:09:39,991 --> 03:09:42,326 TAKE IT AWAY. 4004 03:09:42,326 --> 03:09:44,428 >> SO I'M GOING TO TALK ABOUT 4005 03:09:44,428 --> 03:09:50,401 HOW WE'RE ABLE TO LEVERAGE THIS 4006 03:09:50,401 --> 03:09:56,007 DATA MULTI-INSTITUTE DATA AND GO 4007 03:09:56,007 --> 03:09:56,540 TOWARDS BUILDING MACHINE 4008 03:09:56,540 --> 03:10:04,048 LEARNING MODELS OF DISEASE. 4009 03:10:04,048 --> 03:10:08,119 SOME STATS WHY THE N3C OR 4010 03:10:08,119 --> 03:10:09,620 NATIONAL COVID COHORT 4011 03:10:09,620 --> 03:10:11,222 COLLABORATE. 4012 03:10:11,222 --> 03:10:12,023 IVE. 4013 03:10:12,023 --> 03:10:15,793 WE HAVE E.H.R. RECORDS FROM 4014 03:10:15,793 --> 03:10:22,900 ABOUT 20 MILLION PATIENTS AND 8 4015 03:10:22,900 --> 03:10:24,168 MILLION ARE CONFIRMED TO BE 4016 03:10:24,168 --> 03:10:25,603 COVID POSITIVE. 4017 03:10:25,603 --> 03:10:28,606 THE DATA COMES FROM 81 SITES. 4018 03:10:28,606 --> 03:10:32,243 WE MEAN HEALTH CARE SYSTEMS. 4019 03:10:32,243 --> 03:10:36,347 SO IT'S OUR STATEWIDE H.I.E.s 4020 03:10:36,347 --> 03:10:39,817 AND THERE'S BEEN MAYOS AND THEY 4021 03:10:39,817 --> 03:10:41,385 HAVE DATA FROM THEIR SITES 4022 03:10:41,385 --> 03:10:47,958 ACROSS DIFFERENT STATES AND THE 4023 03:10:47,958 --> 03:10:50,795 E.H.R. GIVES 27 BILLION ROWS OF 4024 03:10:50,795 --> 03:10:57,468 DATA TO DO COMPUTATION ON. 4025 03:10:57,468 --> 03:11:01,305 THE DATA THAT COMES IN COMES 4026 03:11:01,305 --> 03:11:05,810 FROM THE SITES' OWN DATA MODEL 4027 03:11:05,810 --> 03:11:08,546 IN SOME OTHER COMMON DATA MODEL 4028 03:11:08,546 --> 03:11:10,414 WHICH WE THINK HAS BEEN 4029 03:11:10,414 --> 03:11:13,918 IMPORTANT FOR GETTING GOOD 4030 03:11:13,918 --> 03:11:15,152 PARTICIPATION FROM THE 4031 03:11:15,152 --> 03:11:15,419 COMMUNITY. 4032 03:11:15,419 --> 03:11:18,155 BECAUSE WE TAKE THE DATA AS IT 4033 03:11:18,155 --> 03:11:24,628 WAS AT A HEALTH CARE SITE, WE 4034 03:11:24,628 --> 03:11:26,731 TRANSIT INTO THE OMA COMMON DATA 4035 03:11:26,731 --> 03:11:29,934 MODEL WITH A SERIES OF MAPPINGS. 4036 03:11:29,934 --> 03:11:36,107 AND THERE'S LOTS OF DATA QUALITY 4037 03:11:36,107 --> 03:11:41,178 CHECKS WE LOOK TO THE COMMUNITY 4038 03:11:41,178 --> 03:11:43,047 TO SEE IF IT GETS PASSED FOR 4039 03:11:43,047 --> 03:11:44,949 DATA ANALYSIS AND TO GIVE 4040 03:11:44,949 --> 03:11:47,284 FEEDBACK BACK TO THE SITES THAT 4041 03:11:47,284 --> 03:11:51,789 PROVIDE DATA IF THERE'S 4042 03:11:51,789 --> 03:11:53,891 DEFICIENCY WE CAN HELP THEM FIX 4043 03:11:53,891 --> 03:11:56,694 IT AT THE SOURCE WHICH IMPROVES 4044 03:11:56,694 --> 03:12:03,167 THE DATA IN N3C AND BACK AT THE 4045 03:12:03,167 --> 03:12:13,410 ORIGINAL SITE. 4046 03:12:19,049 --> 03:12:21,352 YOU CAN GOOGLE N3C AND YOU CAN 4047 03:12:21,352 --> 03:12:23,854 GET DETAILS AND CODE AND 4048 03:12:23,854 --> 03:12:26,023 BASICALLY WE TAKE ALL THE COVID 4049 03:12:26,023 --> 03:12:30,227 POSITIVE PATIENTS AT A SITE AND 4050 03:12:30,227 --> 03:12:31,395 2-1 MATCH DEMOGRAPHICALLY WITH 4051 03:12:31,395 --> 03:12:41,806 COVID NEGATIVE PATIENTS. 4052 03:12:55,686 --> 03:13:01,025 SO THE TYPE OF DATA WE HAVE IS 4053 03:13:01,025 --> 03:13:03,160 THE COMMON DATA MODEL AND HAVE 4054 03:13:03,160 --> 03:13:04,995 TABLES FOR PERSON, DRUG, 4055 03:13:04,995 --> 03:13:05,963 PROCEDURE, CONDITION, 4056 03:13:05,963 --> 03:13:06,564 MEASUREMENT. 4057 03:13:06,564 --> 03:13:07,765 WE HAVE ALL THE DEMOGRAPHIC 4058 03:13:07,765 --> 03:13:08,999 INFORMATION YOU'D WANT TO KNOW 4059 03:13:08,999 --> 03:13:10,601 ABOUT A PATIENT. 4060 03:13:10,601 --> 03:13:21,078 THEIR AGE, GENDER, ALL THAT. 4061 03:13:21,078 --> 03:13:23,314 AND THERE'S DIAGNOSIS AND BY 4062 03:13:23,314 --> 03:13:25,149 MEASUREMENT WE MEAN LAB 4063 03:13:25,149 --> 03:13:26,083 MEASUREMENT AND NOT ONLY DO WE 4064 03:13:26,083 --> 03:13:27,618 HAVE THE TIMING OF THE LABS BUT 4065 03:13:27,618 --> 03:13:29,987 WE HAVE THE RESULTS. 4066 03:13:29,987 --> 03:13:32,389 ONE OF THE KEY HARMONIZATIONS WE 4067 03:13:32,389 --> 03:13:36,260 DO INSIDE OF N3C IS MAP THE 4068 03:13:36,260 --> 03:13:38,863 COMMON MEASUREMENTS TO A COMMON 4069 03:13:38,863 --> 03:13:40,331 UNIT SPACE. 4070 03:13:40,331 --> 03:13:43,701 SO WHEN YOU GRAB WEIGHT OR 4071 03:13:43,701 --> 03:13:45,002 SODIUM THEY'RE ALL DEALING WITH 4072 03:13:45,002 --> 03:13:47,438 ONE PARTICULAR UNIT ACROSS THE 4073 03:13:47,438 --> 03:13:48,606 ENTIRE DATA SET SO USERS DON'T 4074 03:13:48,606 --> 03:13:50,274 HAVE TO DEAL WITH THAT. 4075 03:13:50,274 --> 03:13:52,810 IN ADDITION TO THE TYPICAL DATA 4076 03:13:52,810 --> 03:13:55,779 YOU GET FROM AN E.H.R. ABOVE, 4077 03:13:55,779 --> 03:13:57,281 WE'VE ALSO BEEN ABLE TO GET 4078 03:13:57,281 --> 03:14:01,085 ENHANCEMENTS EXTRACTING THINGS 4079 03:14:01,085 --> 03:14:03,988 FROM HAND WRITTEN NOTES FROM NLP 4080 03:14:03,988 --> 03:14:05,923 AND WE DON'T GET THE NOTES 4081 03:14:05,923 --> 03:14:07,691 THEMSELVES BUT WE GET THINGS 4082 03:14:07,691 --> 03:14:10,194 EXTRACTED FROM THE NOTES LIKE 4083 03:14:10,194 --> 03:14:15,199 CERTAIN DIAGNOSES, COUGH, THINGS 4084 03:14:15,199 --> 03:14:18,335 THAT DON'T SHOW UP AS A 4085 03:14:18,335 --> 03:14:20,304 CONDITION BUT SYMPTOM CAN GET 4086 03:14:20,304 --> 03:14:23,641 PICKED UP BY NATURAL LANGUAGE 4087 03:14:23,641 --> 03:14:23,941 PROCESSING. 4088 03:14:23,941 --> 03:14:25,843 AND WE HAVE DATA ON DEATH 4089 03:14:25,843 --> 03:14:27,811 OUTSIDE THE HOSPITAL TO INCREASE 4090 03:14:27,811 --> 03:14:30,147 OUR MORTALITY AND CNS CLAIMS 4091 03:14:30,147 --> 03:14:32,049 DATA TO SEE STUFF MAYBE NOT 4092 03:14:32,049 --> 03:14:33,784 PICKED UP BY A PARTICULAR HEALTH 4093 03:14:33,784 --> 03:14:36,153 SYSTEM BUT PEOPLE ON MEDICARE 4094 03:14:36,153 --> 03:14:37,521 AND MEDICAID AND MORE PROCEDURES 4095 03:14:37,521 --> 03:14:46,630 THAN MEDICATIONS. 4096 03:14:46,630 --> 03:14:47,564 IT'S A GREAT RESOURCE OF DATA 4097 03:14:47,564 --> 03:14:49,600 AND THERE'S RESTRICTIONS HERE 4098 03:14:49,600 --> 03:14:53,737 BECAUSE IT'S E.H.R. DATA. 4099 03:14:53,737 --> 03:14:55,172 THE FIRST IS IT HAS TO BE COVID 4100 03:14:55,172 --> 03:14:55,773 RELATED ONLY. 4101 03:14:55,773 --> 03:14:57,741 NO ATTEMPTS TO REIDENTIFY 4102 03:14:57,741 --> 03:14:59,710 PATIENTS THOUGH THE DATA IS 4103 03:14:59,710 --> 03:15:03,547 COMPLETELY DEIDENTIFIED EXCEPT 4104 03:15:03,547 --> 03:15:06,850 FOR DATES AND FIVE-DIGIT ZIP 4105 03:15:06,850 --> 03:15:07,184 CODES. 4106 03:15:07,184 --> 03:15:08,686 HIPAA LIMITED IN THAT WAY. 4107 03:15:08,686 --> 03:15:11,822 THE SOFTWARE FOR THE PLATFORM 4108 03:15:11,822 --> 03:15:13,991 PREVENTS USERS FROM DOWNLOADING 4109 03:15:13,991 --> 03:15:16,160 OR CAPTURING THE RAW DATA. 4110 03:15:16,160 --> 03:15:18,629 NOT ONLY ARE YOU DISALLOWED, 4111 03:15:18,629 --> 03:15:20,431 YOU'RE ALSO NOT CAPABLE OF 4112 03:15:20,431 --> 03:15:21,298 DOWNLOADING THE DATA. 4113 03:15:21,298 --> 03:15:24,168 THE DATA COMES IN TWO TIERS OF 4114 03:15:24,168 --> 03:15:24,401 ACCESS. 4115 03:15:24,401 --> 03:15:26,971 ONE IS THE HIPAA LIMITED WHERE 4116 03:15:26,971 --> 03:15:29,440 YOU HAVE DATES AND LOCATIONS. 4117 03:15:29,440 --> 03:15:30,975 AND THERE'S ALSO A SAFE HARBOR 4118 03:15:30,975 --> 03:15:32,343 VERSION WHERE THE DATES HAVE 4119 03:15:32,343 --> 03:15:35,512 BEEN SHIFTED AND THE ZIP CODES 4120 03:15:35,512 --> 03:15:43,520 HAVE BEEN OB OBFUSCATED AND ONE 4121 03:15:43,520 --> 03:15:45,055 ADVANTAGE OF THE LOCK DOWN OF 4122 03:15:45,055 --> 03:15:49,326 THE DATA IS COMPLETE ANALYTICAL 4123 03:15:49,326 --> 03:15:50,260 PROVIDENCE AND IT'S TRACEABLE 4124 03:15:50,260 --> 03:15:52,196 BACK TO THE ROOTS. 4125 03:15:52,196 --> 03:15:53,530 USERS CAN EVEN DIG UP HILL IN 4126 03:15:53,530 --> 03:15:55,332 THE MAPPING STEPS TO SEE ALL THE 4127 03:15:55,332 --> 03:15:58,669 CODE AND TRANSFORMATIONS FOR 4128 03:15:58,669 --> 03:16:01,605 EXAMPLE TO TAKE SOMETHING FROM 4129 03:16:01,605 --> 03:16:08,178 AN ACT AND MAP IT TO OMAM AND 4130 03:16:08,178 --> 03:16:09,947 IT'S TRANSPARENT AND TRACKABLE 4131 03:16:09,947 --> 03:16:15,185 ALLOWING PEOPLE TO SHARE CODE 4132 03:16:15,185 --> 03:16:25,629 ACROSS QUITE TRANSPARENT. 4133 03:16:26,997 --> 03:16:28,966 I'M GOING TO TALK ABOUT THINGS 4134 03:16:28,966 --> 03:16:30,968 THAT HAVE BEEN DONE IN THE PAST 4135 03:16:30,968 --> 03:16:34,505 TO GIVE THE IDEA OF THE RICHNESS 4136 03:16:34,505 --> 03:16:35,539 OF AVAILABLE FOR USE AND CAN 4137 03:16:35,539 --> 03:16:37,341 INSPIRE QUESTIONS YOU WANT TO DO 4138 03:16:37,341 --> 03:16:37,608 YOURSELF. 4139 03:16:37,608 --> 03:16:41,478 ON THE LEFT IS A FIGURE FROM THE 4140 03:16:41,478 --> 03:16:43,147 INITIAL COHORT CHARACTERIZATION 4141 03:16:43,147 --> 03:16:44,448 PAPER WE PUT OUT. 4142 03:16:44,448 --> 03:16:45,749 YOU'LL PUT OUT THERE'S NOT EVEN 4143 03:16:45,749 --> 03:16:49,219 A YEAR DOWN THERE BECAUSE IT WAS 4144 03:16:49,219 --> 03:16:50,854 2020 AND WE'RE LOOKING AT 4145 03:16:50,854 --> 03:16:51,822 SEVERITY OVER TIME AND GENERALLY 4146 03:16:51,822 --> 03:16:52,956 YOU CAN SEE THE BARS ARE GOING 4147 03:16:52,956 --> 03:16:54,558 DOWN AS WE GO OUT TO THE RIGHT 4148 03:16:54,558 --> 03:16:59,696 WHICH WAS A HOPEFUL AND PERHAPS 4149 03:16:59,696 --> 03:17:00,798 REASSURING TREND THE SEVERITY OF 4150 03:17:00,798 --> 03:17:02,699 PATIENTS INFECTED WITH COVID WAS 4151 03:17:02,699 --> 03:17:05,702 GOING DOWN. 4152 03:17:05,702 --> 03:17:09,807 PATIENTS MILD WOULD BE LIKE OUT 4153 03:17:09,807 --> 03:17:11,108 PATIENTS, MILD IN THE E.D. AND 4154 03:17:11,108 --> 03:17:16,413 SEVERE IS YOUR HOSPITALIZED AND 4155 03:17:16,413 --> 03:17:22,453 YOU NEED SOME INVASIVE 4156 03:17:22,453 --> 03:17:23,454 VENTILATION AND ONE NICE THING 4157 03:17:23,454 --> 03:17:25,889 ABOUT BUILDING THE PIPELINES IS 4158 03:17:25,889 --> 03:17:27,825 AS THE NEW DATA'S COMING IN WE 4159 03:17:27,825 --> 03:17:30,627 CAN RERUN THE PIPELINES ON THE 4160 03:17:30,627 --> 03:17:33,397 SCHEDULE AND DATA COMES IN TO 4161 03:17:33,397 --> 03:17:34,731 N3C PERIODLY FROM PROVIDING 4162 03:17:34,731 --> 03:17:36,900 SIGHT BUT A NEW CUT OF THE DATA 4163 03:17:36,900 --> 03:17:39,536 IS GIVEN TO RESEARCHERS ONCE A 4164 03:17:39,536 --> 03:17:39,736 WEEK. 4165 03:17:39,736 --> 03:17:41,238 EVERY WEEK WE CAN UPDATE OUR 4166 03:17:41,238 --> 03:17:43,941 RESULTS AND IN FACT ABLE TO TAKE 4167 03:17:43,941 --> 03:17:45,309 THE SNAPSHOT PUBLISHED IN THE 4168 03:17:45,309 --> 03:17:47,945 PAPER AND TURN IT INTO A 4169 03:17:47,945 --> 03:17:52,816 DASHBOARD WHERE WE'RE ABLE TO 4170 03:17:52,816 --> 03:17:55,185 SEE UNFORTUNATELY THE TREND OF 4171 03:17:55,185 --> 03:17:56,286 DECREASING SEVERITY ABOUT THE 4172 03:17:56,286 --> 03:17:58,355 TIME WE PUBLISH THE PAPER 4173 03:17:58,355 --> 03:18:01,058 STARTED CREEPING UP AS DELTA 4174 03:18:01,058 --> 03:18:03,760 CAME TO DOWN. 4175 03:18:03,760 --> 03:18:12,536 AND IF YOU GO TO COVID.CT2H.org 4176 03:18:12,536 --> 03:18:13,203 YOU'LL FIND MET INFORMATION 4177 03:18:13,203 --> 03:18:17,207 ABOUT THE ENCLAVE AS WELL AS THE 4178 03:18:17,207 --> 03:18:27,518 ACTUAL DATA UNDER. 4179 03:18:27,518 --> 03:18:28,051 WE HAVE INFORMATION ON 4180 03:18:28,051 --> 03:18:29,052 MEDICATION AND YOU SEE THE 4181 03:18:29,052 --> 03:18:31,788 FRACTION OF PATIENTS AT THE 4182 03:18:31,788 --> 03:18:33,757 VARIOUS SEVERITY LEVELS AND 4183 03:18:33,757 --> 03:18:35,926 PATIENTS HOSPITALIZED AND EITHER 4184 03:18:35,926 --> 03:18:38,962 REQUIRED VENTILATION OR ENDED UP 4185 03:18:38,962 --> 03:18:41,098 SUCCUMBING TO DISEASE. 4186 03:18:41,098 --> 03:18:44,601 YOU SEE AZITHROMYCIN WAS POPULAR 4187 03:18:44,601 --> 03:18:48,305 AND MELLOWED OUT AND 4188 03:18:48,305 --> 03:18:51,675 HYDROXYCHLOROQUINE WAS POPULAR 4189 03:18:51,675 --> 03:18:55,078 IN MARCH AND APRIL AND YOU CAN 4190 03:18:55,078 --> 03:18:57,781 SEE REMDESIVIR RISING UP AND 4191 03:18:57,781 --> 03:19:03,086 GENERALLY SYSTEMIC IN BACTERIALS 4192 03:19:03,086 --> 03:19:13,430 WANED AND YOU SEE DEXOMETHOSONE 4193 03:19:13,430 --> 03:19:15,232 AND YOU SEE THE MASSIVE NUMBER 4194 03:19:15,232 --> 03:19:16,300 OF PATIENTS WE CAN ASK THE 4195 03:19:16,300 --> 03:19:23,941 QUESTIONS ABOUT. 4196 03:19:23,941 --> 03:19:25,475 HERE ARE GRAPHS IF YOU LOOK AT 4197 03:19:25,475 --> 03:19:28,912 THE X AXIS THAT IS DAYS OF 4198 03:19:28,912 --> 03:19:29,146 VISITS. 4199 03:19:29,146 --> 03:19:30,314 SO ZERO IS THE DAY THEY SHOWED 4200 03:19:30,314 --> 03:19:31,949 UP TO THE HOSPITAL AND AS WE GO 4201 03:19:31,949 --> 03:19:33,684 OUT TO THE RIGHT AS PATIENTS WHO 4202 03:19:33,684 --> 03:19:39,389 ARE STAYING LONGER AND LONGER. 4203 03:19:39,389 --> 03:19:42,159 PATIEN 4204 03:19:42,159 --> 03:19:46,163 PATIENTS IN BLACK ENDED UP DYING 4205 03:19:46,163 --> 03:19:48,165 AND PATIENTS IN RED NEEDED 4206 03:19:48,165 --> 03:19:50,000 VENTILATION BUT DIED AND YELLOW 4207 03:19:50,000 --> 03:19:51,635 ARE JUST HOSPITALIZED PATIENTS 4208 03:19:51,635 --> 03:19:53,270 AND LINE IN GREEN ARE PATIENTS 4209 03:19:53,270 --> 03:19:54,605 IN THE E.D. WHICH IS WHY THEIR 4210 03:19:54,605 --> 03:19:59,710 STAYS ARE SHORTER. 4211 03:19:59,710 --> 03:20:03,413 AND LOOK AT THE VALIDITY FOR THE 4212 03:20:03,413 --> 03:20:04,414 VITAL SIGNS AND INTERESTING 4213 03:20:04,414 --> 03:20:05,782 TRENDS BASED ON THOSE ABLE TO 4214 03:20:05,782 --> 03:20:08,185 RECOVER VERSUS THOSE WHO DIED IN 4215 03:20:08,185 --> 03:20:10,554 THE RED AND BLACK FOR EXAMPLE 4216 03:20:10,554 --> 03:20:12,456 LIKE RESPIRATORY RATE AND 4217 03:20:12,456 --> 03:20:14,291 ELEVATED RESPIRATORY RATE AND A 4218 03:20:14,291 --> 03:20:17,194 DIP AS THEY'RE INITIALLY BEING 4219 03:20:17,194 --> 03:20:20,464 TREATED WITH PATIENTS WHO 4220 03:20:20,464 --> 03:20:22,099 EVENTUALLY DIED AND THE RATES 4221 03:20:22,099 --> 03:20:23,867 DRIFT UP AND NEVER GET BACK IN 4222 03:20:23,867 --> 03:20:29,306 CONTROL. 4223 03:20:29,306 --> 03:20:31,108 WE ALSO HAVE THE OTHER 4224 03:20:31,108 --> 03:20:31,508 TRADITIONAL LABS. 4225 03:20:31,508 --> 03:20:33,744 IT'S A SET OF SIX. 4226 03:20:33,744 --> 03:20:37,914 LITERALLY ANY LAB WE SHOULD HAVE 4227 03:20:37,914 --> 03:20:39,549 THE RESULTS OF. 4228 03:20:39,549 --> 03:20:46,323 HERE WE HAVE THE CRP MEASURES 4229 03:20:46,323 --> 03:20:47,724 AND YOU CAN SEE INTERESTING 4230 03:20:47,724 --> 03:20:50,127 TRENDS WHICH ILLUSTRATE THE 4231 03:20:50,127 --> 03:20:52,496 VOLUME OF DATA UNDERNEATH THAT 4232 03:20:52,496 --> 03:20:54,131 ARE ABLE TO TEASE OUT 4233 03:20:54,131 --> 03:20:55,065 INTERESTING DIFFERENCES IN THE 4234 03:20:55,065 --> 03:21:04,274 POPULATIONS OVER TIME. 4235 03:21:04,274 --> 03:21:07,678 I WANT TO WAS ON ONE PARTICULAR 4236 03:21:07,678 --> 03:21:10,747 STUDY FROM COLORADO AND HE'S 4237 03:21:10,747 --> 03:21:11,648 LOOKING AT THE DIFFERENCE 4238 03:21:11,648 --> 03:21:13,650 BETWEEN MISC. 4239 03:21:13,650 --> 03:21:19,089 THEY'RE ALL PEDIATRIC PATIENTS 4240 03:21:19,089 --> 03:21:23,460 WITH THE BLUE GRAY AND PEDIATRIC 4241 03:21:23,460 --> 03:21:24,661 PATIENTS MERELY EXPERIENCING 4242 03:21:24,661 --> 03:21:25,362 COVID INFECTION. 4243 03:21:25,362 --> 03:21:29,166 AND IF WE LOOK AT THE BOTTOM 4244 03:21:29,166 --> 03:21:34,137 LEVEL CIRCLED AND THESE ARE 4245 03:21:34,137 --> 03:21:36,373 COMORBIDITIES OF INTEREST IN THE 4246 03:21:36,373 --> 03:21:37,541 PEDIATRIC POPULATION AND IF YOU 4247 03:21:37,541 --> 03:21:39,476 COMPARE LEFT TO RIGHT WE DON'T 4248 03:21:39,476 --> 03:21:41,712 SEE MUCH DIFFERENCE IN THE SIZE 4249 03:21:41,712 --> 03:21:43,814 OF THE BARS OR NUMBERS WHICH ARE 4250 03:21:43,814 --> 03:21:46,183 PERCENT OF PATIENTS WITH THE 4251 03:21:46,183 --> 03:21:46,717 COMORBIDITY. 4252 03:21:46,717 --> 03:21:48,151 SUGGESTING THAT THERE WAS NOT 4253 03:21:48,151 --> 03:21:50,854 REALLY A BIG DIFFERENCE IN 4254 03:21:50,854 --> 03:21:53,156 PRIORITY BEFORE INFECTION IN A 4255 03:21:53,156 --> 03:21:54,791 POPULATION OF PEDIATRIC PATIENTS 4256 03:21:54,791 --> 03:21:57,994 WHO ARE GOING TO JUST HAVE ACUTE 4257 03:21:57,994 --> 03:21:59,629 COVID VERSUS THOSE WHO ARE GOING 4258 03:21:59,629 --> 03:22:05,836 TO HAVE MISC AFTER THE FACT. 4259 03:22:05,836 --> 03:22:10,707 MEANWHILE HERE'S A BUNCH OF LAB 4260 03:22:10,707 --> 03:22:12,175 VALUES AND THRESHOLDS FOR 4261 03:22:12,175 --> 03:22:13,844 EXTREMISTS AND THE POPULATIONS 4262 03:22:13,844 --> 03:22:15,579 ARE WILDLY DIFFERENT SUGGESTING 4263 03:22:15,579 --> 03:22:18,048 A COMPLETELY DIFFERENT COURSE OF 4264 03:22:18,048 --> 03:22:19,449 DISEASE BEING EXPERIENCED BY 4265 03:22:19,449 --> 03:22:22,753 PEDIATRIC PATIENTS WITH ACUTE 4266 03:22:22,753 --> 03:22:32,829 COVID. 4267 03:22:32,829 --> 03:22:34,364 HOW DO WE TALK ABOUT THE DATA 4268 03:22:34,364 --> 03:22:36,266 AND WE TALKED ABOUT RESTRICTIONS 4269 03:22:36,266 --> 03:22:37,501 AND EVERYTHING WILL GET NICER 4270 03:22:37,501 --> 03:22:39,569 AND NICER HERE ON OUT. 4271 03:22:39,569 --> 03:22:42,005 ON THE RIGHT WE SAW GLYPHS WHERE 4272 03:22:42,005 --> 03:22:44,074 EACH BOX IS A CODE TRANS FORM. 4273 03:22:44,074 --> 03:22:45,542 THE CODE TRANSFORM CAN BE 4274 03:22:45,542 --> 03:22:50,781 WRITTEN IN PYTHON OR R OR SQL 4275 03:22:50,781 --> 03:22:56,453 AND IT IS INHERENTLY VERSION 4276 03:22:56,453 --> 03:22:57,454 CONTROLLED. 4277 03:22:57,454 --> 03:23:00,157 THIS WORKBOOK CAN BE ACCESSED BY 4278 03:23:00,157 --> 03:23:01,391 MULTIPLE USERS IN A PROJECT. 4279 03:23:01,391 --> 03:23:04,027 IN FACT YOU CAN HAVE ONE PERSON 4280 03:23:04,027 --> 03:23:08,231 WHO IS GOOD AT WRITING CODE IN R 4281 03:23:08,231 --> 03:23:11,735 AND IT FLOWS SEAMLESSLY TO A 4282 03:23:11,735 --> 03:23:13,870 TRANSFORM WHICH FLOWS SEAMLESSLY 4283 03:23:13,870 --> 03:23:17,274 INTO A PYTHON TRANSFORM AND THEY 4284 03:23:17,274 --> 03:23:18,608 WORK TOGETHER NICELY WHICH 4285 03:23:18,608 --> 03:23:21,578 ALLOWS FOR GOOD COLLABORATION. 4286 03:23:21,578 --> 03:23:25,849 AND ALSO ALLOWS FOR RETENTION OF 4287 03:23:25,849 --> 03:23:26,149 PROVIDENCE. 4288 03:23:26,149 --> 03:23:29,853 WE CAN GO FROM A FIGURE AND 4289 03:23:29,853 --> 03:23:32,022 TRACE BACK UP HILL WHAT STEPS 4290 03:23:32,022 --> 03:23:34,791 WERE PERFORMED AND WHO WROTE THE 4291 03:23:34,791 --> 03:23:36,993 CODE AND WHEN THE CODE WAS LAST 4292 03:23:36,993 --> 03:23:39,029 RUN TO CREATE THE UNDERLYING 4293 03:23:39,029 --> 03:23:39,229 PIECE. 4294 03:23:39,229 --> 03:23:40,597 YOU CAN QUICKLY DETECT IF A 4295 03:23:40,597 --> 03:23:43,667 PIECE OF YOUR PIPELINE IS STALE 4296 03:23:43,667 --> 03:23:45,502 AND NEEDS TO BE RERUN AND BUT 4297 03:23:45,502 --> 03:23:47,170 EVERYTHING ON SCHEDULES SO THAT 4298 03:23:47,170 --> 03:23:49,105 YOUR FIGURES UPDATE 4299 03:23:49,105 --> 03:23:51,174 AUTOMATICALLY WITH EACH NEW 4300 03:23:51,174 --> 03:23:53,677 WEEKLY RELEASE OF THE DATA. 4301 03:23:53,677 --> 03:23:58,748 THE THING THAT'S POWERFUL ABOUT 4302 03:23:58,748 --> 03:24:01,918 THE DATA IS IT EXISTS WITHIN THE 4303 03:24:01,918 --> 03:24:06,523 PLATFORM AND IN ADDITION TO THE 4304 03:24:06,523 --> 03:24:13,029 NICE COLLABORATIVE WORK SPACES, 4305 03:24:13,029 --> 03:24:23,640 EVERYTHING IS INHERENT LY 4306 03:24:24,941 --> 03:24:29,346 PARALLELED COMPUTED WHICH IS 4307 03:24:29,346 --> 03:24:30,146 NECESSARY WITH THE AMOUNT OF 4308 03:24:30,146 --> 03:24:30,647 DATA. 4309 03:24:30,647 --> 03:24:36,753 IT'S HARD TO SEE BUT THAT'S ONE 4310 03:24:36,753 --> 03:24:47,297 SUCH TRANSFORM AND WE'RE DOING 4311 03:24:48,298 --> 03:24:49,599 AGGREGATES WHEN TRANSFORMING THE 4312 03:24:49,599 --> 03:24:50,967 DATA AND THE PIECE OF CODE IS 4313 03:24:50,967 --> 03:24:55,071 TRYING TO FIND THE LONGEST VISIT 4314 03:24:55,071 --> 03:24:55,839 A PATIENT HAD WAS ALSO COVID 4315 03:24:55,839 --> 03:25:05,148 INFECTED. 4316 03:25:05,148 --> 03:25:09,386 IN OCTOBER OF 2021 WE JOINED THE 4317 03:25:09,386 --> 03:25:13,723 RECOVER EFFORT AND INVESTIGATING 4318 03:25:13,723 --> 03:25:15,825 PASC AND LOOKED AT WHAT IS LONG 4319 03:25:15,825 --> 03:25:18,161 COVID OR THE SUBTYPES AND RISK 4320 03:25:18,161 --> 03:25:19,629 FACTORS AND INTERVENTIONS THAT 4321 03:25:19,629 --> 03:25:27,671 AFFECT PASC. 4322 03:25:27,671 --> 03:25:32,576 IN ORDER TO DO THIS WE USED THE 4323 03:25:32,576 --> 03:25:35,178 UO9 DIAGNOSTIC CODE USED FOR 4324 03:25:35,178 --> 03:25:41,685 POST COVID CONDITION. 4325 03:25:41,685 --> 03:25:43,386 WE USED IT TO BUILD MACHINE 4326 03:25:43,386 --> 03:25:45,855 LEARNING AND IDENTIFY PATIENTS 4327 03:25:45,855 --> 03:25:48,058 WITH LONG COVID AND WE PUT OUT A 4328 03:25:48,058 --> 03:25:49,359 PAPER CHARACTERIZING THE 4329 03:25:49,359 --> 03:25:51,394 PATIENTS IN TERMS OF WHAT OTHER 4330 03:25:51,394 --> 03:25:52,829 DIAGNOSES OR MEDICATIONS OR 4331 03:25:52,829 --> 03:25:55,398 PROCEDURES DO THEY HAVE AROUND 4332 03:25:55,398 --> 03:26:04,407 THAT DIAGNOSIS. 4333 03:26:04,407 --> 03:26:06,676 WE'RE ABLE TO APPLY MACHINE 4334 03:26:06,676 --> 03:26:08,745 LEARNING TO IDENTIFY THE 4335 03:26:08,745 --> 03:26:11,247 PATIENTS AND APPLY IT TO OTHER 4336 03:26:11,247 --> 03:26:14,084 PATIENTS WHICH DON'T NECESSARY 4337 03:26:14,084 --> 03:26:16,519 HAVE A DIAGNOSIS AND IDENTIFY 4338 03:26:16,519 --> 03:26:18,254 WHAT WE THINK IS THE REAL 4339 03:26:18,254 --> 03:26:18,888 POPULATION OF PATIENTS WITH LONG 4340 03:26:18,888 --> 03:26:28,431 COVID. 4341 03:26:28,431 --> 03:26:29,899 MOST OF IT IS NOT SURPRISING 4342 03:26:29,899 --> 03:26:32,202 WHICH IS GOOD WHEN YOU EVALUATE 4343 03:26:32,202 --> 03:26:34,037 THE MACHINE LEARNING MODEL AND 4344 03:26:34,037 --> 03:26:36,539 HIGHLIGHTING IN YELLOW LOOKING 4345 03:26:36,539 --> 03:26:37,540 AT PLOTS. 4346 03:26:37,540 --> 03:26:40,777 THE RED STUFF IS ON THE RIGHT 4347 03:26:40,777 --> 03:26:41,645 SUGGESTING THAT THIS VARIABLE 4348 03:26:41,645 --> 03:26:43,446 DIFFICULTY BREATHING IS 4349 03:26:43,446 --> 03:26:49,452 POSITIVELY ASSOCIATED WITH PASC 4350 03:26:49,452 --> 03:26:53,223 OR LONG COVID AND ALTERNATIVELY 4351 03:26:53,223 --> 03:26:55,191 IN BLUE THE VACCINATION IS 4352 03:26:55,191 --> 03:26:59,262 ASSOCIATED WITH A LOWER RISK OF 4353 03:26:59,262 --> 03:27:05,402 PASC. 4354 03:27:05,402 --> 03:27:06,870 YOU CAN TAKE THE PATIENT AND 4355 03:27:06,870 --> 03:27:12,142 OBVIOUS NEXT STEP IS CLUSTERING 4356 03:27:12,142 --> 03:27:12,776 AND VARIOUS GROUPS I'LL GLOSS 4357 03:27:12,776 --> 03:27:18,148 OVER FOR TIME HERE. 4358 03:27:18,148 --> 03:27:23,186 SO MOST IMPORTANT QUESTION I'VE 4359 03:27:23,186 --> 03:27:23,586 TIE 4360 03:27:23,586 --> 03:27:24,554 TEASED THE LARGE DATA SET AND 4361 03:27:24,554 --> 03:27:33,663 HOW DO YOU GET ACCESS, COVID. 4362 03:27:33,663 --> 03:27:33,930 CD2H.org. 4363 03:27:33,930 --> 03:27:35,665 WE NEED AN INSTITUTIONAL DATA 4364 03:27:35,665 --> 03:27:37,367 USE AGREEMENT WHICH AT THIS 4365 03:27:37,367 --> 03:27:39,469 POINT ALL YOUR INSTITUTIONS 4366 03:27:39,469 --> 03:27:41,037 PROBABLY ALREADY HAVE ONE SIGNED 4367 03:27:41,037 --> 03:27:42,038 WITH N3C. 4368 03:27:42,038 --> 03:27:46,576 I'M SHOWING THE NETWORK OF 4369 03:27:46,576 --> 03:27:47,143 COLLABORATORS AT EMORY AND 4370 03:27:47,143 --> 03:27:55,785 ATLANTA AND THE NETWORK OF USERS 4371 03:27:55,785 --> 03:27:57,654 ARE BROADER THAN MY OWN SOCIAL 4372 03:27:57,654 --> 03:27:57,887 NETWORK. 4373 03:27:57,887 --> 03:28:01,424 I DON'T KNOW HALF THE PEOPLE AT 4374 03:28:01,424 --> 03:28:01,791 EMORY. 4375 03:28:01,791 --> 03:28:05,095 THERE'S PROBABLY USING IT 4376 03:28:05,095 --> 03:28:06,162 ALREADY. 4377 03:28:06,162 --> 03:28:13,103 YOU REGISTER WITHIN 3C AND YOU 4378 03:28:13,103 --> 03:28:21,411 NEED A LOCAL IRB AND YOU STILL 4379 03:28:21,411 --> 03:28:23,113 NEED THE DETERMINATION LETTER. 4380 03:28:23,113 --> 03:28:25,548 IT GOES TO THE DATA ACCESS 4381 03:28:25,548 --> 03:28:28,551 COMMITTEE WHICH IS NIH AND THEY 4382 03:28:28,551 --> 03:28:30,153 JUST CHECKED FOR APPROPRIATE USE 4383 03:28:30,153 --> 03:28:31,354 TO MAKE THE IRB MATCHES AND THEN 4384 03:28:31,354 --> 03:28:32,989 DO THE WORK WHICH I THINK IS 4385 03:28:32,989 --> 03:28:34,657 GETTING EASIER AND EASIER. 4386 03:28:34,657 --> 03:28:40,130 A LOT OF CODE IS POSTED IN WHAT 4387 03:28:40,130 --> 03:28:47,003 WE CALL KNOWLEDGE STORE ACROSS 4388 03:28:47,003 --> 03:28:49,606 PROJECT AND THERE WAS ZERO 4389 03:28:49,606 --> 03:28:50,940 DOLLARS OF COMPUTE COST AND 4390 03:28:50,940 --> 03:28:55,945 OFFERED AS A FREE RESOURCE. 4391 03:28:55,945 --> 03:28:58,681 THERE'S A PASSIVE LIST OF PEOPLE 4392 03:28:58,681 --> 03:29:00,850 I TOOK FROM THE FIRST PAPER 4393 03:29:00,850 --> 03:29:03,019 LOOKING UP BUT I SHOULD MENTION 4394 03:29:03,019 --> 03:29:07,423 AGAIN N3C IS FUNDED ALMOST 4395 03:29:07,423 --> 03:29:08,458 ENTIRELY BY NCATS HERE AND DATA 4396 03:29:08,458 --> 03:29:14,297 IS COMING TO US FROM CTSA 4397 03:29:14,297 --> 03:29:17,734 PROGRAMS AS WELL AS DATA MODELS 4398 03:29:17,734 --> 03:29:22,038 FUNDED BY PCORI AND RECENTLY 4399 03:29:22,038 --> 03:29:24,140 SOME OF OUR ANALYTICS HAVE BEEN 4400 03:29:24,140 --> 03:29:28,111 SUPPORTED BY THE RECOVER PROGRAM 4401 03:29:28,111 --> 03:29:30,146 LOOKING INTO LONG COVID AND PASC 4402 03:29:30,146 --> 03:29:35,852 SO THANK YOU. 4403 03:29:35,852 --> 03:29:38,688 >> WONDERFUL. 4404 03:29:38,688 --> 03:29:38,988 FASCINATING. 4405 03:29:38,988 --> 03:29:39,722 I'VE KNOWN SOMETHING ABOUT THIS 4406 03:29:39,722 --> 03:29:41,457 BUT THE SIZE AND SCOPE AND THE 4407 03:29:41,457 --> 03:29:47,197 ABILITY TO DO THIS RAPIDLY IS 4408 03:29:47,197 --> 03:29:54,137 QUITE IMPRESSIVE. 4409 03:29:54,137 --> 03:29:54,938 QUESTIONS FROM ANYBODY. 4410 03:29:54,938 --> 03:30:05,281 I HAD ONE I FORGOT. 4411 03:30:09,185 --> 03:30:11,287 THERE'S A QUESTION IN THE Q&A. 4412 03:30:11,287 --> 03:30:14,657 >> WHEN THERE'S A STRONG PERIOD 4413 03:30:14,657 --> 03:30:18,795 SUCH AS THE COVID PANDEMIC, DOES 4414 03:30:18,795 --> 03:30:29,305 IT TRULY UNIDENTIFY THE DATA? 4415 03:30:30,373 --> 03:30:31,908 FIRST THE DATA IS PRETTY MUCH IN 4416 03:30:31,908 --> 03:30:38,181 THE ZIP CODE IS THE ONLY 4417 03:30:38,181 --> 03:30:40,383 IDENTIFIER LEFT THAT THE POINT 4418 03:30:40,383 --> 03:30:42,652 AND IN THE DATE SHIFT DATA ONLY 4419 03:30:42,652 --> 03:30:53,196 A THREE-DIGIT CODE AND OB -- 4420 03:30:54,697 --> 03:30:55,298 OBFUSCATES ALMOST EVERYTHING AND 4421 03:30:55,298 --> 03:30:58,601 THE DATE SHIFTING IS DONE BY 180 4422 03:30:58,601 --> 03:31:00,169 DAYS IN EITHER DIRECTION WHICH 4423 03:31:00,169 --> 03:31:01,471 HONESTLY MAKES IT DIFFICULT TO 4424 03:31:01,471 --> 03:31:06,476 ASK A LOT OF THE SCIENTIFIC 4425 03:31:06,476 --> 03:31:14,651 QUESTIONS AROUND VARIANT. 4426 03:31:14,651 --> 03:31:17,587 MOST PEOPLE WIND UP TRYING TO 4427 03:31:17,587 --> 03:31:21,591 GET ACCESS TO THE FULL DATA 4428 03:31:21,591 --> 03:31:25,561 SHIFT AND 180 IS A STRONG SHIFT 4429 03:31:25,561 --> 03:31:27,697 ESPECIALLY IF IT'S THE ONLY 4430 03:31:27,697 --> 03:31:28,831 LIMITED IDENTIFIER LEFT. 4431 03:31:28,831 --> 03:31:33,536 >> EXCELLENT. 4432 03:31:33,536 --> 03:31:44,047 WE HAVE ANOTHER QUESTION THE 4433 03:31:47,250 --> 03:31:50,019 NUMERATOR IS GREAT AND HOW DO 4434 03:31:50,019 --> 03:31:51,154 YOU ACCOUNT FOR MORE. 4435 03:31:51,154 --> 03:31:54,157 >> THE DATA IS CONTINUALLY 4436 03:31:54,157 --> 03:31:59,829 REFRESHED TO THE EXTENT THE 4437 03:31:59,829 --> 03:32:02,932 E.H.R.s ARE REFRESHED AT THE 4438 03:32:02,932 --> 03:32:03,132 SITE. 4439 03:32:03,132 --> 03:32:08,438 WE HAVE CONTINUOUS FOLLOW-UP. 4440 03:32:08,438 --> 03:32:12,175 >> IF MR. SMITH SHOWED UP FOR 4441 03:32:12,175 --> 03:32:16,980 RECOVER AT NYU LANGONE AND THEN 4442 03:32:16,980 --> 03:32:18,381 WENT HOME AND NEVER CAME BACK 4443 03:32:18,381 --> 03:32:22,518 BUT ENDED UP DYING AT MOUNT 4444 03:32:22,518 --> 03:32:26,055 SINAI OR AT AN OUT-PATIENT 4445 03:32:26,055 --> 03:32:26,889 CLINIC ON LONG ISLAND WOULD YOU 4446 03:32:26,889 --> 03:32:27,623 KNOW ? 4447 03:32:27,623 --> 03:32:29,225 >> A, THAT'S A PROBLEM. 4448 03:32:29,225 --> 03:32:35,198 THERE'S TWO GOOD SOLUTIONS WE 4449 03:32:35,198 --> 03:32:35,565 HAVE. 4450 03:32:35,565 --> 03:32:37,100 FIRST WE HAVE PATIENT 4451 03:32:37,100 --> 03:32:38,935 DUPLICATION IN A PRIVACY 4452 03:32:38,935 --> 03:32:40,269 PRESERVING WAY. 4453 03:32:40,269 --> 03:32:42,271 IF THEY'RE IN THE DUPE AND UNC 4454 03:32:42,271 --> 03:32:44,540 DATA SET WE SHOULD BE ABLE TO 4455 03:32:44,540 --> 03:32:46,876 IDENTIFY AND PUT THE PATIENT 4456 03:32:46,876 --> 03:32:47,710 BACK TOGETHER AGAIN. 4457 03:32:47,710 --> 03:32:51,814 AS FAR AS OUT OF HOSPITAL 4458 03:32:51,814 --> 03:32:54,117 MORTALITY THAT'S ONE WHERE THEY 4459 03:32:54,117 --> 03:32:56,085 SOUGHT EXTERNAL MORTALITY DATA 4460 03:32:56,085 --> 03:32:58,087 SPECIFICALLY AND THOSE ARE LINK 4461 03:32:58,087 --> 03:33:01,791 IN WITH THE SAME PRIVACY 4462 03:33:01,791 --> 03:33:05,194 PRESERVING LINKAGES. 4463 03:33:05,194 --> 03:33:06,429 >> UP NORTH CAROLINA WHAT 4464 03:33:06,429 --> 03:33:08,264 PERCENTAGE OF THE HOSPITALS ARE 4465 03:33:08,264 --> 03:33:09,032 IN YOUR SYSTEM? 4466 03:33:09,032 --> 03:33:10,466 >> I DON'T KNOW I CAN QUOTE THAT 4467 03:33:10,466 --> 03:33:20,977 NUMBER OFF THE TOP OF MY HEAD. 4468 03:33:37,460 --> 03:33:39,062 >> IT CAN BECOME MORE 4469 03:33:39,062 --> 03:33:39,362 COMPLICATED. 4470 03:33:39,362 --> 03:33:42,999 >> THE SAVING GRACE I THINK IS 4471 03:33:42,999 --> 03:33:45,668 THAT WE HAVE PRETTY BROAD 4472 03:33:45,668 --> 03:33:47,203 NATIONAL COVERAGE NOW AND THE 4473 03:33:47,203 --> 03:33:48,638 TIME SCALE WE'RE TALKING ABOUT 4474 03:33:48,638 --> 03:33:50,740 WITH MOST THE PEOPLE AND THE 4475 03:33:50,740 --> 03:33:52,275 QUESTIONS OF COVID IS RELATIVELY 4476 03:33:52,275 --> 03:33:52,475 SHORT. 4477 03:33:52,475 --> 03:33:55,244 WE'RE NOT TALKING ABOUT A 4478 03:33:55,244 --> 03:33:56,579 20-YEAR STUDY. 4479 03:33:56,579 --> 03:33:58,681 HOPEFULLY THAT'S REDUCED BUT 4480 03:33:58,681 --> 03:34:03,186 THIS IS A PROBLEM WITH ANY 4481 03:34:03,186 --> 03:34:03,886 E.H.R.-BASED STUDY. 4482 03:34:03,886 --> 03:34:06,089 WE CAN WRITE A TEXTBOOK AND I'M 4483 03:34:06,089 --> 03:34:09,358 SURE TEXTBOOKS HAVE BEEN WRITTEN 4484 03:34:09,358 --> 03:34:10,460 ABOUT LIMITATION WITH CONVENIENT 4485 03:34:10,460 --> 03:34:11,494 SAMPLES FROM E.H.R. 4486 03:34:11,494 --> 03:34:13,096 ONE THING WE DEFINITELY DON'T 4487 03:34:13,096 --> 03:34:14,163 WANT TO DO IS ASK QUESTIONS 4488 03:34:14,163 --> 03:34:16,966 ABOUT WHO IS MORE LIKELY TO GET 4489 03:34:16,966 --> 03:34:17,300 COVID. 4490 03:34:17,300 --> 03:34:18,968 IT'S A COMMON QUESTION PEOPLE 4491 03:34:18,968 --> 03:34:21,604 LOVE TO ASK AND WE SAY DON'T ASK 4492 03:34:21,604 --> 03:34:22,538 THAT QUESTION BECAUSE OUR DATA 4493 03:34:22,538 --> 03:34:24,173 SET ARE PEOPLE WOULD HAVE COVID 4494 03:34:24,173 --> 03:34:31,681 AND MATCH CONTROL. 4495 03:34:31,681 --> 03:34:35,184 AUTOMATICALLY DON'T ASKS ABOUT 4496 03:34:35,184 --> 03:34:35,551 SUSCEPTIBILITY. 4497 03:34:35,551 --> 03:34:38,788 ALL THE GOOD QUESTIONS ARE 4498 03:34:38,788 --> 03:34:41,858 WITHIN THE PEOPLE WITH THAT GET 4499 03:34:41,858 --> 03:34:42,792 COVID WHAT HAPPENS. 4500 03:34:42,792 --> 03:34:43,860 >> WONDERFUL PRESENTATION AND 4501 03:34:43,860 --> 03:34:44,961 RICH DATA AND THANK YOU VERY 4502 03:34:44,961 --> 03:34:46,362 MUCH AND WE'LL HAVE THE QUESTION 4503 03:34:46,362 --> 03:34:48,564 AND ANSWER PORTION AT THE END. 4504 03:34:48,564 --> 03:34:57,340 IT'S MY PLEASURE TO INTRODUCE 4505 03:34:57,340 --> 03:35:01,878 DR. JESSILYN DUNN AND SHE'S BEEN 4506 03:35:01,878 --> 03:35:02,812 CO-HOSTING AND IT'S A PLEASURE 4507 03:35:02,812 --> 03:35:07,683 TO GET TO KNOW HER AND MIGHT AS 4508 03:35:07,683 --> 03:35:09,318 WELL REPEAT HER QUALIFICATIONS. 4509 03:35:09,318 --> 03:35:12,355 SHE'S AN ASSISTANT PROFESSOR OF 4510 03:35:12,355 --> 03:35:14,790 BIOMEDICAL ENGINEER AND BIO 4511 03:35:14,790 --> 03:35:16,926 STATISTIC AND BIO INFORMATICS AT 4512 03:35:16,926 --> 03:35:18,461 THE DUKE AND DIRECTOR OF THE BIG 4513 03:35:18,461 --> 03:35:20,596 IDEAS LABORATORY TO PREVENT 4514 03:35:20,596 --> 03:35:25,635 CHRONIC DISEASE THROUGH DIGITAL 4515 03:35:25,635 --> 03:35:27,870 HEALTH INNOVATION AND SHE'S P.I. 4516 03:35:27,870 --> 03:35:34,544 OF THE COVID STUDY TO MONITOR 4517 03:35:34,544 --> 03:35:38,781 COVID-19 USING MOBILE HEALTH 4518 03:35:38,781 --> 03:35:40,950 TECHNOLOGIES AND PART OF THE AN 4519 03:35:40,950 --> 03:35:43,386 OPEN SOURCE PROGRAM FOR DIGITAL 4520 03:35:43,386 --> 03:35:47,190 BIOMARKER DEVELOPMENT. 4521 03:35:47,190 --> 03:35:48,991 AND HAS BEEN A POST-DOCTORAL 4522 03:35:48,991 --> 03:35:51,827 FELLOW SO SHE CAN TELL YOU MORE 4523 03:35:51,827 --> 03:35:54,030 ABOUT THE NIH TRAINING 4524 03:35:54,030 --> 03:35:54,630 MECHANISMS. 4525 03:35:54,630 --> 03:35:55,364 THANK YOU VERY MUCH, JESSILYN. 4526 03:35:55,364 --> 03:36:05,608 TAKE IT AWAY. 4527 03:36:05,875 --> 03:36:07,843 >> THANK YOU FOR CO-CHAIRING 4528 03:36:07,843 --> 03:36:08,377 WITH ME. 4529 03:36:08,377 --> 03:36:14,784 IT'S GREAT IT GIVE MORE DEEP 4530 03:36:14,784 --> 03:36:21,791 DIVE INFORMATION ON DATA IN 4531 03:36:21,791 --> 03:36:22,525 EPIDEMIOLOGY. 4532 03:36:22,525 --> 03:36:25,027 I WANT TO RE-EMPHASIZE WHY I 4533 03:36:25,027 --> 03:36:28,297 PERSONALLY AM SO EXCITED ABOUT 4534 03:36:28,297 --> 03:36:29,365 DIGITAL HEALTH DATA. 4535 03:36:29,365 --> 03:36:32,001 AND THE IDEA HERE ON THE 4536 03:36:32,001 --> 03:36:33,669 LEFT-HAND SIDE IS SHOWING ALL 4537 03:36:33,669 --> 03:36:36,172 THE DIFFERENT PHYSIO LODGE 4538 03:36:36,172 --> 03:36:39,442 SYSTEMS THAT WE CAN MONITOR 4539 03:36:39,442 --> 03:36:41,043 NON-INVASIVELY THROUGH SENSORS 4540 03:36:41,043 --> 03:36:42,478 THAT ARE EITHER BODY WORN OR IN 4541 03:36:42,478 --> 03:36:48,551 THE ENVIRONMENT. 4542 03:36:48,551 --> 03:36:50,553 RIGHT NOW WE THINK ABOUT SMART 4543 03:36:50,553 --> 03:36:52,088 WATCHES AND THINGS YOU HAVE TO 4544 03:36:52,088 --> 03:36:56,025 REMEMBER TO PUT ON AND WE'RE 4545 03:36:56,025 --> 03:36:57,793 HAVING INCREDIBLE ADVANCES IN 4546 03:36:57,793 --> 03:37:01,631 NOT ONLY COMPUTE BUT IN HARDWARE 4547 03:37:01,631 --> 03:37:02,999 AND MINIATURIZATION. 4548 03:37:02,999 --> 03:37:10,640 SO WE'RE MOVING FROM DEVICES TO 4549 03:37:10,640 --> 03:37:11,941 DEVICES THAT INTEGRATE 4550 03:37:11,941 --> 03:37:13,309 SEAMLESSLY WITH OUR LIVES. 4551 03:37:13,309 --> 03:37:18,547 FOR EXAMPLE, FABRIC IN CLOTHING. 4552 03:37:18,547 --> 03:37:19,582 YOU CAN SEE IN THE BOTTOM 4553 03:37:19,582 --> 03:37:23,519 PICTURE WE PAINTED ON 4554 03:37:23,519 --> 03:37:23,819 ELECTRONICS. 4555 03:37:23,819 --> 03:37:28,624 YOU MAY HEAR ABOUT TATTOO 4556 03:37:28,624 --> 03:37:30,660 ELECTRONICS BUT WHAT WE'RE 4557 03:37:30,660 --> 03:37:32,361 MOVING TOWARDS ARE TYPES OF 4558 03:37:32,361 --> 03:37:35,197 SENSORS THAT ARE HARDLY 4559 03:37:35,197 --> 03:37:36,932 NOTICEABLE AT ALL. 4560 03:37:36,932 --> 03:37:41,804 SO WHEN WE THINK OF GOING FROM A 4561 03:37:41,804 --> 03:37:47,109 MONITOR SAY FROM THE BULKIEST IS 4562 03:37:47,109 --> 03:37:51,514 IN-CLINIC ECG AT AN HOME MONITOR 4563 03:37:51,514 --> 03:37:55,618 TO MEASURE ECG OVER 24, 48 HOURS 4564 03:37:55,618 --> 03:37:57,787 THAT INVOLVED A CLUNKY PIECE OF 4565 03:37:57,787 --> 03:37:59,588 EQUIPMENT BUT COULD BE DONE IN 4566 03:37:59,588 --> 03:38:02,358 THE HOME TO TODAY PATCHES THAT 4567 03:38:02,358 --> 03:38:03,559 SIT ON THE CHEST AND THEY'RE 4568 03:38:03,559 --> 03:38:06,462 ABOUT THIS BIG AND WE CAN THINK 4569 03:38:06,462 --> 03:38:11,167 AHEAD TO THE FUTURE OF THESE 4570 03:38:11,167 --> 03:38:14,103 STICKERS OR TATTOOS THAT COULD 4571 03:38:14,103 --> 03:38:17,206 CONTINUOUSLY MONITOR HEART 4572 03:38:17,206 --> 03:38:17,440 RHYTHMS. 4573 03:38:17,440 --> 03:38:19,975 WHERE WE'RE TODAY IS JUST THE 4574 03:38:19,975 --> 03:38:20,276 BEGINNING. 4575 03:38:20,276 --> 03:38:23,913 WE ARE AT THE PRECIPICE OF THE 4576 03:38:23,913 --> 03:38:26,782 ABILITY TO MEASURE ALL THE BIO 4577 03:38:26,782 --> 03:38:29,385 SIGNALS PASSIVELY IN THE 4578 03:38:29,385 --> 03:38:31,387 BACKGROUND AND CONTINUOUSLY. 4579 03:38:31,387 --> 03:38:36,792 ON THE NEXT SLIDE I'LL TALK 4580 03:38:36,792 --> 03:38:39,895 ABOUT THE OVER ARCHING STRUCTURE 4581 03:38:39,895 --> 03:38:41,364 OF THE TALK. 4582 03:38:41,364 --> 03:38:42,665 ON THE NEXT SLIDE I'LL TALK 4583 03:38:42,665 --> 03:38:45,701 ABOUT WHAT A DIGITAL BIOMARKER 4584 03:38:45,701 --> 03:38:47,536 ACTUALLY IS SO WE'RE ALL ON THE 4585 03:38:47,536 --> 03:38:49,105 SAME PAGE IN TERMS OF 4586 03:38:49,105 --> 03:38:50,339 TERMINOLOGY. 4587 03:38:50,339 --> 03:38:52,608 I'LL TALK ABOUT CHALLENGES AND 4588 03:38:52,608 --> 03:38:53,642 THEN APPLICATION AREAS. 4589 03:38:53,642 --> 03:39:00,750 IF WE GO TO THE NEXT SLIDE, WHEN 4590 03:39:00,750 --> 03:39:02,451 I SAY THE TERM DIGITAL BIOMARKER 4591 03:39:02,451 --> 03:39:07,723 I WANT TO DEFINE WHAT I MEAN 4592 03:39:07,723 --> 03:39:15,698 IT'S DIGITALLY COLLECTED DATA 4593 03:39:15,698 --> 03:39:19,201 AND FROM A SMARTPHONE GPS AND 4594 03:39:19,201 --> 03:39:22,338 TRANSFORM THAT DATA TO AN 4595 03:39:22,338 --> 03:39:24,607 INDICATOR OF HEALTH OUTCOMES 4596 03:39:24,607 --> 03:39:27,109 LIKE DOES SOMEBODY HAVE AN 4597 03:39:27,109 --> 03:39:27,376 INFECTION. 4598 03:39:27,376 --> 03:39:29,512 YOU CAN THINK OF IT AS AKIN TO 4599 03:39:29,512 --> 03:39:30,980 AN ECONOMIC INDICATOR. 4600 03:39:30,980 --> 03:39:33,449 THINK OF GDP AN ACCUMULATION OF 4601 03:39:33,449 --> 03:39:36,852 MANY DIFFERENT CONTINUOUS DATA 4602 03:39:36,852 --> 03:39:39,355 STREAMINGS AND ANY POINT IN TIME 4603 03:39:39,355 --> 03:39:42,358 IT COULD BE CALCULATED TO 4604 03:39:42,358 --> 03:39:43,426 DETERMINE THE OVERALL HEALTH OF 4605 03:39:43,426 --> 03:39:43,993 THE ECONOMY. 4606 03:39:43,993 --> 03:39:47,363 IT'S A SIMILAR IDEA. 4607 03:39:47,363 --> 03:39:48,931 AND SO WITH THE MULTIMODAL 4608 03:39:48,931 --> 03:39:50,933 SENSING WE HAVE AND THE ABILITY 4609 03:39:50,933 --> 03:39:52,902 TO COMBINE THE INFORMATION WITH 4610 03:39:52,902 --> 03:39:57,273 OTHER TYPES OF MEASUREMENTS LIKE 4611 03:39:57,273 --> 03:40:01,644 BIO MOLECULAR MEASUREMENTS AND 4612 03:40:01,644 --> 03:40:02,945 MULTIOMICS AND MULTIHEALTH 4613 03:40:02,945 --> 03:40:05,548 RECORDS YOU CAN IMAGINE HOW YOU 4614 03:40:05,548 --> 03:40:08,884 BRING IT TOGETHER TO BRING THE 4615 03:40:08,884 --> 03:40:09,318 INDICATOR VARIABLES. 4616 03:40:09,318 --> 03:40:10,519 THE NEXT SLIDE SHOWS WHAT IT 4617 03:40:10,519 --> 03:40:20,362 LOOKS LIKE MATHEMATICALLY. 4618 03:40:20,362 --> 03:40:26,402 ESSENTIALLY WE ARE BUILDING 4619 03:40:26,402 --> 03:40:30,039 MODELS WITH CLINICAL 4620 03:40:30,039 --> 03:40:31,907 MEASUREMENTS AND ON THE LEFT 4621 03:40:31,907 --> 03:40:33,242 BUILDING A MATHEMATICAL FUNCTION 4622 03:40:33,242 --> 03:40:34,310 TO TAKE IN THE DATA. 4623 03:40:34,310 --> 03:40:40,282 IT COULD BE A LINEAR REGRESSION 4624 03:40:40,282 --> 03:40:50,826 OR AS COMPLEX AS BUILDING THAT 4625 03:40:53,262 --> 03:40:53,863 IS AT THE HEART OF THE BIOMARKER 4626 03:40:53,863 --> 03:41:04,073 DEVELOPMENT. 4627 03:41:06,408 --> 03:41:08,177 IF YOU GO TO THE FDA AND TRY TO 4628 03:41:08,177 --> 03:41:10,412 GET AN APPROVED BIOMARKER IT 4629 03:41:10,412 --> 03:41:15,618 WILL BE DIFFERENT LEVELS OF 4630 03:41:15,618 --> 03:41:19,889 EVIDENCE NEED ED TO JUSTIFY THI 4631 03:41:19,889 --> 03:41:20,589 IN REAL WORLD PRACTICE. 4632 03:41:20,589 --> 03:41:26,562 THERE'S TWO WAYS TO EXPLAIN WHAT 4633 03:41:26,562 --> 03:41:28,664 A DIGITAL BIOMARKER IS AND THEN 4634 03:41:28,664 --> 03:41:30,799 ON TO THE NEXT SLIDE I WANT TO 4635 03:41:30,799 --> 03:41:36,171 TALK ABOUT SOME OF THE 4636 03:41:36,171 --> 03:41:39,542 CHALLENGES THAT GO INTO INTO THE 4637 03:41:39,542 --> 03:41:40,509 DIGITAL BIOMARKERS. 4638 03:41:40,509 --> 03:41:41,810 THEY'RE NOT ENTIRELY DIFFERENT 4639 03:41:41,810 --> 03:41:44,480 FROM OTHER CHALLENGE WE HEARD 4640 03:41:44,480 --> 03:41:47,216 FROM OTHER PRESENTERS OVER THE 4641 03:41:47,216 --> 03:41:48,250 PAST TWO DAYS. 4642 03:41:48,250 --> 03:41:49,752 WHEN IT COMES TO VARIOUS 4643 03:41:49,752 --> 03:41:54,056 TECHNOLOGIES THAT GENERATE DATA. 4644 03:41:54,056 --> 03:41:55,891 WE WANT TO KNOW THE DATA WE'RE 4645 03:41:55,891 --> 03:41:59,929 GETTING IS VALID AND ACCURATE 4646 03:41:59,929 --> 03:42:01,330 AND OUR MEASUREMENT TOOLS ARE 4647 03:42:01,330 --> 03:42:02,298 DOING WHAT WE THINK THEY SHOULD 4648 03:42:02,298 --> 03:42:03,966 BE DOING AND WHEN WE HAVE THE 4649 03:42:03,966 --> 03:42:08,337 DATA AND BUILD THESE MODELS THAT 4650 03:42:08,337 --> 03:42:10,773 IT'S NOT OKAY TO PEOPLE WHO ARE 4651 03:42:10,773 --> 03:42:13,342 DOWN STREAM USERS THAT THE 4652 03:42:13,342 --> 03:42:14,610 MODELS ARE INTERPRETABLE. 4653 03:42:14,610 --> 03:42:17,713 THE DATA AND MODELS FOLLOW THESE 4654 03:42:17,713 --> 03:42:19,949 FAIR PRINCIPLES WHICH IS 4655 03:42:19,949 --> 03:42:22,151 FINDABLE, ACCESSIBLE AND 4656 03:42:22,151 --> 03:42:24,853 INTEROPERABLE AND REPRODUCIBLE. 4657 03:42:24,853 --> 03:42:29,425 SO A LOT OF THAT GETS TOWARD 4658 03:42:29,425 --> 03:42:31,560 THIS OPEN SOURCE SOFTWARE 4659 03:42:31,560 --> 03:42:34,029 COMMUNITY WE'VE BEEN BUILDING 4660 03:42:34,029 --> 03:42:36,665 THAT IS SPECIFICALLY CENTERED 4661 03:42:36,665 --> 03:42:38,934 AROUND DIGITAL BIOMARKER 4662 03:42:38,934 --> 03:42:39,234 DEVELOPMENT. 4663 03:42:39,234 --> 03:42:42,538 THEN THERE'S A WHOLE OTHER PIECE 4664 03:42:42,538 --> 03:42:44,073 THAT IS TOWARD THE TRANSLATION 4665 03:42:44,073 --> 03:42:46,342 OF THE WORK TO REAL PRACTICE. 4666 03:42:46,342 --> 03:42:47,676 THIS IS CHALLENGING AND I HAVE A 4667 03:42:47,676 --> 03:42:49,244 FEW SLIDES WHERE I WILL TALK 4668 03:42:49,244 --> 03:42:51,180 ABOUT SOME OF THE STICKY ISSUES 4669 03:42:51,180 --> 03:42:54,850 WHEN IT COMES TO REGULATORY 4670 03:42:54,850 --> 03:42:57,119 OVERSIGHT OF DIGITAL HEALTH 4671 03:42:57,119 --> 03:42:58,387 MEASUREMENT TOOLS PARTICULARLY 4672 03:42:58,387 --> 03:43:01,090 THOSE THAT MAY BE MORE OF 4673 03:43:01,090 --> 03:43:06,395 CONSUMER DEVICES RATHER THAN 4674 03:43:06,395 --> 03:43:13,836 DEVICES THAT ARE TYPICALLY USED 4675 03:43:13,836 --> 03:43:16,472 IN HEALTH CARE SETTING. 4676 03:43:16,472 --> 03:43:20,576 WE HAVE DATA COMING IN AND THE 4677 03:43:20,576 --> 03:43:22,578 TALK BY DR. MOFFITT WAS A GREAT 4678 03:43:22,578 --> 03:43:25,014 EXAMPLE OF TOOLS WE MAY NEED IT 4679 03:43:25,014 --> 03:43:28,717 RELY ON TO DO A LARGE SCALE AND 4680 03:43:28,717 --> 03:43:30,019 PARALLEL COMPUTE TO HANDLE LARGE 4681 03:43:30,019 --> 03:43:35,157 CONTINUOUS STREAMS OF DATA AND 4682 03:43:35,157 --> 03:43:42,164 THE LAST CHALLENGE IS THE 4683 03:43:42,164 --> 03:43:43,732 ETHICAL, LEGAL ISSUES AND 4684 03:43:43,732 --> 03:43:44,933 PRIVACY AND SECURITY AND 4685 03:43:44,933 --> 03:43:46,235 UNDERSTANDING THE RISK VERSUS 4686 03:43:46,235 --> 03:43:47,536 BENEFIT TRADE-OFF FOR 4687 03:43:47,536 --> 03:43:48,837 PARTICIPANTS IN THE STUDIES AND 4688 03:43:48,837 --> 03:43:50,272 ONE EXAMPLE OF THAT IS SOME OF 4689 03:43:50,272 --> 03:43:52,474 THE WORK WE'VE BEEN DOING AROUND 4690 03:43:52,474 --> 03:43:57,446 ABILITY TO REIDENTIFY 4691 03:43:57,446 --> 03:43:59,014 PARTICIPANTS FROM SIMPLE BIO 4692 03:43:59,014 --> 03:44:00,749 SIGNALS OR WEARABLES DATA. 4693 03:44:00,749 --> 03:44:01,984 ALL THESE ARE CHALLENGES THAT 4694 03:44:01,984 --> 03:44:03,886 ARE BEING TACKLED BY US AND 4695 03:44:03,886 --> 03:44:06,321 OTHER PEOPLE WORKING IN THE 4696 03:44:06,321 --> 03:44:11,326 DIGITAL BIOMARKER DISCOVERY 4697 03:44:11,326 --> 03:44:11,860 SPACE. 4698 03:44:11,860 --> 03:44:16,098 ON THE NEXT SLIDE I'LL TALK 4699 03:44:16,098 --> 03:44:18,167 ABOUT THE OPEN SOURCE SOFTWARE 4700 03:44:18,167 --> 03:44:19,802 COMMUNITY AND I'LL ENCOURAGE 4701 03:44:19,802 --> 03:44:20,769 ANYBODY WITH INTEREST IN THE 4702 03:44:20,769 --> 03:44:25,441 DIGITAL DATA TO CHECK OUT THE 4703 03:44:25,441 --> 03:44:27,176 RESOURCES HERE BECAUSE NOT ONLY 4704 03:44:27,176 --> 03:44:28,811 IS THIS AN OPPORTUNITY TO USE 4705 03:44:28,811 --> 03:44:31,113 AND SHARE DATA, CODE AND 4706 03:44:31,113 --> 03:44:32,781 ALGORITHMS BUT THERE'S TONS OF 4707 03:44:32,781 --> 03:44:34,183 EDUCATIONAL RESOURCE WE AND 4708 03:44:34,183 --> 03:44:35,851 OTHERS HAVE BEEN PUTTING 4709 03:44:35,851 --> 03:44:37,820 TOGETHER THAT GIVE AN 4710 03:44:37,820 --> 03:44:40,089 OVERARCHING VIEW OF DIGITAL 4711 03:44:40,089 --> 03:44:42,057 DATA, DIFFERENT TOOLS YOU CAN 4712 03:44:42,057 --> 03:44:43,692 USE TO COLLECT SUCH DIGITAL 4713 03:44:43,692 --> 03:44:46,995 DATA, WHAT ARE SOME OF THE 4714 03:44:46,995 --> 03:44:47,963 ACQUISITIONS AROUND DATA 4715 03:44:47,963 --> 03:44:51,433 PROCESSING AND UNDERSTANDING THE 4716 03:44:51,433 --> 03:44:52,668 TOOLS THEMSELVES. 4717 03:44:52,668 --> 03:44:55,604 SO THERE'S A LOT HERE AND WE ASK 4718 03:44:55,604 --> 03:44:56,972 PEOPLE TO CONSIDER PARTICIPATING 4719 03:44:56,972 --> 03:44:59,608 ON TWO SIDES. 4720 03:44:59,608 --> 03:45:02,444 ONE SIDE IS TO BE AN INGEST ER 4721 03:45:02,444 --> 03:45:03,512 OF THIS INFORMATION AND ON THE 4722 03:45:03,512 --> 03:45:04,847 OTHER SIDE IS TO BE A 4723 03:45:04,847 --> 03:45:05,247 CONTRIBUTOR. 4724 03:45:05,247 --> 03:45:08,183 THIS IS REALLY A COMMUNITY BUILT 4725 03:45:08,183 --> 03:45:09,384 BY US AND FOR US. 4726 03:45:09,384 --> 03:45:12,221 SO ANYBODY WHO WANTS TO WORK 4727 03:45:12,221 --> 03:45:15,424 WITH DIGITAL DATA EVEN CITIZEN 4728 03:45:15,424 --> 03:45:17,493 SCIENTISTS ARE WELCOME TO BECOME 4729 03:45:17,493 --> 03:45:19,061 A PART OF THIS. 4730 03:45:19,061 --> 03:45:23,532 THERE'S CONTACT INFORMATION ON 4731 03:45:23,532 --> 03:45:27,469 THAT WEBSITE. 4732 03:45:27,469 --> 03:45:32,608 CHECK OUT DBP DOT ORG AND I HAVE 4733 03:45:32,608 --> 03:45:34,176 MORE EXAMPLES HOW TO GET STARTED 4734 03:45:34,176 --> 03:45:35,511 HANDS ON. 4735 03:45:35,511 --> 03:45:40,082 WE SAW ONE TUTORIAL THAT WAS 4736 03:45:40,082 --> 03:45:45,420 DEMONSTRATING ONE OF THE SLEEP 4737 03:45:45,420 --> 03:45:47,122 ALGORITHMS THAT USES A SMART 4738 03:45:47,122 --> 03:45:50,526 WATCH AND YOU CAN USE THE QR 4739 03:45:50,526 --> 03:45:52,961 CODE AND SCAN IT WITH YOUR 4740 03:45:52,961 --> 03:45:56,532 CAMERA AND BE LED TIE HOST OF 4741 03:45:56,532 --> 03:45:58,901 OTHER CASE STUDIES THAT SHOW HOW 4742 03:45:58,901 --> 03:46:03,172 TO USE CONTINUOUS GLUCOSE 4743 03:46:03,172 --> 03:46:06,041 MONITO 4744 03:46:06,041 --> 03:46:07,442 MONITORING DATA AND MANY MODULES 4745 03:46:07,442 --> 03:46:09,511 AS WELL AS CODE BOOKS TO FOLLOW 4746 03:46:09,511 --> 03:46:11,446 LONG AND RUN SNIPPETS OF CODE TO 4747 03:46:11,446 --> 03:46:14,483 SEE HOW IT WORKS IN REAL TIME. 4748 03:46:14,483 --> 03:46:15,784 SO HOPEFULLY FOLKS HAVE A CHANCE 4749 03:46:15,784 --> 03:46:25,227 TO CHECK THAT OUT AS WELL. 4750 03:46:25,227 --> 03:46:26,862 GOING BACK TO CHALLENGES, I WANT 4751 03:46:26,862 --> 03:46:28,897 TO TALK ABOUT REGULATORY 4752 03:46:28,897 --> 03:46:29,264 CONSIDERATIONS. 4753 03:46:29,264 --> 03:46:30,032 THIS IS AN INTERESTING PROBLEM 4754 03:46:30,032 --> 03:46:33,335 WE'VE RUN INTO AS WE START TO 4755 03:46:33,335 --> 03:46:36,905 THINK ABOUT HOW WE EXPLAIN THE 4756 03:46:36,905 --> 03:46:38,373 LIABILITY OF THE DATA TO 4757 03:46:38,373 --> 03:46:39,007 DIFFERENT USERS. 4758 03:46:39,007 --> 03:46:41,476 SO A LOT OF THE QUESTIONS WE GET 4759 03:46:41,476 --> 03:46:45,180 COME FROM CLINICIANS OR FROM 4760 03:46:45,180 --> 03:46:47,182 PATIENTS EITHER USING THEIR 4761 03:46:47,182 --> 03:46:49,685 CONSUMER WEARABLE DEVICE IN 4762 03:46:49,685 --> 03:46:51,653 THEIR EVERYDAY LIFE OR BRINGING 4763 03:46:51,653 --> 03:46:52,487 INFORMATION FROM THOSE DEVICES 4764 03:46:52,487 --> 03:46:53,422 TO THEIR DOCTORS. 4765 03:46:53,422 --> 03:46:56,491 THE QUESTIONS WE GET ARE HOW 4766 03:46:56,491 --> 03:46:58,126 RELIABLE IS THE DATA AND IF I 4767 03:46:58,126 --> 03:46:59,661 SEE SOMETHING ABNORMAL WHAT IS 4768 03:46:59,661 --> 03:47:04,032 THE NEXT BEST THING TO DO. 4769 03:47:04,032 --> 03:47:10,272 THIS IS AN EXAMPLE THAT EXISTS 4770 03:47:10,272 --> 03:47:13,542 ON MULTIPLE DEVICES, APPLE 4771 03:47:13,542 --> 03:47:17,913 WATCH, FITBIT, CARMEN THERE'S 4772 03:47:17,913 --> 03:47:20,315 FUNCTIONALITIES OF THE DEVICE 4773 03:47:20,315 --> 03:47:22,384 REGULATED AND OTHER 4774 03:47:22,384 --> 03:47:27,422 FUNCTIONALITIES NOT FDA 4775 03:47:27,422 --> 03:47:28,357 REGULATED. 4776 03:47:28,357 --> 03:47:30,192 IT'S CONFUSING. 4777 03:47:30,192 --> 03:47:35,130 WHEN IT'S MARKETED TO CONSUMERS 4778 03:47:35,130 --> 03:47:38,033 THERE'S DIFFERENT LEVELS OF 4779 03:47:38,033 --> 03:47:39,501 CERTAINTY DEPENDING ON WHICH 4780 03:47:39,501 --> 03:47:42,905 FUNCTIONALITY YOU'RE LOOKING AT. 4781 03:47:42,905 --> 03:47:46,275 THE EXAMPLE IS THE IRREGULAR 4782 03:47:46,275 --> 03:47:48,343 HEART RHYTHM DETECTION ALGORITHM 4783 03:47:48,343 --> 03:47:50,679 FDA CLEARED ON SEVERAL DEVICES 4784 03:47:50,679 --> 03:47:55,550 AND THE SAME DEVICES HAVE SPO2 4785 03:47:55,550 --> 03:48:00,188 FUNCTIONALITY NOT CURRENTLY 4786 03:48:00,188 --> 03:48:01,723 REGULATED AND THE FINE PRINT 4787 03:48:01,723 --> 03:48:03,325 SAYS DON'T USE FOR MEDICAL 4788 03:48:03,325 --> 03:48:04,793 PURPOSES AND BUT THE 4789 03:48:04,793 --> 03:48:06,028 FUNCTIONALITY WAS RELEASED 4790 03:48:06,028 --> 03:48:06,795 DURING THE COVID-19 PANDEMIC. 4791 03:48:06,795 --> 03:48:09,464 WE HAVE TO WONDER, WHAT ARE 4792 03:48:09,464 --> 03:48:15,170 PEOPLE THEN USING THE SP 02 4793 03:48:15,170 --> 03:48:16,705 INFORMATION IF IT'S NOT TO 4794 03:48:16,705 --> 03:48:17,239 MONITOR HEALTH? 4795 03:48:17,239 --> 03:48:20,142 THE RECOMMEND IS TO USE THIS FOR 4796 03:48:20,142 --> 03:48:21,043 MOUNTAI 4797 03:48:21,043 --> 03:48:30,786 MOUNTAINEERING, FOR EXAMPLE. 4798 03:48:30,786 --> 03:48:31,253 AS IT IMPORTANT TO BE 4799 03:48:31,253 --> 03:48:41,463 CONSIDERING. 4800 03:48:45,267 --> 03:48:45,934 START TO UNDERSTAND HOW TO 4801 03:48:45,934 --> 03:48:48,003 BETTER REGULATE THE PRODUCTS AND 4802 03:48:48,003 --> 03:48:53,308 INFORM CONSUMERS, PATIENT AND 4803 03:48:53,308 --> 03:48:55,477 PROVIDERS ABOUT THE DIFFERENT 4804 03:48:55,477 --> 03:48:57,145 LEVELS OF EVIDENCE THAT SUPPORT 4805 03:48:57,145 --> 03:48:58,046 HOW TO USE THE DATA. 4806 03:48:58,046 --> 03:49:00,615 THE ANSWERS ARE NOT ALWAYS 4807 03:49:00,615 --> 03:49:01,316 CLEAR. 4808 03:49:01,316 --> 03:49:02,584 AGAIN, THIS SAY COMMUNITY EFFORT 4809 03:49:02,584 --> 03:49:04,653 TO START TO UNDERSTAND WHAT ARE 4810 03:49:04,653 --> 03:49:06,321 THE OPEN ISSUES AND HOW SHOULD 4811 03:49:06,321 --> 03:49:12,661 WE BE DRESSING THEM. 4812 03:49:12,661 --> 03:49:13,996 SO WITH ALL THAT BACKGROUND I 4813 03:49:13,996 --> 03:49:17,432 WANT TO GO TO ONE SPECIFIC 4814 03:49:17,432 --> 03:49:18,467 EXAMPLE OF DIGITAL BIOMEDICAL 4815 03:49:18,467 --> 03:49:22,170 PROJECT THAT WE'VE BEEN WORKING 4816 03:49:22,170 --> 03:49:25,407 ON AND THAT IS CENTERED AROUND 4817 03:49:25,407 --> 03:49:27,009 INFECTIOUS DISEASE DETECTION. 4818 03:49:27,009 --> 03:49:29,444 WE START THE WORK I'M GOING TO 4819 03:49:29,444 --> 03:49:32,781 TALK ABOUT ALL THE WAY BACK WHEN 4820 03:49:32,781 --> 03:49:35,851 I WAS DOING MY POST-DOCTORAL 4821 03:49:35,851 --> 03:49:40,956 WORK AT STANFORD MORE THAN FIVE 4822 03:49:40,956 --> 03:49:42,991 YEARS AGO AND THAT WORK HAS 4823 03:49:42,991 --> 03:49:43,258 CONTINUED. 4824 03:49:43,258 --> 03:49:45,527 WHAT WE'VE BEEN TRYING TO DO IS 4825 03:49:45,527 --> 03:49:47,796 UNDERSTAND HOW CHANGES IN 4826 03:49:47,796 --> 03:49:49,765 PHYSIOLOGY THAT OCCUR WHEN 4827 03:49:49,765 --> 03:49:52,968 SOMEBODY HAS AN INFECTION CAN BE 4828 03:49:52,968 --> 03:49:54,870 DETECTED THROUGH SIMPLE CONSUMER 4829 03:49:54,870 --> 03:49:55,337 SMART WATCHES. 4830 03:49:55,337 --> 03:49:57,572 SOME OF THE WORK WE DID PRIOR TO 4831 03:49:57,572 --> 03:50:00,208 THE COVID-19 PANDEMIC WAS IN 4832 03:50:00,208 --> 03:50:02,477 DETECTING VIRAL INFECTIONS IN 4833 03:50:02,477 --> 03:50:04,146 DETECTING INFLUENZA. 4834 03:50:04,146 --> 03:50:07,983 WE HEARD EARLIER FROM MIKE 4835 03:50:07,983 --> 03:50:12,721 SNYDER ABOUT THE LYME'S DISEASE 4836 03:50:12,721 --> 03:50:19,161 DETECTION AND DID WORK WITH H1N1 4837 03:50:19,161 --> 03:50:20,495 AND THEN COVID HIT. 4838 03:50:20,495 --> 03:50:24,800 ON THE NEXT SLIDE I WANT TO TALK 4839 03:50:24,800 --> 03:50:27,469 HOW WE GET BEGAN THINKING ABOUT 4840 03:50:27,469 --> 03:50:28,437 THE INFRASTRUCTURE FOR FUTURE 4841 03:50:28,437 --> 03:50:29,638 PANDEMICS AND WE WERE CLEARLY 4842 03:50:29,638 --> 03:50:31,506 NOT THE ONLY ONES THINKING ABOUT 4843 03:50:31,506 --> 03:50:31,807 THIS. 4844 03:50:31,807 --> 03:50:33,642 THERE WERE LOTS OF EFFORTS IN 4845 03:50:33,642 --> 03:50:39,614 HOW TO TAKE SOME OF OUR ANALOG 4846 03:50:39,614 --> 03:50:41,083 METHODS OF PANDEMIC PREVENTION 4847 03:50:41,083 --> 03:50:42,818 TOWARDS MORE DIGITAL EXAMPLES. 4848 03:50:42,818 --> 03:50:44,086 CASE INVESTIGATIONS IS A GREAT 4849 03:50:44,086 --> 03:50:47,856 ONE WHEN WE THINK OF CONTACT 4850 03:50:47,856 --> 03:50:48,090 TRACING. 4851 03:50:48,090 --> 03:50:50,459 THE VERY ANALOG METHOD WAS TO 4852 03:50:50,459 --> 03:50:52,527 CALL PEOPLE AND ASK THEM WHO 4853 03:50:52,527 --> 03:50:54,196 THEY HAD BEEN IN CONTACT WITH 4854 03:50:54,196 --> 03:50:57,632 AND PERFORM CONTACT TRACING IN 4855 03:50:57,632 --> 03:50:58,934 AN ANALOG WAY. 4856 03:50:58,934 --> 03:51:01,036 HOWEVER, WE KNOW SMARTPHONES 4857 03:51:01,036 --> 03:51:02,104 GIVE INFORMATION ABOUT 4858 03:51:02,104 --> 03:51:02,370 PROXIMITY. 4859 03:51:02,370 --> 03:51:04,206 THAT'S A WAY TO AUTOMATE AND 4860 03:51:04,206 --> 03:51:05,507 DIGITIZE THE INFORMATION SO IT 4861 03:51:05,507 --> 03:51:08,310 CAN BE PERFORMED ON A LARGER 4862 03:51:08,310 --> 03:51:08,510 SCALE. 4863 03:51:08,510 --> 03:51:11,179 WHAT WE HAD BEEN THINKING ABOUT 4864 03:51:11,179 --> 03:51:13,315 IS HOW WE COULD LEVERAGE 4865 03:51:13,315 --> 03:51:13,582 WEARABLES. 4866 03:51:13,582 --> 03:51:14,916 THAT'S OUR OF INTEREST. 4867 03:51:14,916 --> 03:51:18,386 YOU CAN SEE THERE'S SEVERAL 4868 03:51:18,386 --> 03:51:20,589 OTHER OPPORTUNITIES FOR 4869 03:51:20,589 --> 03:51:21,456 EPIDEMIOLOGIC SURVEILLANCE, 4870 03:51:21,456 --> 03:51:22,190 COMMUNICATING INFORMATION, 4871 03:51:22,190 --> 03:51:24,392 MONITORING THE EFFECTIVENESS OF 4872 03:51:24,392 --> 03:51:24,659 VACCINES. 4873 03:51:24,659 --> 03:51:26,128 THERE'S A LOT HERE THAT CAN BE 4874 03:51:26,128 --> 03:51:28,396 DONE FOR PANDEMIC PREVENTION. 4875 03:51:28,396 --> 03:51:35,170 ON THE NEXT SLIDE IF YOU CAN HIT 4876 03:51:35,170 --> 03:51:43,178 TWICE WE HAVE OPPORTUNITIES FOR 4877 03:51:43,178 --> 03:51:46,515 DETECTION AND MONITORING. 4878 03:51:46,515 --> 03:51:47,382 THERE ARE TWO AREAS OF FOCUS 4879 03:51:47,382 --> 03:51:49,584 WHEN WE WERE LOOKING AT 4880 03:51:49,584 --> 03:51:51,353 IDENTIFYING COVID, WE WERE 4881 03:51:51,353 --> 03:51:53,355 THINKING ABOUT WHERE THE USE OF 4882 03:51:53,355 --> 03:51:54,990 WEARABLES WOULD BE MOST 4883 03:51:54,990 --> 03:51:55,257 EFFECTIVE. 4884 03:51:55,257 --> 03:51:57,325 WE COULD PERFORM EARLY DETECTION 4885 03:51:57,325 --> 03:51:59,261 AT HOME MONITORING, PUBLIC 4886 03:51:59,261 --> 03:52:01,530 HEALTH MONITORING AND HOSPITAL 4887 03:52:01,530 --> 03:52:02,164 TRIAGE. 4888 03:52:02,164 --> 03:52:03,398 BUT WITH THE BACKGROUND 4889 03:52:03,398 --> 03:52:05,267 INFORMATION WE HAD EARLY 4890 03:52:05,267 --> 03:52:07,469 DETECTION IN PUBLIC HEALTH 4891 03:52:07,469 --> 03:52:14,509 MONITORING STOOD OUT AS TWO 4892 03:52:14,509 --> 03:52:15,677 POSSIBILITIES TO CHANGE THE 4893 03:52:15,677 --> 03:52:18,113 DIRECTION OF THE INFECTION 4894 03:52:18,113 --> 03:52:18,446 OUTBREAKS. 4895 03:52:18,446 --> 03:52:23,185 ON THE NEXT SLIDE I'LL TALK 4896 03:52:23,185 --> 03:52:32,194 ABOUT THE IDENTIFIED STUDY -- 4897 03:52:32,194 --> 03:52:42,737 THE COVID ENTIFY STUDY AND WHO 4898 03:52:43,438 --> 03:52:45,440 MAY NEED SPECIALIZED RESOURCES 4899 03:52:45,440 --> 03:52:48,210 AND GOING BACK TO THE CONCEPT OF 4900 03:52:48,210 --> 03:52:51,479 DIG IT WILL BIOMARKERS WE CAN 4901 03:52:51,479 --> 03:52:53,181 LOOK AT SUSCEPTIBILITY TO 4902 03:52:53,181 --> 03:52:54,416 INFECTION AND WHETHER SOMEONE 4903 03:52:54,416 --> 03:52:58,920 HAS A CURRENT INFECTION JUST BY 4904 03:52:58,920 --> 03:53:01,223 LOOKING AT DATA ON SMART WATCHES 4905 03:53:01,223 --> 03:53:03,758 AND LETTING SOMEBODY KNOW THEY 4906 03:53:03,758 --> 03:53:05,293 MAY BE SICK BEFORE THEY FEEL 4907 03:53:05,293 --> 03:53:06,027 SYMPTOMS. 4908 03:53:06,027 --> 03:53:08,897 HOW CONTAGIOUS A PERSON MAY BE 4909 03:53:08,897 --> 03:53:19,441 AND WHERE THE TRAJECTRY OF THE 4910 03:53:22,544 --> 03:53:26,081 ILLNESS AND IN MARCH 2020 WE 4911 03:53:26,081 --> 03:53:28,350 KNEW THIS WAS AN IMPORTANT 4912 03:53:28,350 --> 03:53:30,018 DIRECTION TO GO AND CREATE THE 4913 03:53:30,018 --> 03:53:31,486 ONLINE PLATFORM TO CONSENT FROM 4914 03:53:31,486 --> 03:53:35,090 ANYWHERE AROUND THE COUNTRY AND 4915 03:53:35,090 --> 03:53:36,558 EVEN GLOBALLY PAYING ATTENTION 4916 03:53:36,558 --> 03:53:41,029 TO PRIVACY RESTRICTIONS AND WE 4917 03:53:41,029 --> 03:53:46,935 WERE ABLE TO CONSENT 7,348 AND 4918 03:53:46,935 --> 03:53:49,738 OF THOSE YOU CAN SEE THE NUMBERS 4919 03:53:49,738 --> 03:53:51,006 DWINDLED DOWN WHEN WE LOOKED AT 4920 03:53:51,006 --> 03:53:56,344 THE COVID CASES. 4921 03:53:56,344 --> 03:53:58,179 WHO ACTUALLY HAD TESTING TO GET 4922 03:53:58,179 --> 03:53:59,281 USEFUL INFORMATION FROM THAT. 4923 03:53:59,281 --> 03:54:02,851 FOR THOSE WHO HAVE TESTING SO WE 4924 03:54:02,851 --> 03:54:04,452 HAVE 132 COVID POSITIVE CASES 4925 03:54:04,452 --> 03:54:08,356 HERE YOU CAN SEE LOOKING AT JUST 4926 03:54:08,356 --> 03:54:10,292 SMART WATCH DATA FROM COUNTS AND 4927 03:54:10,292 --> 03:54:12,594 RESTING HEART RATE THERE'S A 4928 03:54:12,594 --> 03:54:15,096 CLEAR CHANGE IN BEHAVIOR AND 4929 03:54:15,096 --> 03:54:16,798 PHYSIOLOGY PRIOR TO THE TESTING. 4930 03:54:16,798 --> 03:54:19,401 THIS PROVIDES A WINDOW OF 4931 03:54:19,401 --> 03:54:23,171 OPPORTUNITY TO DETECT SOMEBODY 4932 03:54:23,171 --> 03:54:26,074 MAY HAVE AN INFECTION BEFORE 4933 03:54:26,074 --> 03:54:28,943 THEY KNOW IT. 4934 03:54:28,943 --> 03:54:30,845 I'LL MENTION HOW WE GOT TO APPLY 4935 03:54:30,845 --> 03:54:37,619 THIS IN REAL WORLD SETTINGS. 4936 03:54:37,619 --> 03:54:38,687 MANY EXPERIENCED THE CHALLENGE 4937 03:54:38,687 --> 03:54:40,455 OF GOING TO THE PHARMACY FOR A 4938 03:54:40,455 --> 03:54:41,890 COVID TEST AND THERE WERE NO 4939 03:54:41,890 --> 03:54:44,826 TESTS ON THE SHELF AND THE 4940 03:54:44,826 --> 03:54:46,828 INABILITY TO BEST ALLOCATE 4941 03:54:46,828 --> 03:54:48,196 LIMITED RESOURCES DURING THIS 4942 03:54:48,196 --> 03:54:50,632 TIME WHEN THERE WERE SURGES IN 4943 03:54:50,632 --> 03:54:58,673 DEMAND FOR COVID TESTS. 4944 03:54:58,673 --> 03:55:00,041 ON THE NEXT SLIDE I'LL MENTION 4945 03:55:00,041 --> 03:55:00,575 HOW WE THOUGHT ABOUT THIS 4946 03:55:00,575 --> 03:55:05,547 PROBLEM. 4947 03:55:05,547 --> 03:55:07,182 IF WE HAVE A FIXED NUMBER OF 4948 03:55:07,182 --> 03:55:08,316 TESTS AND MORE PEOPLE THAN WE 4949 03:55:08,316 --> 03:55:10,552 HAVE TESTS HOW DO WE BEST 4950 03:55:10,552 --> 03:55:12,887 DETERMINE HOW TO ALLOCATE THOSE 4951 03:55:12,887 --> 03:55:13,088 TESTS? 4952 03:55:13,088 --> 03:55:16,124 THE IDEA IS TALKING ABOUT THE 4953 03:55:16,124 --> 03:55:18,993 BAYESIAN APPROACH WE'VE BEEN 4954 03:55:18,993 --> 03:55:19,794 TALKING ABOUT THROUGHOUT THE 4955 03:55:19,794 --> 03:55:22,497 WORKSHOP AND WE CAN LEVERAGE A 4956 03:55:22,497 --> 03:55:23,998 PRIORITY INFORMATION THAT COMES 4957 03:55:23,998 --> 03:55:26,334 NOT ONLY FROM PEOPLE'S SYMPTOMS 4958 03:55:26,334 --> 03:55:28,937 AND FEELINGS OF BEING ILL BUT 4959 03:55:28,937 --> 03:55:31,072 ALSO FROM THEIR SMART WATCH DATA 4960 03:55:31,072 --> 03:55:32,574 TO GIVE MORE INFORMATION ABOUT 4961 03:55:32,574 --> 03:55:33,842 THEIR LIKELIHOOD OF ACTUALLY 4962 03:55:33,842 --> 03:55:35,443 HAVING AN INSPECTION. 4963 03:55:35,443 --> 03:55:38,747 THROUGH AN INTELLIGENT TESTING 4964 03:55:38,747 --> 03:55:39,514 ALLOCATION ALGORITHM WE CAN 4965 03:55:39,514 --> 03:55:41,883 INCREASE THE LIKELIHOOD WE 4966 03:55:41,883 --> 03:55:42,817 DETECT POSITIVE CASES FROM A 4967 03:55:42,817 --> 03:55:45,387 FIXED NUMBER OF TESTS. 4968 03:55:45,387 --> 03:55:47,722 ON THE NEXT SLIDE I'M SHOWING 4969 03:55:47,722 --> 03:55:48,890 HOW WE ACTUALLY GO THROUGH THIS 4970 03:55:48,890 --> 03:55:52,427 AND YOU CAN CLICK ONE MORE TIME 4971 03:55:52,427 --> 03:55:55,163 TO SHOW WE HAVE DIFFERENCES IN 4972 03:55:55,163 --> 03:55:57,532 THE PHYSIOLOGY AND BEHAVIORS 4973 03:55:57,532 --> 03:55:59,768 BETWEEN PEOPLE WHO DO AND DON'T 4974 03:55:59,768 --> 03:56:00,235 HAVE COVID. 4975 03:56:00,235 --> 03:56:06,341 YOU CAN SEE ON THE LEFT-HAND 4976 03:56:06,341 --> 03:56:10,178 SIDE AND BUILDING AN ALGORITHM 4977 03:56:10,178 --> 03:56:11,246 DISTINGUISHING BETWEEN PEOPLE 4978 03:56:11,246 --> 03:56:13,214 WHO HAVE COVID AND NOT WE HAVE A 4979 03:56:13,214 --> 03:56:14,215 LOT OF PARAMETERS TO OPTIMIZE 4980 03:56:14,215 --> 03:56:16,384 AND THIS IS JUST LOOKING AT 4981 03:56:16,384 --> 03:56:17,652 RESTING HEART RATE AND STEPS 4982 03:56:17,652 --> 03:56:20,989 FROM A SMART WATCH AND YOU CAN 4983 03:56:20,989 --> 03:56:24,192 IMAGINE HOW THIS OPTIMIZATION OF 4984 03:56:24,192 --> 03:56:25,760 FEATURES SCALES. 4985 03:56:25,760 --> 03:56:27,729 SO THERE'S A LOT OF HYPER 4986 03:56:27,729 --> 03:56:30,999 PARAMETER TUNING WELL DESCRIBED 4987 03:56:30,999 --> 03:56:33,334 IN THE PAPER CITED AT THE 4988 03:56:33,334 --> 03:56:33,768 BOTTOM. 4989 03:56:33,768 --> 03:56:35,303 OND THE NEXT SLIDE A QUICK 4990 03:56:35,303 --> 03:56:40,708 SHOWING OF RESULTS WE CAN SEE 4991 03:56:40,708 --> 03:56:44,712 THAT THIS METHOD ALONE PERFORMS 4992 03:56:44,712 --> 03:56:45,980 WELL IN DISTINGUISHING WHO IS 4993 03:56:45,980 --> 03:56:48,783 LIKELY TO HAVE A COVID INFECTION 4994 03:56:48,783 --> 03:56:50,218 AND NOT AND BECOMES MOST 4995 03:56:50,218 --> 03:56:53,388 EFFECTIVE IN PANEL C AND F WHEN 4996 03:56:53,388 --> 03:56:54,522 WE HAVE A SMALLER NUMBER OF 4997 03:56:54,522 --> 03:56:55,790 TESTS THAN PEOPLE TO TEST. 4998 03:56:55,790 --> 03:56:57,559 THIS IS GOING TO BE VERY USEFUL 4999 03:56:57,559 --> 03:57:00,528 TO IMPLEMENT AT THE BEGINNING OF 5000 03:57:00,528 --> 03:57:02,130 LET'S SAY A NOVEL OUTBREAK OF A 5001 03:57:02,130 --> 03:57:06,701 NOVEL VIRUS. 5002 03:57:06,701 --> 03:57:08,937 I'LL MENTION A FEW KEY RESULTS 5003 03:57:08,937 --> 03:57:09,604 FROM THIS. 5004 03:57:09,604 --> 03:57:11,773 THE INTELLIGENT TESTING 5005 03:57:11,773 --> 03:57:17,111 ALLOCATION RESULTS IN A 6.5 FOLD 5006 03:57:17,111 --> 03:57:22,350 INCREASE IN THE POSITIVE 5007 03:57:22,350 --> 03:57:22,584 TESTING. 5008 03:57:22,584 --> 03:57:27,288 YOU HAVE THE RESTING HEART RATE 5009 03:57:27,288 --> 03:57:28,189 GIVING DIFFERENT INFORMATION AND 5010 03:57:28,189 --> 03:57:34,162 HELPS TO FURTHER REFINE THE 5011 03:57:34,162 --> 03:57:34,696 ALGORITHMS. 5012 03:57:34,696 --> 03:57:36,865 ON THE NEXT SLIDE I'LL MENTION 5013 03:57:36,865 --> 03:57:40,935 AN EXAMPLE OF WORK FROM SCRIPPS 5014 03:57:40,935 --> 03:57:42,871 THAT SHOWS THE POWER ON A LARGE 5015 03:57:42,871 --> 03:57:43,505 SCALE. 5016 03:57:43,505 --> 03:57:47,775 BEING ABLE TO PREDICT INFLUENZA 5017 03:57:47,775 --> 03:57:49,177 OUTBREAKS USING FITBIT DATA FROM 5018 03:57:49,177 --> 03:57:50,645 ACROSS THE COUNTRY BEFORE THE 5019 03:57:50,645 --> 03:57:51,212 OUTBREAKS OCCURRED. 5020 03:57:51,212 --> 03:57:54,516 THE CDC HAS A TWO-WEEK LAG FROM 5021 03:57:54,516 --> 03:57:56,117 PUBLIC HEALTH AGENCIES AND 5022 03:57:56,117 --> 03:57:57,218 STATES BUT FITBIT CAN BE USED IN 5023 03:57:57,218 --> 03:58:05,426 REAL TIME. 5024 03:58:05,426 --> 03:58:07,562 WE HAVE DIGITALLY COLLECTED DATA 5025 03:58:07,562 --> 03:58:11,733 TRANSFORMED TO INDICATORS OF 5026 03:58:11,733 --> 03:58:12,867 HEALTH OUTCOMES AND TO BE ABLE 5027 03:58:12,867 --> 03:58:17,672 TO BUILD THAT AS A COMMUNITY WE 5028 03:58:17,672 --> 03:58:20,575 HAVE OPEN SOURCE PLATFORM AND 5029 03:58:20,575 --> 03:58:23,011 THE GOAL IS TO USE THE 5030 03:58:23,011 --> 03:58:24,379 BIOMARKERS AS EARLY INDICATION 5031 03:58:24,379 --> 03:58:26,281 OF INFECTION. 5032 03:58:26,281 --> 03:58:27,882 THIS IS ALL THE THANK YOUs FOR 5033 03:58:27,882 --> 03:58:29,551 ALL THAT CONTRIBUTED TO THE WORK 5034 03:58:29,551 --> 03:58:31,085 AND I'M NOT SURE THERE'S TIME 5035 03:58:31,085 --> 03:58:32,754 FOR QUESTIONS SO I'LL HAND IT 5036 03:58:32,754 --> 03:58:35,189 BACK OVER TO JOE. 5037 03:58:35,189 --> 03:58:39,994 >> THANK YOU VERY MUCH. 5038 03:58:39,994 --> 03:58:43,164 >> THAT WAS A LOVELY TALK AND 5039 03:58:43,164 --> 03:58:47,368 WEARABLES ARE CLEARLY EVERYWHERE 5040 03:58:47,368 --> 03:58:49,070 AND INCREASING. 5041 03:58:49,070 --> 03:58:50,905 IS WE MAY HAVE TIME FOR ONE 5042 03:58:50,905 --> 03:58:51,172 QUESTION. 5043 03:58:51,172 --> 03:58:52,974 HOW DO YOU CAPTURE DATA FROM THE 5044 03:58:52,974 --> 03:58:53,241 WEARABLES. 5045 03:58:53,241 --> 03:58:58,580 ? 5046 03:58:58,580 --> 03:58:59,080 5047 03:58:59,080 --> 03:58:59,981 >> DIFFERENT DEVICES HAVE 5048 03:58:59,981 --> 03:59:01,649 DIFFERENT METHODS OF DATA 5049 03:59:01,649 --> 03:59:01,950 COLLECTION. 5050 03:59:01,950 --> 03:59:10,224 THAT'S ONE OF THE LARGEST 5051 03:59:10,224 --> 03:59:12,026 ASPECTS OF THE WORK WE DO AND 5052 03:59:12,026 --> 03:59:16,464 MANY TIMES IT'S USING AN API A 5053 03:59:16,464 --> 03:59:19,033 COMPANY HAS ACCESS TO AND BUILD 5054 03:59:19,033 --> 03:59:21,169 CONNECTIONS THROUGH THE 5055 03:59:21,169 --> 03:59:23,838 PROGRAMMING INTERFACES TO BE 5056 03:59:23,838 --> 03:59:26,674 ABLE TO TAP INTO THE 5057 03:59:26,674 --> 03:59:27,175 INFRASTRUCTURE. 5058 03:59:27,175 --> 03:59:30,912 FOR FITBIT, CARMEN, APPLE WATCH, 5059 03:59:30,912 --> 03:59:33,247 SAMSUNG, EACH HAS A DIFFERENT 5060 03:59:33,247 --> 03:59:34,215 API AND REQUIRE DIFFERENT 5061 03:59:34,215 --> 03:59:35,249 METHODS OF CONNECTION. 5062 03:59:35,249 --> 03:59:36,918 LOTS OF SOFTWARE DEVELOPMENT 5063 03:59:36,918 --> 03:59:37,318 BEHIND THE SCENES. 5064 03:59:37,318 --> 03:59:41,522 >> WONDERFUL. 5065 03:59:41,522 --> 03:59:42,824 WE'LL QUEUE UP THE NEXT SPEAKER 5066 03:59:42,824 --> 03:59:44,826 AND KNOW YOU'LL BE WITH US AT 5067 03:59:44,826 --> 03:59:45,960 THE END FOR THE Q&A. 5068 03:59:45,960 --> 03:59:47,762 IT'S BEEN FASCINATING. 5069 03:59:47,762 --> 03:59:48,429 I'VE LEARNED A LOT WHICH IS 5070 03:59:48,429 --> 03:59:50,765 GREAT. 5071 03:59:50,765 --> 03:59:56,738 I WANT TO INTRODUCE OUR NEXT 5072 03:59:56,738 --> 03:59:56,971 SPEAKER. 5073 03:59:56,971 --> 03:59:58,906 DR. TURAKHIA. 5074 03:59:58,906 --> 04:00:00,074 HE'S AN INTERNATIONALLY 5075 04:00:00,074 --> 04:00:02,443 RECOGNIZED CARDIAC 5076 04:00:02,443 --> 04:00:03,077 ELECTROPHYSIOLOGIST RESEARCHER 5077 04:00:03,077 --> 04:00:06,514 EXECUTIVE AND LEADER IN DIGITAL 5078 04:00:06,514 --> 04:00:08,650 AN HEART RHYTHM CARE AND THE 5079 04:00:08,650 --> 04:00:12,186 CHIEF MEDICAL OFFICER AND CHIEF 5080 04:00:12,186 --> 04:00:17,625 SCIENTIFIC OFFICER AT I RHYTHM 5081 04:00:17,625 --> 04:00:19,160 TECHNOLOGIES. 5082 04:00:19,160 --> 04:00:22,597 IT PRODUCES WHAT WE'VE USED FOR 5083 04:00:22,597 --> 04:00:23,364 RESEARCH GREAT GRADE DATA 5084 04:00:23,364 --> 04:00:24,198 COLLECTION AND THERE FOR 5085 04:00:24,198 --> 04:00:24,532 CLINICAL WORK. 5086 04:00:24,532 --> 04:00:29,637 ARE YOU WITH US? 5087 04:00:29,637 --> 04:00:31,005 >> I'M HERE. 5088 04:00:31,005 --> 04:00:31,439 CAN YOU SEE ME OKAY? 5089 04:00:31,439 --> 04:00:36,477 OKAY. 5090 04:00:36,477 --> 04:00:38,112 I BELIEVE IT'S 20 MINUTES? 5091 04:00:38,112 --> 04:00:44,452 I'LL TEE UP MY CLOCK. 5092 04:00:44,452 --> 04:00:53,127 >> PLUS A FEW FOR QUESTIONS. 5093 04:00:53,127 --> 04:00:53,761 >> I APPRECIATE THE CHANCE TO BE 5094 04:00:53,761 --> 04:00:56,397 HERE. 5095 04:00:56,397 --> 04:01:00,301 I THINK YOU'RE GOING TO ADVANCE 5096 04:01:00,301 --> 04:01:05,506 LET'S GO TO THE NEXT SLIDE. 5097 04:01:05,506 --> 04:01:08,142 HERE'S MY DISCLOSURES. 5098 04:01:08,142 --> 04:01:12,747 I'M EMPLOYED BY PUBLIC COMPANY 5099 04:01:12,747 --> 04:01:15,450 AND SPEAKING AS MY ROLE AS A 5100 04:01:15,450 --> 04:01:21,022 PROFESSOR AT STANFORD MEDICINE 5101 04:01:21,022 --> 04:01:22,623 AND HERE'S MY DISCLOSURES. 5102 04:01:22,623 --> 04:01:24,392 MY GOAL IS TO EDUCATE ON 5103 04:01:24,392 --> 04:01:25,259 EPIDEMIOLOGY ON SCALE AND IF YOU 5104 04:01:25,259 --> 04:01:27,528 LOOK AT THE DISEASE I CARE ABOUT 5105 04:01:27,528 --> 04:01:30,498 AND MANY ARE FAMILIAR WITH AFIB. 5106 04:01:30,498 --> 04:01:32,967 IT CAUSES STROKE. 5107 04:01:32,967 --> 04:01:35,470 FIRST YOU HAD LARGE COHORT 5108 04:01:35,470 --> 04:01:35,703 STUDIES. 5109 04:01:35,703 --> 04:01:39,941 YOU HAD THE FRAMINGHAM STROKE 5110 04:01:39,941 --> 04:01:47,148 AFIB WE DON'T USE AND THE 5111 04:01:47,148 --> 04:01:48,516 STROKES IS WHERE YOU STARTED AND 5112 04:01:48,516 --> 04:01:50,084 THERE WERE CLAIMS DATA AND WE 5113 04:01:50,084 --> 04:01:50,752 THOUGHT IT'S GREAT. 5114 04:01:50,752 --> 04:01:52,487 LET'S GO AT SCALE. 5115 04:01:52,487 --> 04:01:54,956 YOU ENDED UP WITH MODERATE TO 5116 04:01:54,956 --> 04:01:56,758 POORLY PERFORMING RISK SCORES 5117 04:01:56,758 --> 04:02:06,267 THAT WERE USED IN 1700 AND 5118 04:02:06,267 --> 04:02:08,402 THERE'S A PROPORTION THAT'S DOWN 5119 04:02:08,402 --> 04:02:09,771 WITH TIME CREATING NEW 5120 04:02:09,771 --> 04:02:11,839 CHALLENGES. 5121 04:02:11,839 --> 04:02:12,807 THAT'S WHERE WE WERE. 5122 04:02:12,807 --> 04:02:15,476 SO THE PROBLEM WITH ALL THE 5123 04:02:15,476 --> 04:02:19,080 STROKE SCORES LIKE WITH ANY 5124 04:02:19,080 --> 04:02:20,648 SCORES ON CLAIMS DATA THEY 5125 04:02:20,648 --> 04:02:21,149 DISCRIMINATE POORLY. 5126 04:02:21,149 --> 04:02:23,651 THE AFIB WAS DEFINED BY THE 5127 04:02:23,651 --> 04:02:25,052 TREATMENT BECAUSE IT WAS CLAIMS 5128 04:02:25,052 --> 04:02:29,257 DATA WITH A CLINICAL ENCOUNTER. 5129 04:02:29,257 --> 04:02:31,959 AND YOU DON'T GET THE SMALL 5130 04:02:31,959 --> 04:02:35,429 AMOUNTS OF AFIB AS IN MODERN 5131 04:02:35,429 --> 04:02:41,035 TECHNOLOGIES AND AMBULATORIES AN 5132 04:02:41,035 --> 04:02:43,171 WEARABLE AND CREATES CHALLENGE 5133 04:02:43,171 --> 04:02:53,514 IN GENERALIZABILITY. 5134 04:02:54,982 --> 04:02:59,153 AND THIS IS WHERE EVIDENCE IS 5135 04:02:59,153 --> 04:03:02,056 COMING FROM. 5136 04:03:02,056 --> 04:03:03,090 AND THERE'S DISTRIBUTION BUT WE 5137 04:03:03,090 --> 04:03:05,560 DON'T HAVE ENOUGH NUMBERS TO 5138 04:03:05,560 --> 04:03:08,029 HAVE CONFIDENCE INTERVALS AT 5139 04:03:08,029 --> 04:03:11,032 EACH SCORE AND END UP WITH A 5140 04:03:11,032 --> 04:03:14,569 FALSE SENSE OF PRECISION WHEN 5141 04:03:14,569 --> 04:03:16,571 USED IN CLINICAL PRACTICE. 5142 04:03:16,571 --> 04:03:18,506 AF BURDEN IS PROBABLY RELATED TO 5143 04:03:18,506 --> 04:03:19,106 STROKE. 5144 04:03:19,106 --> 04:03:20,374 THE REASON WE KNOW THIS FROM A 5145 04:03:20,374 --> 04:03:20,808 LOT OF DATA. 5146 04:03:20,808 --> 04:03:23,010 HERE'S ONE CLINICAL STUDY. 5147 04:03:23,010 --> 04:03:24,846 GO AHEAD AND ADVANCE. 5148 04:03:24,846 --> 04:03:30,051 WHAT IT SHOWED IS THAT THE 5149 04:03:30,051 --> 04:03:34,355 CLINICALLY DEFINED PERMANENT A 5150 04:03:34,355 --> 04:03:38,526 FIB HAD A GRADIENT OF STROKE AND 5151 04:03:38,526 --> 04:03:43,865 THE FIRST SIGNAL WE HAD. 5152 04:03:43,865 --> 04:03:45,766 AS YOU JUST HEARD FROM JESSILYN 5153 04:03:45,766 --> 04:03:50,137 THERE'S A TON OF DEVICES OUT 5154 04:03:50,137 --> 04:03:50,338 THERE. 5155 04:03:50,338 --> 04:03:53,374 I WANT TO BUILD A STORY WITH 5156 04:03:53,374 --> 04:03:56,310 PACE MAKERS AND IMPLANTABLE 5157 04:03:56,310 --> 04:03:58,746 DEVICES WE THINK ABOUT IN 5158 04:03:58,746 --> 04:03:59,013 WEARABLES. 5159 04:03:59,013 --> 04:04:00,348 THIS IS THE FIRST DATA RELATED 5160 04:04:00,348 --> 04:04:01,482 TO REMOTE MONITORING. 5161 04:04:01,482 --> 04:04:05,920 THE REMOTE MONITORING HAS BEEN 5162 04:04:05,920 --> 04:04:08,723 AROUND SINCE THE '90s WITH 5163 04:04:08,723 --> 04:04:12,793 IMPLANTABLE PACE MAKERS AND 5164 04:04:12,793 --> 04:04:15,162 DEFIBRILLATORS WITH REIMBU 5165 04:04:15,162 --> 04:04:16,130 REIMBURSEMENT AND YOU GET DATA 5166 04:04:16,130 --> 04:04:18,766 IN A PLACE THAT'S REVIEWED BY 5167 04:04:18,766 --> 04:04:22,136 CLINICIANS, IT'S REIMBURSED SO 5168 04:04:22,136 --> 04:04:24,839 THE WORK FLOW'S IN PLACE AND 5169 04:04:24,839 --> 04:04:25,706 PEOPLE LOOK AT IT. 5170 04:04:25,706 --> 04:04:27,141 WHAT DO YOU DO WITH THE DATA AND 5171 04:04:27,141 --> 04:04:30,111 CAN YOU TIE IT BACK TO E.H.R.? 5172 04:04:30,111 --> 04:04:36,784 SO WHAT WE DID STARTING EIGHT OR 5173 04:04:36,784 --> 04:04:42,189 SO YEARS AGO WAS STARTING LINK 5174 04:04:42,189 --> 04:04:44,892 AT THIS AND TOOK CLAIMS AND THE 5175 04:04:44,892 --> 04:04:47,395 DATA SETS ARE ROBUST. 5176 04:04:47,395 --> 04:04:52,133 IT'S NATIONAL HEALTH CARE SYSTEM 5177 04:04:52,133 --> 04:04:54,201 DATA BECAUSE THEY'RE ON A COMMON 5178 04:04:54,201 --> 04:04:55,903 DATA MODEL ACROSS THE SYSTEM 5179 04:04:55,903 --> 04:04:56,604 MORE OR LESS. 5180 04:04:56,604 --> 04:04:58,372 YOU CAN GO TO MEDICARE CLAIMS 5181 04:04:58,372 --> 04:05:08,816 AND DEATH FILES AND GO TO 5182 04:05:10,484 --> 04:05:12,186 MEDICARE DATA AND AMBULATORY 5183 04:05:12,186 --> 04:05:14,422 CARE AND THE NUMBERS ARE 5184 04:05:14,422 --> 04:05:14,655 SMALLER. 5185 04:05:14,655 --> 04:05:16,090 THEY'RE NOW YOU CAN ADD A ZERO 5186 04:05:16,090 --> 04:05:23,998 IN TERMS OF THE SAMPLE SIZE. 5187 04:05:23,998 --> 04:05:27,234 THIS PROVIDES A RICH OPPORTUNITY 5188 04:05:27,234 --> 04:05:29,370 FOR SIGNAL FOR BASELINE 5189 04:05:29,370 --> 04:05:32,740 PREDICTOR AND COULD BE USED IN 5190 04:05:32,740 --> 04:05:34,875 OUTCOME UP CERTAIN CASES. 5191 04:05:34,875 --> 04:05:44,151 THIS IS WHAT WE STARTED WITH. 5192 04:05:44,151 --> 04:05:45,586 YOUR ANSWERING DIFFERENT 5193 04:05:45,586 --> 04:05:46,854 QUESTIONS FROM THE SAME DATA 5194 04:05:46,854 --> 04:05:47,054 SETS. 5195 04:05:47,054 --> 04:05:51,625 THIS IS ONE OF THE FIRST STUDIES 5196 04:05:51,625 --> 04:05:54,795 WE DID WITH THE LINKED DATA FROM 5197 04:05:54,795 --> 04:05:56,931 IMPLANTABLE DEVICES TO THE V.A. 5198 04:05:56,931 --> 04:05:58,132 THE FIRST QUESTION IS WHAT'S THE 5199 04:05:58,132 --> 04:06:01,569 CARE VARIATION BEFORE WE GET TO 5200 04:06:01,569 --> 04:06:02,737 EPIDEMIOLOGY AND THEN GET INTO 5201 04:06:02,737 --> 04:06:03,704 INTERESTING QUESTIONS ON 5202 04:06:03,704 --> 04:06:09,777 OUTCOMES IN EPIDEMIOLOGY. 5203 04:06:09,777 --> 04:06:12,046 WHAT WE FOUND IS THERE WAS LARGE 5204 04:06:12,046 --> 04:06:13,247 VARIATION IN TREATMENT. 5205 04:06:13,247 --> 04:06:17,151 YOU'RE SUPPOSED TO GET 5206 04:06:17,151 --> 04:06:17,818 ANTICOAGULATED BRAIN FIB. 5207 04:06:17,818 --> 04:06:19,787 THE PROBLEM IS HOW MUCH TO 5208 04:06:19,787 --> 04:06:20,021 TRIGGER. 5209 04:06:20,021 --> 04:06:21,322 WE HAVE MORE RECENT CLARITY WITH 5210 04:06:21,322 --> 04:06:22,356 TRIALS PUBLISHED A MONTH OR SO 5211 04:06:22,356 --> 04:06:27,862 GOOD. 5212 04:06:27,862 --> 04:06:29,797 AGAIN, THERE'S NO LINE IN THE 5213 04:06:29,797 --> 04:06:31,499 SAND FOR WHAT TO DO AND IT 5214 04:06:31,499 --> 04:06:34,935 DIDN'T MATTER SIX MINUTES, TWO 5215 04:06:34,935 --> 04:06:35,302 HOURS, 24 HOURS. 5216 04:06:35,302 --> 04:06:37,104 THERE WAS VARIATION. 5217 04:06:37,104 --> 04:06:40,341 EACH BAR REPRESENTS A SITE AND 5218 04:06:40,341 --> 04:06:42,043 YOU CAN SEE THE SPREAD WAS FROM 5219 04:06:42,043 --> 04:06:47,181 SUB 5% TO 55%. 5220 04:06:47,181 --> 04:06:48,315 THERE'S A CARE GAP FOR SURE. 5221 04:06:48,315 --> 04:06:55,656 WHAT THIS ALLOWS YOU TO DO IS IT 5222 04:06:55,656 --> 04:06:59,060 DEMONSTRATE AN EQUIPOISE IN 5223 04:06:59,060 --> 04:07:01,729 TREATMENT AND LOOKING AT DATA TO 5224 04:07:01,729 --> 04:07:04,265 ANSWER OBSERVATIONAL QUESTIONS. 5225 04:07:04,265 --> 04:07:06,667 AND ONE THING USING SEVERAL 5226 04:07:06,667 --> 04:07:09,437 MODELS MULTIVARIABLE AND INVERSE 5227 04:07:09,437 --> 04:07:11,372 WEIGHTING WE FOUND THERE WAS A 5228 04:07:11,372 --> 04:07:18,012 CLEAR TREATMENT BENEFIT WHEN 5229 04:07:18,012 --> 04:07:21,482 ANTICOAGULATION WAS PERFORMED 5230 04:07:21,482 --> 04:07:29,990 WHAT IS MORE AM -- AMBIGUOUS 5231 04:07:29,990 --> 04:07:31,292 THE CONFIDENCE INTERVAL AND NOT 5232 04:07:31,292 --> 04:07:34,462 CLEAR WHAT TO DO AND AS YOU 5233 04:07:34,462 --> 04:07:38,365 STARTED SEEING VARYING DEGREES 5234 04:07:38,365 --> 04:07:39,467 AND THERE WERE CLEAR AND 5235 04:07:39,467 --> 04:07:42,236 CONSISTENT AT 24 HOURS SO AGAIN 5236 04:07:42,236 --> 04:07:43,704 MADE OUT MORE CONFIDENT IN 5237 04:07:43,704 --> 04:07:47,141 LONGER DURATION YOU WERE LIKELY 5238 04:07:47,141 --> 04:07:48,642 TO SEE A TREATMENT BENEFIT. 5239 04:07:48,642 --> 04:07:50,778 IN SHORTER DURATION WE'RE NOT 5240 04:07:50,778 --> 04:07:52,113 SURE AND NOT RANDOMIZED DATA BUT 5241 04:07:52,113 --> 04:07:59,120 WE DO THE BEST WE CAN. 5242 04:07:59,120 --> 04:08:01,155 THIS TRIAL WAS PUBLISHED WEEKS 5243 04:08:01,155 --> 04:08:03,557 AGO AND IN SOME WAYS VALIDATED 5244 04:08:03,557 --> 04:08:04,692 THE OBSERVATIONAL DATA NOT 5245 04:08:04,692 --> 04:08:06,026 ENTIRELY BUT IT FOUND WHEN YOU 5246 04:08:06,026 --> 04:08:08,329 START TREATING AT SIX MINUTES OR 5247 04:08:08,329 --> 04:08:11,165 MORE OF DEVICE DETECTED AFIB YOU 5248 04:08:11,165 --> 04:08:13,367 HAVE NO BENEFIT FOR THE OUTCOME 5249 04:08:13,367 --> 04:08:14,535 OF STROKE OR CARDIOVASCULAR 5250 04:08:14,535 --> 04:08:16,370 DEATH IN A COMPOSITE. 5251 04:08:16,370 --> 04:08:18,939 BUT THERE WAS A SAFETY SIGNAL OF 5252 04:08:18,939 --> 04:08:19,974 INCREASED BLEEDING. 5253 04:08:19,974 --> 04:08:21,675 YOU CAN'T USE AN OBSERVATIONAL 5254 04:08:21,675 --> 04:08:23,410 STUDY NO MATTER HOW GOOD TO BE 5255 04:08:23,410 --> 04:08:25,379 DEFINITIVE BUT THE SIGNAL WAS 5256 04:08:25,379 --> 04:08:27,414 POINTING IN A SIMILAR DIRECTION 5257 04:08:27,414 --> 04:08:30,651 AT A MINIMUM COULD HELP DEFINE 5258 04:08:30,651 --> 04:08:34,088 YOUR BAYESIAN PARAMETERS AND 5259 04:08:34,088 --> 04:08:38,492 ESTIMATED AFFECT SIDES. 5260 04:08:38,492 --> 04:08:39,093 LINKAGE IS IMPORTANT FOR MANY 5261 04:08:39,093 --> 04:08:45,966 REASONS. 5262 04:08:45,966 --> 04:08:49,970 KAISER LOOKS TO SEE IF THERE WAS 5263 04:08:49,970 --> 04:08:53,174 A GRADIENT OF STROKE RISK BASED 5264 04:08:53,174 --> 04:09:00,080 ON AFIB AND OVER ALL A RISK NOT 5265 04:09:00,080 --> 04:09:00,581 SURPRISE. 5266 04:09:00,581 --> 04:09:01,182 PATIEN 5267 04:09:01,182 --> 04:09:07,955 PATIENTS WERE NOT ANTICOAGULATED 5268 04:09:07,955 --> 04:09:10,891 AND THIS DID NOT SUGGEST THE 5269 04:09:10,891 --> 04:09:17,565 THRESHOLD EFFECT AND BY THE TIME 5270 04:09:17,565 --> 04:09:24,538 THEY WHITTLED IT DOWN SAW THE 5271 04:09:24,538 --> 04:09:25,272 PATIENTS. 5272 04:09:25,272 --> 04:09:27,174 AND WHAT THEY SAW IS EVEN WHEN 5273 04:09:27,174 --> 04:09:31,178 YOU STARTED ADJUSTING FOR STROKE 5274 04:09:31,178 --> 04:09:32,246 RISK SCORES THESE HAZARD RATIOS 5275 04:09:32,246 --> 04:09:33,447 DID NOT MOVE. 5276 04:09:33,447 --> 04:09:41,589 THE OVER ALL PROBLEM IS THAT 5277 04:09:41,589 --> 04:09:45,492 THOUGH TERTILES THEY WERE SMALL 5278 04:09:45,492 --> 04:09:46,927 BURDEN AND STARTING COMPARING 5279 04:09:46,927 --> 04:09:49,463 THE THIRD TERTILE VERSUS THE 5280 04:09:49,463 --> 04:09:51,065 COMBINED FIRST AND SECOND 5281 04:09:51,065 --> 04:09:55,102 SHOWING A GRADIENT OF RISK. 5282 04:09:55,102 --> 04:09:57,538 IF YOU LOOK AT STROKE ON THE 5283 04:09:57,538 --> 04:09:58,639 AMBULATORY MONITOR WHAT'S THE 5284 04:09:58,639 --> 04:10:00,374 TREATMENT BENEFIT NOT JUST THE 5285 04:10:00,374 --> 04:10:05,879 RISK OF STROKE BUT WHEN SHOULD 5286 04:10:05,879 --> 04:10:09,717 YOU ANTICOAGULATE AND WHEN IT 5287 04:10:09,717 --> 04:10:10,751 TRANSLATES TO THOSE WITHOUT 5288 04:10:10,751 --> 04:10:14,154 DEVICES YOU SEE CLEAR BENEFIT 5289 04:10:14,154 --> 04:10:17,658 WITH HAZARD RATIO TREATMENT FOR 5290 04:10:17,658 --> 04:10:20,995 .63 AND UNCLEAR BELOW PROBABLY 5291 04:10:20,995 --> 04:10:21,929 BECAUSE OF SMALLER NUMBERS AND 5292 04:10:21,929 --> 04:10:24,665 IF YOU LOOK AT STROKE INCIDENTS 5293 04:10:24,665 --> 04:10:26,133 UNADJUSTED ON THE LEFT GREATER 5294 04:10:26,133 --> 04:10:28,502 THAN 24 HOUR EPISODES AND LESS 5295 04:10:28,502 --> 04:10:30,738 THAN 24, YOU SEE WHAT HAPPENS 5296 04:10:30,738 --> 04:10:32,606 WITH TREATMENT THE GREATER THAN 5297 04:10:32,606 --> 04:10:33,841 24 STARTS NORMALIZING TO THE 5298 04:10:33,841 --> 04:10:34,675 LESS THAN 24. 5299 04:10:34,675 --> 04:10:36,844 AGAIN, THIS IS NOT RANDOMIZED 5300 04:10:36,844 --> 04:10:38,412 BUT IT GIVES A GOOD STARTING 5301 04:10:38,412 --> 04:10:42,816 POINT AND MAYBE GETS YOU TO 2A 5302 04:10:42,816 --> 04:10:47,187 OR 2B EVIDENCE UNTIL YOU HAVE A 5303 04:10:47,187 --> 04:10:47,921 TRIAL. 5304 04:10:47,921 --> 04:10:51,158 WE HAVE ALSO DONE TEMPORAL 5305 04:10:51,158 --> 04:10:57,598 ANALYSES TO HE SEE -- TO SEE 5306 04:10:57,598 --> 04:11:01,568 THE CAUSAL AND YOU SEE CAUSATION 5307 04:11:01,568 --> 04:11:04,171 BECAUSE THE RATIO WAS 5.4. 5308 04:11:04,171 --> 04:11:05,572 WHEN PATIENTS WERE USED AS THEIR 5309 04:11:05,572 --> 04:11:09,143 OWN CONTROL DURING THE AF 5310 04:11:09,143 --> 04:11:11,979 BRIEFLY PERIOD AND MORE NEAR 5311 04:11:11,979 --> 04:11:13,714 TERM TO THE PERIOD AND IT'S 5312 04:11:13,714 --> 04:11:15,582 WITHIN THE FIST SEVEN DAYS YOU 5313 04:11:15,582 --> 04:11:18,018 START SEEING A SIGNAL AND YOU 5314 04:11:18,018 --> 04:11:19,553 NEED SO MANY PATIENTS AND THE 5315 04:11:19,553 --> 04:11:24,825 CONFIDENCE INTERVALSZ -- 5316 04:11:24,825 --> 04:11:25,526 INTERVALS AND THERE'S DEBATE 5317 04:11:25,526 --> 04:11:27,127 WHETHER AFIB IS A MARKER OR 5318 04:11:27,127 --> 04:11:37,037 DIRECT CAUSE OF STROKE OR BOTH. 5319 04:11:37,037 --> 04:11:40,140 THERE'S A PATTERN OF AFIB AND 5320 04:11:40,140 --> 04:11:43,110 YOU'RE AFIB BURDEN OVER ONE 5321 04:11:43,110 --> 04:11:48,716 MONTH COULD BE 50% AND IF YOU'RE 5322 04:11:48,716 --> 04:11:51,652 A FIB DOES THE PATTERN OR 5323 04:11:51,652 --> 04:11:52,453 SIGNATURE MATTER? 5324 04:11:52,453 --> 04:11:54,588 THIS IS HYPOTHESIS GENERATING 5325 04:11:54,588 --> 04:11:55,589 WORK THAT IT MIGHT. 5326 04:11:55,589 --> 04:11:58,992 IT'S THE IDEA OF TAKING THE DAY 5327 04:11:58,992 --> 04:12:00,627 LEVEL AF BURDEN AND OTHER 5328 04:12:00,627 --> 04:12:02,396 PARAMETERS IN A MEDICAL DEVICE 5329 04:12:02,396 --> 04:12:06,200 LINKING BACK TO HEALTH SYSTEM 5330 04:12:06,200 --> 04:12:06,400 DATA. 5331 04:12:06,400 --> 04:12:08,936 IMPORTANT WORK. 5332 04:12:08,936 --> 04:12:10,003 WHAT ABOUT NATURAL EXPERIMENTS, 5333 04:12:10,003 --> 04:12:12,406 COULD YOU LEARN SOMETHING HERE? 5334 04:12:12,406 --> 04:12:14,108 SO SOME OF YOU MIGHT HAVE LIVED 5335 04:12:14,108 --> 04:12:17,544 THROUGH THIS IF YOU'RE ON THE 5336 04:12:17,544 --> 04:12:18,212 WEST COAST. 5337 04:12:18,212 --> 04:12:19,213 I DID. 5338 04:12:19,213 --> 04:12:21,315 THE LOWER LEFT IS OUR HOUSE IN 5339 04:12:21,315 --> 04:12:21,682 2020. 5340 04:12:21,682 --> 04:12:23,984 THE SKY IS TOTALLY ORANGE 5341 04:12:23,984 --> 04:12:26,286 BECAUSE OF THE FIRE IN NAPA AND 5342 04:12:26,286 --> 04:12:28,756 THE FIRES IN OREGON ON THE TOP 5343 04:12:28,756 --> 04:12:29,156 RIGHT. 5344 04:12:29,156 --> 04:12:32,459 THIS IS A GREAT OPPORTUNITY IN 5345 04:12:32,459 --> 04:12:35,362 AN IMPLANTABLE DEVICE COHORT TO 5346 04:12:35,362 --> 04:12:36,964 UNDERSTAND HOW AIR POLLUTION CAN 5347 04:12:36,964 --> 04:12:40,334 AFFECT ARRHYTHMIAS AND START 5348 04:12:40,334 --> 04:12:42,035 APPLYING AS AN EXPOSURE TO SEE 5349 04:12:42,035 --> 04:12:50,644 WHAT HAPPENS. 5350 04:12:50,644 --> 04:12:53,046 WE LINKED IT TO AIR POLLUTANT 5351 04:12:53,046 --> 04:12:56,283 DATA FROM ZIP CODES AND USED 5352 04:12:56,283 --> 04:12:59,186 TEMPORAL AND GEOGRAPHIC CONTROLS 5353 04:12:59,186 --> 04:13:00,821 COMPARED TO NON-FIRE STATES. 5354 04:13:00,821 --> 04:13:02,723 YOU CAN SEE THE JUST THE EPA 5355 04:13:02,723 --> 04:13:04,825 DATA SHOWING A SIGNAL WITH THE 5356 04:13:04,825 --> 04:13:06,627 RISE IN AIR POLLUTANT TO DENSITY 5357 04:13:06,627 --> 04:13:11,999 OVER A SPECIFIC PERIOD AND WHAT 5358 04:13:11,999 --> 04:13:17,070 YOU SEE THORACIC IMPEDANCE AND 5359 04:13:17,070 --> 04:13:19,440 SHOCK TO HEART RATES AND PRE AND 5360 04:13:19,440 --> 04:13:21,175 POST FIRE AND WHAT IT DOES IN 5361 04:13:21,175 --> 04:13:22,276 THE AGGREGATE POPULATION. 5362 04:13:22,276 --> 04:13:24,545 YOU SEE CHANGES IN FISCAL 5363 04:13:24,545 --> 04:13:26,280 ACTIVITY AND HEART RATE AND SEE 5364 04:13:26,280 --> 04:13:27,281 EVIDENCE OF HEART FAILURE. 5365 04:13:27,281 --> 04:13:28,348 THE QUESTION IS WHY. 5366 04:13:28,348 --> 04:13:30,484 WE WERE INTERESTED TO SEE IF THE 5367 04:13:30,484 --> 04:13:34,655 AIR POLLUTANT PREDICTORS 5368 04:13:34,655 --> 04:13:37,257 AFFECTED ARRHYTHMIAS OR 5369 04:13:37,257 --> 04:13:37,558 OUTCOMES. 5370 04:13:37,558 --> 04:13:43,297 AT SCALE YOU CAN A LOT. 5371 04:13:43,297 --> 04:13:46,166 WE HAD 29,000 INDIVIDUALS. 5372 04:13:46,166 --> 04:13:47,434 IN CASE CROSSOVER ANALYSIS WE 5373 04:13:47,434 --> 04:13:49,470 SAW A CHANGE IN HEART RATE. 5374 04:13:49,470 --> 04:13:50,971 YOU CAN ARGUE THAT'S CAUSAL BUT 5375 04:13:50,971 --> 04:13:53,373 COULD BE MEDIATED BY THE FACT 5376 04:13:53,373 --> 04:13:55,075 WHEN THERE'S A FIRE AND YOU 5377 04:13:55,075 --> 04:13:57,711 BECOME INACTIVE. 5378 04:13:57,711 --> 04:13:59,513 EVEN WITH CASE CROSSOVER 5379 04:13:59,513 --> 04:14:00,948 ANALYSIS THERE COULD BE A 5380 04:14:00,948 --> 04:14:02,416 MEDIATOR IN THE MIDDLE. 5381 04:14:02,416 --> 04:14:09,056 WE SAW ASSOCIATION WITH PHYSICAL 5382 04:14:09,056 --> 04:14:12,192 ACTIVITY AND DIDN'T SEE ANYTHING 5383 04:14:12,192 --> 04:14:14,862 SHOCKS TREATMENT FOR VENTRICULAR 5384 04:14:14,862 --> 04:14:17,831 ARRHYTHMIAS AND IT WAS HARD TO 5385 04:14:17,831 --> 04:14:19,333 FINAL SIGNAL. 5386 04:14:19,333 --> 04:14:21,502 AND WE'RE DOING MORE WORK WE 5387 04:14:21,502 --> 04:14:23,904 HAVE TO GET MORE GRANULAR AROUND 5388 04:14:23,904 --> 04:14:28,542 INDIVIDUAL ZIP CODES AND 5389 04:14:28,542 --> 04:14:30,811 EVACUATIONS AND NOT USE THE SAME 5390 04:14:30,811 --> 04:14:32,279 TRIGGER DATE. 5391 04:14:32,279 --> 04:14:34,448 WE HAVE TO GET MORE GRANULAR AND 5392 04:14:34,448 --> 04:14:35,849 SHOWS THE POTENTIAL AND ON THE 5393 04:14:35,849 --> 04:14:37,150 FIRST LOOK WE WERE ABLE TO DO 5394 04:14:37,150 --> 04:14:47,561 SOMETHING QUITE RAPIDLY. 5395 04:14:49,663 --> 04:14:56,403 THIS SYNDROME IS RARE AND CAN 5396 04:14:56,403 --> 04:14:57,938 CAUSE SUDDEN DEATH AND IF YOU 5397 04:14:57,938 --> 04:15:00,007 GET THE COVID VACCINE WILL THAT 5398 04:15:00,007 --> 04:15:02,042 TRIGGER THIS? 5399 04:15:02,042 --> 04:15:04,044 MANY OF US FELT UNWELL AFTER A 5400 04:15:04,044 --> 04:15:05,212 COVID VACCINE. 5401 04:15:05,212 --> 04:15:10,417 YOU CAN VIEW THE SAFETY 5402 04:15:10,417 --> 04:15:12,486 ASSESSMENTS WITH LINKED DATA. 5403 04:15:12,486 --> 04:15:16,056 A STETHOSCOPE COMPANY USEDED A 5404 04:15:16,056 --> 04:15:17,090 CONNECTED THERMOMETER DEPLOYED 5405 04:15:17,090 --> 04:15:20,561 ACROSS SCHOOLS AND LOOKING AT 5406 04:15:20,561 --> 04:15:21,361 EPICENTERS FOR COVID AND WHEN 5407 04:15:21,361 --> 04:15:25,332 THE CAUSE OF FEVER IS HIGH AS 5408 04:15:25,332 --> 04:15:28,569 IT'S A PANDEMIC MORE COMPLICATED 5409 04:15:28,569 --> 04:15:30,304 NOW FOR SPECIFIC ILLNESS BUT 5410 04:15:30,304 --> 04:15:33,307 TALKS ABOUT THE POTENTIAL. 5411 04:15:33,307 --> 04:15:34,541 WHAT ABOUT PARALLEL HEALTH 5412 04:15:34,541 --> 04:15:35,175 SYSTEM COHORTS DOING THINGS 5413 04:15:35,175 --> 04:15:45,352 TOGETHER. 5414 04:15:45,552 --> 04:15:48,589 THIS IS A PROJECT WITH BETWEEN 5415 04:15:48,589 --> 04:15:54,294 ICSF STANFORD IN PART WITH THE 5416 04:15:54,294 --> 04:16:04,771 FDA AND THIS IS A SCALABLE 5417 04:16:06,506 --> 04:16:07,975 METHOD OF POSTMARKET 5418 04:16:07,975 --> 04:16:14,848 SURVEILLANCE. 5419 04:16:14,848 --> 04:16:24,858 AND WE USED A SET OF THIS WAS 5420 04:16:24,858 --> 04:16:28,629 MAINLY FROM THIS AND THE 5421 04:16:28,629 --> 04:16:29,529 LABELLING SCHEMA ARE HERE AND 5422 04:16:29,529 --> 04:16:31,531 THIS BASICALLY WE WERE TRYING TO 5423 04:16:31,531 --> 04:16:38,138 EXTRACT THIS OUT. 5424 04:16:38,138 --> 04:16:41,575 WE FOUND 34,000 PATIENTS WITH A 5425 04:16:41,575 --> 04:16:42,609 TARGET WEARABLE DEVICE AT 5426 04:16:42,609 --> 04:16:50,317 STANFORD. 5427 04:16:50,317 --> 04:16:52,419 AND NOW WHAT WE'RE DOING IS 5428 04:16:52,419 --> 04:16:55,455 TRYING TO LOOK AT DIAGNOSIS AND 5429 04:16:55,455 --> 04:16:57,190 CLINICAL OUTCOME AND WILL BE 5430 04:16:57,190 --> 04:16:58,358 PUBLISHING SOON. 5431 04:16:58,358 --> 04:17:02,029 HERE'S THE SITUATION WHERE WE 5432 04:17:02,029 --> 04:17:03,964 DIDN'T HAVE DIRECT LINKAGE AND 5433 04:17:03,964 --> 04:17:06,199 SHOW WHAT HAPPENED IN THE 5434 04:17:06,199 --> 04:17:06,800 PATIENT GENERATED DATA TO 5435 04:17:06,800 --> 04:17:17,277 TRIGGER MEDICAL USE. 5436 04:17:17,277 --> 04:17:18,078 SO THERE'S A LOT OF DATA OUT 5437 04:17:18,078 --> 04:17:21,448 THERE AND THINGS YOU CAN CONNECT 5438 04:17:21,448 --> 04:17:25,819 AND A LOT OF DATA AGGREGATED. 5439 04:17:25,819 --> 04:17:27,554 THE QUESTION CAN YOU COMBINE 5440 04:17:27,554 --> 04:17:29,456 MULTIPLE DATA SOURCES NOT JUST 5441 04:17:29,456 --> 04:17:31,658 ONE DEVICE WITH E.H.R. BUT WHAT 5442 04:17:31,658 --> 04:17:38,265 ABOUT MULTIPLE DEVICES AND YOU 5443 04:17:38,265 --> 04:17:41,134 TAKE THE IDENTIFIERS AND PUT IT 5444 04:17:41,134 --> 04:17:42,302 THROUGH A HASH FUNCTION AND HAVE 5445 04:17:42,302 --> 04:17:45,839 A TOKEN FOR THE IDENTIFIER. 5446 04:17:45,839 --> 04:17:47,874 WHAT YOU CAN DO THEN IS IF YOU 5447 04:17:47,874 --> 04:17:51,511 HAVE A SLEEP APNEA AND 5448 04:17:51,511 --> 04:17:54,681 AMBULATORY MONITOR OR SOME OTHER 5449 04:17:54,681 --> 04:17:59,186 TEST YOU CAN CONNECT IT ALL IN A 5450 04:17:59,186 --> 04:17:59,953 DEIDENTIFIED WAY. 5451 04:17:59,953 --> 04:18:02,956 THIS IS STRAIGHTFORWARD BUT NOW 5452 04:18:02,956 --> 04:18:03,757 ON THE ENTERPRISE SIDE THERE'S 5453 04:18:03,757 --> 04:18:10,163 WAYS TO DO THIS. 5454 04:18:10,163 --> 04:18:10,964 THERE'S A LOT OF APPLICATIONS 5455 04:18:10,964 --> 04:18:12,933 FOR EXPOSURES AND OUTCOMES. 5456 04:18:12,933 --> 04:18:18,872 IT'S BECOME IMPORTANT FOR A.I. 5457 04:18:18,872 --> 04:18:19,172 DEVELOPMENT. 5458 04:18:19,172 --> 04:18:29,349 YOU CAN UNDERSTAND THIS SUMMARY 5459 04:18:29,349 --> 04:18:39,459 AND CLAIMS DATA IS IS USEFUL AND 5460 04:18:39,459 --> 04:18:41,094 WE LOOK AT EPIDEMIOLOGY AND THE 5461 04:18:41,094 --> 04:18:43,163 AND A HALF EXPERIMENT IS ONE 5462 04:18:43,163 --> 04:18:43,396 EXAMPLE. 5463 04:18:43,396 --> 04:18:45,766 WE DON'T ALWAYS NEED THE DEVICE 5464 04:18:45,766 --> 04:18:47,667 DATA TO QUOTE, LINK, AS I'VE 5465 04:18:47,667 --> 04:18:49,603 SHOWN YOU AND ONE TO MANY 5466 04:18:49,603 --> 04:18:51,004 LINKAGES AND BEYOND SINGLE 5467 04:18:51,004 --> 04:18:52,105 HEALTH SYSTEM ARE REALLY 5468 04:18:52,105 --> 04:18:52,639 PROMISING FOR FUTURE WORK. 5469 04:18:52,639 --> 04:19:02,816 THANK YOU. 5470 04:19:07,554 --> 04:19:08,955 >> THANK YOU VERY MUCH. 5471 04:19:08,955 --> 04:19:13,560 I WAS IMPRESSED WITH YOUR FIRE 5472 04:19:13,560 --> 04:19:14,661 NATURAL AIR POLLUTION 5473 04:19:14,661 --> 04:19:14,961 EXPERIMENT. 5474 04:19:14,961 --> 04:19:17,297 THE BODY IS RESILIENT WHICH 5475 04:19:17,297 --> 04:19:21,601 TELLS US SOMETHING ABOUT 5476 04:19:21,601 --> 04:19:24,871 MONITORING TRANSIENT CHANGES IF 5477 04:19:24,871 --> 04:19:26,039 HORRIBLE AIR DIDN'T KILL PEOPLE 5478 04:19:26,039 --> 04:19:29,342 WITH HEART DISEASE OR LEAD TO A 5479 04:19:29,342 --> 04:19:30,977 DETECTABLE SYMBOL IT'S NOT EASY. 5480 04:19:30,977 --> 04:19:36,650 I WAS GOING TO ASK AT LEAST ONE 5481 04:19:36,650 --> 04:19:39,419 QUESTION SO YOU'RE DOING 5482 04:19:39,419 --> 04:19:41,121 CLINICAL GRADE MONITORING AND 5483 04:19:41,121 --> 04:19:43,056 THE PAPER SHOWS IF YOU HAVE 24 5484 04:19:43,056 --> 04:19:48,829 HOURS OF A FIB YOU GET BETTER. 5485 04:19:48,829 --> 04:19:55,168 IF YOU HAVE LESS, HARD TO PROVE. 5486 04:19:55,168 --> 04:19:58,738 WHAT'S THAT MEAN ABOUT THE TYPES 5487 04:19:58,738 --> 04:20:00,507 OF DEVICES WE'RE SEEING IN A 5488 04:20:00,507 --> 04:20:02,509 HEALTHY POPULATION AND TO BE 5489 04:20:02,509 --> 04:20:06,680 PROVOCATIVE WHERE ARE WE BETWEEN 5490 04:20:06,680 --> 04:20:09,015 ENTERTAINMENT AND WELLNESS AND 5491 04:20:09,015 --> 04:20:11,651 MEDICINE ON THIS STUFF? 5492 04:20:11,651 --> 04:20:12,586 >> GREAT QUESTION. 5493 04:20:12,586 --> 04:20:16,523 THE STRATEGY OF SIX-MINUTE 5494 04:20:16,523 --> 04:20:18,325 TRIGGERED COAGULATION DID NOT 5495 04:20:18,325 --> 04:20:22,762 LEAD TO PRIMARY OUTCOME. 5496 04:20:22,762 --> 04:20:24,064 THE OBSERVATIONAL DATA SUGGESTS 5497 04:20:24,064 --> 04:20:27,234 THAT 24-HOUR EPISODE BENEFITS 5498 04:20:27,234 --> 04:20:30,003 WHICH MAKES CLINICAL SENSE BASED 5499 04:20:30,003 --> 04:20:31,004 ON HOW A LOT OF THE SCORES 5500 04:20:31,004 --> 04:20:36,409 PROVIDE DATA. 5501 04:20:36,409 --> 04:20:41,982 REMEMBER AND WHAT WE HAVE OTHER 5502 04:20:41,982 --> 04:20:43,383 CLINICAL EVIDENCE TO SUGGEST 5503 04:20:43,383 --> 04:20:47,153 EARLIER INTERVENTION OF HEART 5504 04:20:47,153 --> 04:20:51,124 FAILURE COULD BE IMPORTANT. 5505 04:20:51,124 --> 04:20:53,927 AND EARLY IDENTIFICATION OF AFIB 5506 04:20:53,927 --> 04:20:56,463 COULD GO TO PBCs TO IDENTIFYING 5507 04:20:56,463 --> 04:20:57,230 LATENT RISK FACTORS FOR HEART 5508 04:20:57,230 --> 04:21:01,101 DISEASE. 5509 04:21:01,101 --> 04:21:03,336 AN MAYBE YOU GET THERE BY WAY OF 5510 04:21:03,336 --> 04:21:04,938 DETECTED ARRHYTHMIAS. 5511 04:21:04,938 --> 04:21:09,075 WHAT I THINK WE ALL HAVE TO 5512 04:21:09,075 --> 04:21:11,411 DECIDE AS A GROUP IS IS IS IT 5513 04:21:11,411 --> 04:21:13,647 SCREENING OR TECHNOLOGY 5514 04:21:13,647 --> 04:21:20,921 ENABLEMENT OF A FIFTH OR SIXTH 5515 04:21:20,921 --> 04:21:24,991 VITAL SIGN AND PULSE OX AND WE 5516 04:21:24,991 --> 04:21:29,429 DON'T DO ACTIVITY TRENDS AND 5517 04:21:29,429 --> 04:21:30,931 SCREENING AND IT SHOWS YOU WHEN 5518 04:21:30,931 --> 04:21:34,167 THE VO2 IS DECLINING 5519 04:21:34,167 --> 04:21:34,501 PRECIPITOUSLY. 5520 04:21:34,501 --> 04:21:37,470 YOU'RE IN THE GRAY ZONE OF AN 5521 04:21:37,470 --> 04:21:38,939 ECHO SYSTEM BETWEEN WELLNESS AND 5522 04:21:38,939 --> 04:21:39,773 HEALTH. 5523 04:21:39,773 --> 04:21:42,075 WHAT WE DON'T HAVE IS HARD DATA 5524 04:21:42,075 --> 04:21:47,047 TO SUGGEST IT SHOULD BE A 5525 04:21:47,047 --> 04:21:49,482 MEDICALLY PRESCRIBED STRATEGY. 5526 04:21:49,482 --> 04:21:52,118 THERE'S GOOD OBSERVATIONAL DATA 5527 04:21:52,118 --> 04:21:54,454 AND THE HEART LINE STUDY THAT 5528 04:21:54,454 --> 04:21:57,023 TIES APPLE WATCH NOTIFICATIONS 5529 04:21:57,023 --> 04:21:59,960 TO ENGAGEMENT AND STRUCTURED 5530 04:21:59,960 --> 04:22:01,995 CARE HAS COMPLETED ENROLLMENT 5531 04:22:01,995 --> 04:22:12,706 AND GETS REPORTED OUT NEXT YEAR. 5532 04:22:12,706 --> 04:22:15,475 >> WONDERFUL, WE'RE TIGHT ON 5533 04:22:15,475 --> 04:22:17,610 TIME AND WE'LL TAKE QUESTIONS 5534 04:22:17,610 --> 04:22:19,279 AFTER THE SESSION AND IT IS FAS 5535 04:22:19,279 --> 04:22:21,314 FATE AND NICE TO SEE REAL 5536 04:22:21,314 --> 04:22:22,282 CLINICAL TRIALS TO TRY AND SEE 5537 04:22:22,282 --> 04:22:24,718 THE BENEFIT OF WHERE WE THINK 5538 04:22:24,718 --> 04:22:26,152 THERE MAY BE BENEFIT AND IT'S 5539 04:22:26,152 --> 04:22:31,157 IMPRESSIVE SOME DEVICES FINDING 5540 04:22:31,157 --> 04:22:33,560 AT AN OLDER AGE THE MAJORITY OF 5541 04:22:33,560 --> 04:22:36,663 PEOPLE HAVE SOMETHING ALL SORTS 5542 04:22:36,663 --> 04:22:37,497 OF INTERESTING SOMETHING. 5543 04:22:37,497 --> 04:22:39,699 THERE'S A RANGE OF THINGS WE CAN 5544 04:22:39,699 --> 04:22:42,202 DO FOR PEOPLE WHICH WILL BE 5545 04:22:42,202 --> 04:22:44,871 INTERESTING. 5546 04:22:44,871 --> 04:22:47,507 >> THE THING WE HAVEN'T 5547 04:22:47,507 --> 04:22:55,749 ADDRESSED IS THE NON-SUSTAINED 5548 04:22:55,749 --> 04:22:57,717 B.U.T. FOR THE PANEL. 5549 04:22:57,717 --> 04:23:03,590 >> I'D LIKE TO RE-INTRODUCE RUI 5550 04:23:03,590 --> 04:23:06,659 ZHANG IN THE DIVISION OF 5551 04:23:06,659 --> 04:23:08,228 COMPUTATIONAL HEALTH SCIENCE AND 5552 04:23:08,228 --> 04:23:08,962 ASSOCIATE PROFESSOR IN THE 5553 04:23:08,962 --> 04:23:10,397 DEPARTMENT OF SURGERY AT THE 5554 04:23:10,397 --> 04:23:12,132 UNIVERSITY OF MINNESOTA. 5555 04:23:12,132 --> 04:23:16,202 A DIRECTOR OF NATURAL LANGUAGE 5556 04:23:16,202 --> 04:23:17,303 PROCESSING RESEARCH PROGRAM AND 5557 04:23:17,303 --> 04:23:19,172 SCIENTIFIC CO-DIRECTOR OF 5558 04:23:19,172 --> 04:23:20,940 INNOVATIVE METHODS AND SCIENCE 5559 04:23:20,940 --> 04:23:22,075 PROGRAM AT THE CENTER FOR 5560 04:23:22,075 --> 04:23:24,978 LEARNING HEALTH SYSTEM SCIENCE. 5561 04:23:24,978 --> 04:23:28,248 HE'S DONE A WIDE RANGE OF 5562 04:23:28,248 --> 04:23:29,916 RESEARCH INCLUDING ON NATURAL 5563 04:23:29,916 --> 04:23:32,619 LANGUAGE PROCESSING, TEXT 5564 04:23:32,619 --> 04:23:35,822 MINING, LITERATURE-BASED 5565 04:23:35,822 --> 04:23:37,457 DISCOVERY AND COMPLEMENTARY 5566 04:23:37,457 --> 04:23:40,160 INTEGRATED MEDICINE AND 5567 04:23:40,160 --> 04:23:42,929 INFORMATICS AND HAS BEEN WIDELY 5568 04:23:42,929 --> 04:23:43,696 COVERED IN THE PRESS. 5569 04:23:43,696 --> 04:23:44,631 THANK YOU VERY MUCH. 5570 04:23:44,631 --> 04:23:48,635 THIS IS FASCINATING THE NATURAL 5571 04:23:48,635 --> 04:23:50,070 LANGUAGE PROCESS. 5572 04:23:50,070 --> 04:23:54,207 >> THANK YOU, DR. CORESH FOR A 5573 04:23:54,207 --> 04:23:57,410 NICE INTRODUCTION. 5574 04:23:57,410 --> 04:23:59,779 THIS IS A PICTURE I ALWAYS LIKE 5575 04:23:59,779 --> 04:24:02,115 TO GIVE PEOPLE A HIGH OVERVIEW 5576 04:24:02,115 --> 04:24:07,020 ABOUT THE DIMENSIONALITY AND THE 5577 04:24:07,020 --> 04:24:08,488 COMPASS OF BIOMEDICAL BIG DATA 5578 04:24:08,488 --> 04:24:11,124 AND THE DIFFERENT ROLES PRESENT 5579 04:24:11,124 --> 04:24:13,226 DIFFERENT MODALITIES AS WELL AS 5580 04:24:13,226 --> 04:24:15,361 INCREASING THE COLUMNS THAT ARE 5581 04:24:15,361 --> 04:24:21,067 STRUCTURED ON THE LEFT PANEL AS 5582 04:24:21,067 --> 04:24:29,909 WE KNOW THE TRUCK STRUCTURE AND 5583 04:24:29,909 --> 04:24:35,148 THERE'S 80% OF PATIENT 5584 04:24:35,148 --> 04:24:35,615 INFORMATION. 5585 04:24:35,615 --> 04:24:38,017 YOU SEE THOSE ARE CHARTS OR 5586 04:24:38,017 --> 04:24:38,952 REPORTS OR EVEN SOME SOCIAL 5587 04:24:38,952 --> 04:24:42,088 MEDIA THAT WE DEFINITELY NEED 5588 04:24:42,088 --> 04:24:44,858 SOME WAY AND TOOL TO HELP US TO 5589 04:24:44,858 --> 04:24:47,160 BETTER UNDERSTAND AND REPRESENT 5590 04:24:47,160 --> 04:24:57,337 PATIENTS. 5591 04:25:00,540 --> 04:25:02,041 THERE'S ALL RIGHT RESEARCH IN 5592 04:25:02,041 --> 04:25:03,343 SOCIAL MEDIA AND THROUGH AN 5593 04:25:03,343 --> 04:25:07,080 ALGORITHM THE INFORMATION CAN 5594 04:25:07,080 --> 04:25:12,852 CONVERT TO A MORE STRUCTURAL WAY 5595 04:25:12,852 --> 04:25:21,661 AND GET SURVEILLANCE AND FROM 5596 04:25:21,661 --> 04:25:26,332 LITERATURE WE CAN BRING THEM 5597 04:25:26,332 --> 04:25:27,500 TOGETHER AS A DOWN TREATMENT 5598 04:25:27,500 --> 04:25:32,672 TEST FROM THE SOCIAL MEDIA 5599 04:25:32,672 --> 04:25:34,307 PATIENTS SHARE THEIR FIRST 5600 04:25:34,307 --> 04:25:39,312 EXPERIENCE ABOUT MEDICATION USE 5601 04:25:39,312 --> 04:25:44,517 WHICH IS BETTER TO UNDERSTAND. 5602 04:25:44,517 --> 04:25:45,785 IT CAN FORM THE HEALTH CARE 5603 04:25:45,785 --> 04:25:48,888 PROVIDER TO MAKE A BETTER 5604 04:25:48,888 --> 04:25:51,791 DECISION OR CREATE A NEW LINE OF 5605 04:25:51,791 --> 04:25:52,258 HYPOTHESIS TO FURTHER 5606 04:25:52,258 --> 04:26:02,468 INVESTIGATE. 5607 04:26:22,255 --> 04:26:32,498 1SZ WE SEE THE MODEL IN USE AND 5608 04:26:32,498 --> 04:26:35,068 LATER TRANSFORMER MODELS BECOME 5609 04:26:35,068 --> 04:26:41,541 POPULAR UNTIL THE EARLY 2019 TO 5610 04:26:41,541 --> 04:26:45,678 T2 AND T5 AND RECENTLY IN 2022 5611 04:26:45,678 --> 04:26:50,516 THERE'S A LARGE NUMBER OF MODELS 5612 04:26:50,516 --> 04:26:54,053 WITH CHAT GPT AND DIFFERENT 5613 04:26:54,053 --> 04:26:57,290 VERSIONS OF GPT 2.5 AND OTHER 5614 04:26:57,290 --> 04:27:02,895 COMPANIES LIKE GOOGLE BART AND 5615 04:27:02,895 --> 04:27:05,064 LLAMA FROM META-AND LATER THIS 5616 04:27:05,064 --> 04:27:14,340 YEAR GPT 4 COMES OUT AND IN MAY 5617 04:27:14,340 --> 04:27:14,941 ANOTHER WILL BE PUBLISHED AS 5618 04:27:14,941 --> 04:27:18,845 WELL. 5619 04:27:18,845 --> 04:27:19,646 OUR TOP THREE AREAS THE FIRST 5620 04:27:19,646 --> 04:27:24,717 PART I WANT TO TALK ABOUT IS IT 5621 04:27:24,717 --> 04:27:27,186 CAN HELP DEVELOP COMPUTATIONAL 5622 04:27:27,186 --> 04:27:32,558 PHENOTYPES IN THE CHART. 5623 04:27:32,558 --> 04:27:37,597 SO NLP HAS EXTRACTION AND 5624 04:27:37,597 --> 04:27:43,069 EXTRACT THE BIOMEDICAL CONCEPTS 5625 04:27:43,069 --> 04:27:44,270 FROM THE E.H.R. NOTES AND 5626 04:27:44,270 --> 04:27:46,072 THERE'S DIFFERENT TYPES OF 5627 04:27:46,072 --> 04:27:51,177 MODELS IN NLP. 5628 04:27:51,177 --> 04:27:55,448 IT'S SET UP DIFFERENT RULES AND 5629 04:27:55,448 --> 04:27:56,516 LARGER GROUPS AND HYBRID IS 5630 04:27:56,516 --> 04:28:00,620 BETWEEN THE RULE-BASED AND 5631 04:28:00,620 --> 04:28:02,822 MACHINE LEARNING MODEL. 5632 04:28:02,822 --> 04:28:05,892 AND MACHINE LEARNING CAN BE 5633 04:28:05,892 --> 04:28:08,661 TRADITIONAL MACHINE LEARNING AND 5634 04:28:08,661 --> 04:28:12,065 DEEP LEARNING AND THE IDEA IS TO 5635 04:28:12,065 --> 04:28:15,768 GIVE AN EVERY VIEW ABOUT THE 5636 04:28:15,768 --> 04:28:19,005 QUANTITY OF THE MODELS BECAUSE 5637 04:28:19,005 --> 04:28:22,475 THE MODELS AND YOU SEE RULE 5638 04:28:22,475 --> 04:28:24,377 BASED IN THE BEGINNING BUT WHEN 5639 04:28:24,377 --> 04:28:26,913 THE TIME CHANGE AND THERE'S MORE 5640 04:28:26,913 --> 04:28:29,782 AND MORE MACHINE AND DEEP 5641 04:28:29,782 --> 04:28:30,516 LEARNING. 5642 04:28:30,516 --> 04:28:32,151 AND THE DIFFERENT AREAS LIKE 5643 04:28:32,151 --> 04:28:37,890 DISEASE OR WORK FLOW AND THEY 5644 04:28:37,890 --> 04:28:43,229 COVER A LOT OF THOSE AREAS IN 5645 04:28:43,229 --> 04:28:53,639 DIFFERENT SPECIFIC WAYS. 5646 04:29:04,450 --> 04:29:07,854 THERE'S A BROAD BIOMEDICAL 5647 04:29:07,854 --> 04:29:10,289 DOMAIN AND THERE'S A TREND IN 5648 04:29:10,289 --> 04:29:14,360 PUB MED WHICH FOCUSSED ON ICU 5649 04:29:14,360 --> 04:29:16,763 THERE'S NO SPECIFIC FOCUSSED 5650 04:29:16,763 --> 04:29:19,966 MODEL THAT CAN'T EXTRACT CANCER 5651 04:29:19,966 --> 04:29:21,167 PHENOTYPES. 5652 04:29:21,167 --> 04:29:22,769 AND WE DEVELOPED A CANCER 5653 04:29:22,769 --> 04:29:26,572 SPECIFIC MEDICAL MODEL THAT CAN 5654 04:29:26,572 --> 04:29:28,107 AUTOMATICALLY EXTRACT EIGHT 5655 04:29:28,107 --> 04:29:32,578 PHENOTYPES AS SHOWN IN THE RIGHT 5656 04:29:32,578 --> 04:29:43,089 PANEL AND SEE THE ANNOTATION. 5657 04:30:07,046 --> 04:30:09,749 IT CONTINUES TO TRAIN IN THE 5658 04:30:09,749 --> 04:30:10,583 UNIVERSITY OF MINNESOTA BREAST 5659 04:30:10,583 --> 04:30:16,656 CANCER COHORTS IN THEIR 5660 04:30:16,656 --> 04:30:19,025 PATHOLOGY REPORTS TOTALLY 5661 04:30:19,025 --> 04:30:20,793 INVOLVED 1 BILLION TOKENS PER 5662 04:30:20,793 --> 04:30:24,230 TRAINING AND FORMING A 5663 04:30:24,230 --> 04:30:27,200 COLLABORATIVE CANCER PHENOTYPING 5664 04:30:27,200 --> 04:30:34,440 MANUALLY AN -- ANNOTATED DATA 5665 04:30:34,440 --> 04:30:37,310 SET AND REVIEWED BY YALE REVIEW. 5666 04:30:37,310 --> 04:30:38,277 THE RED ARE THE DIFFERENT KINDS 5667 04:30:38,277 --> 04:30:41,180 OF MODEL. 5668 04:30:41,180 --> 04:30:44,717 IN ADDITION WE FOUND THE 5669 04:30:44,717 --> 04:30:47,353 ORIGINAL MODEL SINCE SOME 5670 04:30:47,353 --> 04:30:49,822 SPECIFIC DOMAIN TERMS FOR 5671 04:30:49,822 --> 04:30:54,227 EXAMPLE HER 2 IS DISPLAYED IN 5672 04:30:54,227 --> 04:30:55,461 DIFFERENT TOKENS. 5673 04:30:55,461 --> 04:30:59,432 WHILE WE ADD ADDITIONAL SPECIFIC 5674 04:30:59,432 --> 04:31:01,267 TERMS IN THE DICTIONARY MAKE IT 5675 04:31:01,267 --> 04:31:02,969 BETTER RID OF THE ENTITIES. 5676 04:31:02,969 --> 04:31:07,874 WE COMPARE ALL THE THREE MODELS 5677 04:31:07,874 --> 04:31:09,842 TO SOME OTHER MODELS AT THAT 5678 04:31:09,842 --> 04:31:11,978 TIME WE FOUND MAJORITY OF THE 5679 04:31:11,978 --> 04:31:13,446 MODEL ACHIEVED A BETTER 5680 04:31:13,446 --> 04:31:15,581 PERFORMANCE COMPARED TO OTHERS 5681 04:31:15,581 --> 04:31:18,217 AND THIS IS ACROSS THE DIFFERENT 5682 04:31:18,217 --> 04:31:26,325 EIGHT PHENOTYPES. 5683 04:31:26,325 --> 04:31:30,730 IB ANOTHER CASE WE DEVELOPED A 5684 04:31:30,730 --> 04:31:33,833 DEEP LEARNING MODEL FOR DIETARY 5685 04:31:33,833 --> 04:31:34,133 SUPPLEMENTS. 5686 04:31:34,133 --> 04:31:38,004 THE GOAL IS TO IDENTIFY THOSE 5687 04:31:38,004 --> 04:31:39,405 ADVERSE EVENT VERSUS INDICATION 5688 04:31:39,405 --> 04:31:42,742 USING DIETARY SUPPLEMENTS. 5689 04:31:42,742 --> 04:31:45,511 AND DIETARY SUPPLEMENTS IS LESS 5690 04:31:45,511 --> 04:31:47,013 DOCUMENTED IN A LOT OF ADVERSE 5691 04:31:47,013 --> 04:31:49,749 EVENT REPORTING SYSTEMS AND IT'S 5692 04:31:49,749 --> 04:31:54,954 SOMETIMES TREATED AS FOOD. 5693 04:31:54,954 --> 04:31:56,756 IT'S NOT MEANT FOR ADVERSE EVENT 5694 04:31:56,756 --> 04:31:58,224 IN REPORTING. 5695 04:31:58,224 --> 04:32:02,361 WE FOUND E.H.R. IS A GOOD 5696 04:32:02,361 --> 04:32:03,963 RESOURCE TO DOCUMENT BY THE 5697 04:32:03,963 --> 04:32:06,799 PHYSICIAN MENTION SOME ADVERSE 5698 04:32:06,799 --> 04:32:09,235 EVENT THAT'S NOT REALLY SEVERE 5699 04:32:09,235 --> 04:32:12,371 BUT MODERATE OR MILD. 5700 04:32:12,371 --> 04:32:14,740 WE DEVELOPED A DIFFERENT MODEL 5701 04:32:14,740 --> 04:32:17,810 TO EXTRACT DIETARY SUPPLEMENTS 5702 04:32:17,810 --> 04:32:18,678 MENTIONED AND SOME SYMPTOMS 5703 04:32:18,678 --> 04:32:19,111 MENTIONED AND THEIR 5704 04:32:19,111 --> 04:32:23,316 RELATIONSHIP. 5705 04:32:23,316 --> 04:32:28,621 THIS IS NER AND R.E. DEVELOPED 5706 04:32:28,621 --> 04:32:29,188 HERE. 5707 04:32:29,188 --> 04:32:34,994 AFTER WE THAT WE APPLY THE 5708 04:32:34,994 --> 04:32:40,967 METHOD TO THE DIETARY 5709 04:32:40,967 --> 04:32:44,036 SUPPLEMENTS AND COMPARE ALL THE 5710 04:32:44,036 --> 04:32:46,372 RESULTS WITH EXISTING KNOWLEDGE 5711 04:32:46,372 --> 04:32:48,507 BASIS AND FOUND SEVERAL ARE NOT 5712 04:32:48,507 --> 04:32:50,076 REALLY KNOWN IN ANY OF THOSE 5713 04:32:50,076 --> 04:32:54,814 KNOWLEDGE BASES. 5714 04:32:54,814 --> 04:33:01,020 AND WE FOUND ABOUT 30% WERE 5715 04:33:01,020 --> 04:33:10,663 UNKNOWN AND AMONG NEGATIVE AND 5716 04:33:10,663 --> 04:33:12,031 THE RECORDS CAN PROVIDE 5717 04:33:12,031 --> 04:33:12,632 ADDITIONAL INFORMATION ABOUT 5718 04:33:12,632 --> 04:33:13,165 SAFETY USING THE DIETARY 5719 04:33:13,165 --> 04:33:23,376 SUPPLEMENTS. 5720 04:33:26,545 --> 04:33:31,851 WE CAN LOOK AT HEALTH 5721 04:33:31,851 --> 04:33:36,656 DISPARITIES AND FOUND STUDIES 5722 04:33:36,656 --> 04:33:39,191 FOR DISEASES AND THEY EFFECT THE 5723 04:33:39,191 --> 04:33:44,897 FUNCTION AND QUALITY OF LIFE AND 5724 04:33:44,897 --> 04:33:45,164 OUTCOMES. 5725 04:33:45,164 --> 04:33:49,135 AND IMPACT VARIOUS OUTCOMES AND 5726 04:33:49,135 --> 04:33:54,240 FOR THE RIGHT FIGURE YOU CAN SEE 5727 04:33:54,240 --> 04:33:57,143 THOSE DIFFERENT NLP METHODS CAN 5728 04:33:57,143 --> 04:33:59,745 BE USED TO EXTRACT DIFFERENT 5729 04:33:59,745 --> 04:34:03,382 TYPES OF SDH CATEGORY FROM 5730 04:34:03,382 --> 04:34:08,320 DIFFERENT TYPES. 5731 04:34:08,320 --> 04:34:11,357 WE ALSO DEVELOPED SOME LIFESTYLE 5732 04:34:11,357 --> 04:34:18,230 INCLUDING DIET AND PHYSICAL 5733 04:34:18,230 --> 04:34:21,701 ACTIVITY IN CLINICAL NOTES. 5734 04:34:21,701 --> 04:34:24,236 WE USE THE RULE-BASED ENGINE TO 5735 04:34:24,236 --> 04:34:28,541 CREATE A LABEL WITH SOME NOISE 5736 04:34:28,541 --> 04:34:31,944 THAT CAN HELP CREATE A LARGE 5737 04:34:31,944 --> 04:34:37,483 NUMBER OF PRELABELLED DATA WE 5738 04:34:37,483 --> 04:34:38,084 COULD TRAIN AND DEEP LEARNING 5739 04:34:38,084 --> 04:34:39,085 MODEL AND FINE TUNING A SMALL 5740 04:34:39,085 --> 04:34:41,387 ANNOTATED GOLD STANDARD AND THIS 5741 04:34:41,387 --> 04:34:44,824 CAN HELP US TO REALLY GET HIGH 5742 04:34:44,824 --> 04:34:46,058 PERFORMANCE COMPARED TO OUR 5743 04:34:46,058 --> 04:34:48,094 MACHINE LEARNING MODEL. 5744 04:34:48,094 --> 04:34:50,596 SO THIS IS A PERFORMANCE 5745 04:34:50,596 --> 04:34:51,764 EVALUATION ACROSS DIFFERENT 5746 04:34:51,764 --> 04:35:02,241 PHYSICAL ACTIVITY AND DIET. 5747 04:35:03,476 --> 04:35:05,845 THERE'S A SPECIAL ISSUE JUST 5748 04:35:05,845 --> 04:35:07,947 PUBLISHED I THINK A MONTH AGO IN 5749 04:35:07,947 --> 04:35:11,016 JAMA OF A VARIETY OF THE WORK 5750 04:35:11,016 --> 04:35:15,654 DONE TO EXTRACT DIFFERENT KINDS 5751 04:35:15,654 --> 04:35:19,859 OF SOCIAL DETERMINATES OF HEALTH 5752 04:35:19,859 --> 04:35:24,263 INCLUDING SUBSTANCE USE AND 5753 04:35:24,263 --> 04:35:27,967 LIFESTYLE AND ECONOMIC FACTORS, 5754 04:35:27,967 --> 04:35:30,569 RELATIONSHIP AND EVICTION STATUS 5755 04:35:30,569 --> 04:35:33,272 AND EMPLOYED AND LIVING 5756 04:35:33,272 --> 04:35:38,611 SITUATION AND THEN MANY STUDIES 5757 04:35:38,611 --> 04:35:44,517 USED N2C2 OPEN SOURCE CHALLENGE 5758 04:35:44,517 --> 04:35:46,619 DATA AND SOME USED NOW OPEN DATA 5759 04:35:46,619 --> 04:35:47,953 SOURCE TO DEVELOP THEIR OWN 5760 04:35:47,953 --> 04:35:48,187 MODELS. 5761 04:35:48,187 --> 04:35:51,690 I ENCOURAGE READERS TO READ 5762 04:35:51,690 --> 04:36:01,934 THOSE AND GET MORE INFORMATION. 5763 04:36:01,934 --> 04:36:03,636 WE FOUND THERE'S ONE ENGINE 5764 04:36:03,636 --> 04:36:09,909 MODEL USED AT THE UNIVERSITY OF 5765 04:36:09,909 --> 04:36:10,442 FLORIDA. 5766 04:36:10,442 --> 04:36:14,380 THEY PUBLISHED THREE TYPES OF 5767 04:36:14,380 --> 04:36:17,449 DATA FROM BASE MODEL AND MEDIUM 5768 04:36:17,449 --> 04:36:20,386 AND LARGE AND THEY HAVE 5769 04:36:20,386 --> 04:36:22,354 DEMONSTRATED THAT THE MODEL 5770 04:36:22,354 --> 04:36:23,789 OUTPERFORMED THE OTHER IN 5771 04:36:23,789 --> 04:36:30,229 DIFFERENT NLP TASKS AND THEY 5772 04:36:30,229 --> 04:36:33,499 ALSO PUBLISHED USING THE NYU 5773 04:36:33,499 --> 04:36:35,301 E.H.R. DATA TO FINE TUNE A LARGE 5774 04:36:35,301 --> 04:36:45,811 MODEL AND SUCCESSFUL IN FIVE 5775 04:36:47,580 --> 04:36:48,848 RISK PREDICTION MODEL I 5776 04:36:48,848 --> 04:36:54,553 ENCOURAGE YOU TO READ AS WELL. 5777 04:36:54,553 --> 04:36:57,289 AND THEY EVALUATE THE LARGE 5778 04:36:57,289 --> 04:37:03,495 MODEL VERSUS THE FINE TUNED 5779 04:37:03,495 --> 04:37:05,965 MODEL IN FIVE DIFFERENT AND THEY 5780 04:37:05,965 --> 04:37:09,501 USED BOTH ZERO SHOT AND ONE SHOT 5781 04:37:09,501 --> 04:37:12,972 FOR 3.5 AND 4 GPT AND VERSUS THE 5782 04:37:12,972 --> 04:37:17,977 OTHER AND THEY FOND THE FINE 5783 04:37:17,977 --> 04:37:21,046 TUNED THEY FIND IT CONTINUES TO 5784 04:37:21,046 --> 04:37:23,349 BE A PROMINENT CHOICE ACROSS 5785 04:37:23,349 --> 04:37:24,817 THOSE AND THERE'S INCONSISTENCY 5786 04:37:24,817 --> 04:37:26,785 AND ERRORS GENERATED BY THE 5787 04:37:26,785 --> 04:37:30,222 LARGE MODEL THAT STILL NEED TO 5788 04:37:30,222 --> 04:37:31,390 BE FURTHER INVESTIGATED BEFORE 5789 04:37:31,390 --> 04:37:33,425 IT CAN BE USED FOR CLINICAL AND 5790 04:37:33,425 --> 04:37:38,664 BIOMEDICAL APPLICATIONS. 5791 04:37:38,664 --> 04:37:40,399 IN THE SECOND SECTION I WANT TO 5792 04:37:40,399 --> 04:37:43,869 TALK ABOUT HOW NLP AND HOW WE 5793 04:37:43,869 --> 04:37:46,839 CAN LEVERAGE EXISTING CONSORTIUM 5794 04:37:46,839 --> 04:37:50,876 TO DO MODIFIED STUDIES AND 5795 04:37:50,876 --> 04:37:51,911 INVOLVE SEVERAL EVALUATIONS AND 5796 04:37:51,911 --> 04:37:55,014 LOOK AT THE CANCER BURDEN ACROSS 5797 04:37:55,014 --> 04:37:58,617 TWO INSTITUTIONS AND LEVERAGE. 5798 04:37:58,617 --> 04:38:02,388 HEALTH FRAMEWORK TO CONVERT N3C 5799 04:38:02,388 --> 04:38:04,857 DATA AND CONTRIBUTE TO N3C AND 5800 04:38:04,857 --> 04:38:09,561 FINALLY I'LL INTRODUCE THE 5801 04:38:09,561 --> 04:38:10,195 ODYSSEY APPROACH AND REPRESENT 5802 04:38:10,195 --> 04:38:17,603 THE DATA. 5803 04:38:17,603 --> 04:38:18,704 WE TREND AT THE UNIVERSITY OF 5804 04:38:18,704 --> 04:38:21,840 MINNESOTA BUT THE QUESTION IS 5805 04:38:21,840 --> 04:38:23,842 HOW CAN WE LEVERAGE THE 5806 04:38:23,842 --> 04:38:27,012 INSTITUTION TO DO THAT. 5807 04:38:27,012 --> 04:38:27,980 AS YOU KNOW THE DIFFERENT 5808 04:38:27,980 --> 04:38:29,248 INSTITUTION THERE'S A LOT SO 5809 04:38:29,248 --> 04:38:32,318 THIS STUDY WE ARE TRYING TO SEE 5810 04:38:32,318 --> 04:38:35,354 IF WE CONVERT THIS AND LEVERAGE 5811 04:38:35,354 --> 04:38:37,423 THAT TO A DIFFERENT INSTITUTION, 5812 04:38:37,423 --> 04:38:40,092 WHAT ARE THE BEST STRATEGIES TO 5813 04:38:40,092 --> 04:38:42,127 BETTER USE THAT. 5814 04:38:42,127 --> 04:38:44,463 SO WE COLLABORATED WITH MAYO 5815 04:38:44,463 --> 04:38:45,698 CLINIC AND COME UP WITH 5816 04:38:45,698 --> 04:38:49,835 DIFFERENT STRATEGIES. 5817 04:38:49,835 --> 04:38:51,770 ONE IS WE WRING THAT CANCER 5818 04:38:51,770 --> 04:38:53,739 BURDEN DIRECTLY FROM HERE AND 5819 04:38:53,739 --> 04:38:56,375 EVALUATE THAT IN MAYO AND 5820 04:38:56,375 --> 04:38:59,812 SECOND, TRAIN IN MAINO CLINIC 5821 04:38:59,812 --> 04:39:01,013 ANNOTATED DATA AND TO SEE HOW 5822 04:39:01,013 --> 04:39:05,551 THE PERFORMANCE CHANGED. 5823 04:39:05,551 --> 04:39:08,587 ALSO WE DID A DATA SET TO 5824 04:39:08,587 --> 04:39:16,362 EVALUATE THE GENERALIZABILITY. 5825 04:39:16,362 --> 04:39:17,696 THIS IS THE EVALUATION ACROSS 5826 04:39:17,696 --> 04:39:20,032 THE DIFFERENT DATA SET AND ALSO 5827 04:39:20,032 --> 04:39:24,036 COMPARED MACHINE LEARNING LIKE 5828 04:39:24,036 --> 04:39:27,906 CRF VERSUS THE CANCER BURDEN 5829 04:39:27,906 --> 04:39:33,012 ACROSS THREE DIFFERENT TESTING 5830 04:39:33,012 --> 04:39:37,916 SET IS COMBINATION OF THE HUMAN 5831 04:39:37,916 --> 04:39:38,917 DATA. 5832 04:39:38,917 --> 04:39:49,428 AND MAYO DATA AND HUMAN DATA. 5833 04:40:06,578 --> 04:40:08,947 THERE'S A MEASURE 5834 04:40:08,947 --> 04:40:10,049 REPRESENTATIVED IN THE TAKE SET. 5835 04:40:10,049 --> 04:40:12,618 -- REPRESENTED IN THE TRAINING 5836 04:40:12,618 --> 04:40:12,785 SET. 5837 04:40:12,785 --> 04:40:13,952 ZERO WOULD BE THE LAST AND ONE 5838 04:40:13,952 --> 04:40:23,095 IS SIMILAR. 5839 04:40:23,095 --> 04:40:29,168 THIS IS A BETTER PERFORMANCE IN 5840 04:40:29,168 --> 04:40:29,968 ALMOST EVERY GROUP AND PERFORMED 5841 04:40:29,968 --> 04:40:40,446 BETTER IN GROUP ONE AND TWO. 5842 04:40:48,187 --> 04:40:49,888 THEY DEVELOPED THE OPEN 5843 04:40:49,888 --> 04:40:51,790 FRAMEWORK TO BE USED AND 5844 04:40:51,790 --> 04:40:54,226 PUBLICLY AVAILABLE TO OTHER 5845 04:40:54,226 --> 04:40:59,364 INSTITUTIONS. 5846 04:40:59,364 --> 04:41:01,733 DURING THE N3C EFFORTS WE CAME 5847 04:41:01,733 --> 04:41:04,503 UP WITH THE WORKING GROUP AND 5848 04:41:04,503 --> 04:41:11,176 WE'RE TRYING TO SEE HOW WE CAN 5849 04:41:11,176 --> 04:41:15,380 LEVERAGE AND CONVERT INTO TABLES 5850 04:41:15,380 --> 04:41:21,286 AND CONTRIBUTE TO N3C DATA 5851 04:41:21,286 --> 04:41:22,855 ENCLAVE. 5852 04:41:22,855 --> 04:41:25,657 THIS IS A FRAMEWORK FROM THE 5853 04:41:25,657 --> 04:41:25,958 NLP. 5854 04:41:25,958 --> 04:41:27,993 THERE'S A PROCESS THAT CAN 5855 04:41:27,993 --> 04:41:34,399 EXTRACT A FILE INTO THE NOTE 5856 04:41:34,399 --> 04:41:37,569 TABLE AND IS A MORE RULE BASED 5857 04:41:37,569 --> 04:41:41,373 ENGINE AND CAN AUTOMATICALLY 5858 04:41:41,373 --> 04:41:45,711 CONVERT THE ENTITIES INTO THE 5859 04:41:45,711 --> 04:41:55,287 CONCEPT THAT REPRESENT IN OH NLP 5860 04:41:55,287 --> 04:42:02,294 AND SENT TO THE N C3T. 5861 04:42:02,294 --> 04:42:05,497 WE DID AN EVALUATION ACROSS 5862 04:42:05,497 --> 04:42:07,599 THREE INSTITUTION, MAYO, 5863 04:42:07,599 --> 04:42:12,237 MINNESOTA AND KENTUCKY. 5864 04:42:12,237 --> 04:42:21,747 WE DE-IDENTIFIED AND AND WE 5865 04:42:21,747 --> 04:42:25,317 FOUND THE AGREEMENT WAS VARIOUS 5866 04:42:25,317 --> 04:42:26,151 ACROSS THREE SITES. 5867 04:42:26,151 --> 04:42:28,887 THAT'S A DEMONSTRATION OF THE 5868 04:42:28,887 --> 04:42:29,788 DIFFERENT INSTITUTION HAVE 5869 04:42:29,788 --> 04:42:31,390 DIFFERENT VARIETY OF 5870 04:42:31,390 --> 04:42:33,091 REPRESENTATION THAT WITH RECORDS 5871 04:42:33,091 --> 04:42:36,228 AND THE ANNOTATION TEAM IS STILL 5872 04:42:36,228 --> 04:42:39,765 IN THE MAYO CLINIC BUT WHEN THEY 5873 04:42:39,765 --> 04:42:42,467 DO THE SAME TASK ACROSS 5874 04:42:42,467 --> 04:42:46,939 INSTITUTION YOU CAN THE I.A.A. 5875 04:42:46,939 --> 04:42:47,606 INTERAGENCY AGREEMENT IS 5876 04:42:47,606 --> 04:42:48,874 DIFFERENT AND THE PROCESS TAKES 5877 04:42:48,874 --> 04:42:51,109 FOUR MONTHS FROM DATA COLLECTION 5878 04:42:51,109 --> 04:42:53,645 AND DEIDENTIFICATION AND IRB 5879 04:42:53,645 --> 04:42:56,014 APPROVAL AND GOVERNANCE AND SEND 5880 04:42:56,014 --> 04:42:58,317 THOSE NOTES TO MAYO. 5881 04:42:58,317 --> 04:43:00,953 THAT MAY BE ANOTHER REASON WHY 5882 04:43:00,953 --> 04:43:02,020 WE FOUND IT'S DIFFERENT. 5883 04:43:02,020 --> 04:43:06,925 AND ALSO I THINK WE THINK THE AN 5884 04:43:06,925 --> 04:43:08,760 OWE TAILINGS IS NEEDED TO MAKE 5885 04:43:08,760 --> 04:43:11,430 SURE WE HAVE HIGH QUALITY 5886 04:43:11,430 --> 04:43:13,232 ANNOTATED DATA WHICH IS GOLD 5887 04:43:13,232 --> 04:43:17,302 STANDARD FOR FINE TUNING MODELS. 5888 04:43:17,302 --> 04:43:22,341 THERE'S EIGHT OF SPECIFIC 5889 04:43:22,341 --> 04:43:25,811 FACTORS SUCH AS TENSION THAT AND 5890 04:43:25,811 --> 04:43:26,345 STRUCTURE AND CAN IMPACT 5891 04:43:26,345 --> 04:43:32,451 ANNOTATION. 5892 04:43:32,451 --> 04:43:36,421 WE DID BOTH RULE BASED AND 5893 04:43:36,421 --> 04:43:39,825 LEARNING BASED AND WE USED BOTH 5894 04:43:39,825 --> 04:43:46,698 SINGLE SITE AND MODEST SITE DATA 5895 04:43:46,698 --> 04:43:46,865 SET. 5896 04:43:46,865 --> 04:43:49,034 IT OUTPERFORM THE DEEP LEARNING 5897 04:43:49,034 --> 04:43:55,340 METHOD AND WE CAN DEIDENTIFY 5898 04:43:55,340 --> 04:43:57,442 DATA AND THEY OUTPERFORM THE 5899 04:43:57,442 --> 04:43:59,778 SINGLE MODEL SINCE IT USES A 5900 04:43:59,778 --> 04:44:03,181 COMBINATION OF THE DIFFERENT 5901 04:44:03,181 --> 04:44:09,454 SITES. 5902 04:44:09,454 --> 04:44:13,358 THERE'S ANOTHER GROUP THAT WE 5903 04:44:13,358 --> 04:44:15,427 COME UP WITH AN APPROACH. 5904 04:44:15,427 --> 04:44:20,265 WE CAN USE A SINGLE OR LOCAL 5905 04:44:20,265 --> 04:44:23,535 DEVELOPED NLP SYSTEM BUT WHEN 5906 04:44:23,535 --> 04:44:25,537 YOU DOCUMENT THAT IN THE NOTE 5907 04:44:25,537 --> 04:44:30,642 NLP TABLE WE MAP THAT INTO THE 5908 04:44:30,642 --> 04:44:33,078 OHDSI TERMINOLOGY SYSTEM AND 5909 04:44:33,078 --> 04:44:36,448 THEN CONVERT THAT INTO THE 5910 04:44:36,448 --> 04:44:39,618 STANDARDIZATION BUT THERE'S A 5911 04:44:39,618 --> 04:44:41,219 LOT OF INFORMATION ON 5912 04:44:41,219 --> 04:44:44,256 UNCERTAINTY THAT ARE NOT REALLY 5913 04:44:44,256 --> 04:44:50,462 IN THE TABLE WE HAVE TO STORE IN 5914 04:44:50,462 --> 04:44:56,368 THE TERM MODIFICATION. 5915 04:44:56,368 --> 04:44:58,003 AND DIFFERENT INSTITUTION 5916 04:44:58,003 --> 04:44:59,571 LEVERAGES ARE OPEN SOURCE TO 5917 04:44:59,571 --> 04:45:00,605 DEMONSTRATE THE APPROACH ACROSS 5918 04:45:00,605 --> 04:45:07,746 DIFFERENT APPLICATIONS HERE. 5919 04:45:07,746 --> 04:45:10,782 I WANT TO TALK ABOUT NLP. 5920 04:45:10,782 --> 04:45:13,452 SINCE IT HAS INFORMATION AND 5921 04:45:13,452 --> 04:45:15,687 DEIDENTIFICATION IS A HARD TASK. 5922 04:45:15,687 --> 04:45:18,223 SO IT COULD POTENTIALLY PROVIDE 5923 04:45:18,223 --> 04:45:21,660 ANOTHER WAY YOU SEND A MODEL TO 5924 04:45:21,660 --> 04:45:25,030 EACH SITE AND THEN LEARNING SOME 5925 04:45:25,030 --> 04:45:27,232 PARAMETERS AND ENSURING THERE 5926 04:45:27,232 --> 04:45:30,736 ARE WAYS BACK AND THEN WE DID A 5927 04:45:30,736 --> 04:45:33,805 SIMULATION USING OPEN SOURCE 5928 04:45:33,805 --> 04:45:36,541 DATA AND FOUND THE SINGLE SITE 5929 04:45:36,541 --> 04:45:37,909 CLAIM IS YOU ONLY TRAIN THE 5930 04:45:37,909 --> 04:45:41,513 MODEL IN YOUR SINGLE INSTITUTION 5931 04:45:41,513 --> 04:45:48,920 AND MANY NLP TASKS PERFORM WITH 5932 04:45:48,920 --> 04:45:51,356 CENTRALIZED DATA AND MEANING YOU 5933 04:45:51,356 --> 04:45:52,991 PUT THEM TOGETHER AND LARGE 5934 04:45:52,991 --> 04:45:54,960 MODELS SEEM TO BE MORE RESILIENT 5935 04:45:54,960 --> 04:45:57,462 TO THE INCREASETION SCALE WITH 5936 04:45:57,462 --> 04:45:59,998 THE DATA SET INTO THE DIFFERENT 5937 04:45:59,998 --> 04:46:04,369 KINDS FROM 2 TO 10 YOU SEE ON 5938 04:46:04,369 --> 04:46:05,570 THE FIGURE ON THE RIGHT. 5939 04:46:05,570 --> 04:46:11,176 FINALLY I WANT TO TALK ABOUT NLP 5940 04:46:11,176 --> 04:46:13,779 FOR KNOWLEDGE DISCOVERY. 5941 04:46:13,779 --> 04:46:15,947 HOW CAN WE DO THE DRUG 5942 04:46:15,947 --> 04:46:17,682 REPURPOSING THAT WILL LEVERAGE 5943 04:46:17,682 --> 04:46:19,050 AND PUBLISH THE REPORTS AND 5944 04:46:19,050 --> 04:46:21,219 SCIENTIFIC PAPERS AND HOW CAN WE 5945 04:46:21,219 --> 04:46:26,124 USE NLP AND CONVERT THEM AND 5946 04:46:26,124 --> 04:46:30,061 FORM THE GRAPH AND LATER WE USE 5947 04:46:30,061 --> 04:46:33,765 THE COMPLETION METHOD TO DO THE 5948 04:46:33,765 --> 04:46:35,267 COMPLETION AND THIS IS COVID-19 5949 04:46:35,267 --> 04:46:40,305 IN THIS CASE DRUG REPURPOSING. 5950 04:46:40,305 --> 04:46:42,474 YOU SEE THE VISUALIZATION ON THE 5951 04:46:42,474 --> 04:46:48,213 CORNER YOU SEE THE HIGH 5952 04:46:48,213 --> 04:46:49,448 DIMENSIO 5953 04:46:49,448 --> 04:46:50,816 DIMENSI 5954 04:46:50,816 --> 04:46:52,617 DIMENSIONAL VISUALIZATION AND 5955 04:46:52,617 --> 04:46:55,754 THE POTENTIAL PATHWAY FOR THE 5956 04:46:55,754 --> 04:46:56,555 THIRD IN DRUGS CAN POTENTIALLY 5957 04:46:56,555 --> 04:47:06,765 TREAT COVID. 5958 04:47:07,098 --> 04:47:09,334 WE PROPOSE THREE CANDIDATE AND 5959 04:47:09,334 --> 04:47:12,270 WE HAVE OVERLAP WITH SOME 5960 04:47:12,270 --> 04:47:13,171 REPORTED STUDY USING DIFFERENT 5961 04:47:13,171 --> 04:47:23,482 DATA AND METHODS. 5962 04:47:23,715 --> 04:47:27,052 AND WE USED DEEP LEARNING TO 5963 04:47:27,052 --> 04:47:30,255 MAKE IT MORE EASILY TO COMPUTE 5964 04:47:30,255 --> 04:47:34,092 AND USING THE DISCOVERY PATTERN 5965 04:47:34,092 --> 04:47:37,362 TO FIND NOVEL DRUG AND DIETARY 5966 04:47:37,362 --> 04:47:37,996 SUPPLEMENT INTERACTION. 5967 04:47:37,996 --> 04:47:40,565 WE COMPARED WITH OTHER EXISTING 5968 04:47:40,565 --> 04:47:41,733 KNOWLEDGE GRAPH WHICH DOESN'T 5969 04:47:41,733 --> 04:47:44,402 REALLY HAVE A LOT OF OVERLAP 5970 04:47:44,402 --> 04:47:47,339 WITH THIS SUB EKG AND IDENTIFIED 5971 04:47:47,339 --> 04:47:48,707 POTENTIALLY DRUG SUPPLEMENT 5972 04:47:48,707 --> 04:47:50,976 INTERACTION AND EXTRACTED THE 5973 04:47:50,976 --> 04:47:56,815 PATHWAY FROM THE LITERATURE AND 5974 04:47:56,815 --> 04:48:00,952 THEN WE HAVE THE PLUSABILITY. 5975 04:48:00,952 --> 04:48:01,820 -- PLAUSIBILITY. 5976 04:48:01,820 --> 04:48:05,290 I'D LIKE TO THANK ALL THE EXTEND 5977 04:48:05,290 --> 04:48:08,693 FUNDING TO SUPPORT OUR RESEARCH 5978 04:48:08,693 --> 04:48:12,864 GROUP AND THIS IS OUR NLP GROUP 5979 04:48:12,864 --> 04:48:13,865 AND THE LAB. 5980 04:48:13,865 --> 04:48:18,169 >> WONDERFUL. 5981 04:48:18,169 --> 04:48:18,904 THANK YOU VERY MUCH. 5982 04:48:18,904 --> 04:48:21,006 IT'S FASCINATING WATCHING THE 5983 04:48:21,006 --> 04:48:22,040 MACHINE SPEAK AS WE DO. 5984 04:48:22,040 --> 04:48:24,509 I DON'T SEE MANY QUESTIONS AND 5985 04:48:24,509 --> 04:48:26,444 WE'RE BEHIND ON TIME SO I MAY 5986 04:48:26,444 --> 04:48:29,848 FOCUS ON ONE QUESTION FROM ME. 5987 04:48:29,848 --> 04:48:33,151 HOW DO YOU SEE MEASURES OF 5988 04:48:33,151 --> 04:48:34,085 ACCURACY FOR DIFFERENT 5989 04:48:34,085 --> 04:48:34,553 DECISIONS? 5990 04:48:34,553 --> 04:48:36,988 WE HEARD IN SOME OF THE EARLIER 5991 04:48:36,988 --> 04:48:39,324 TALKS THE ENTHUSIASM OF THE 5992 04:48:39,324 --> 04:48:42,427 PUBLIC OF PUTTING ONE CHILD 5993 04:48:42,427 --> 04:48:43,161 DIAGNOSIS INTO CHAT GPT AND THEY 5994 04:48:43,161 --> 04:48:48,199 GET AN ANSWER. 5995 04:48:48,199 --> 04:48:53,405 YET YOU HAVE A MILLION PATIENT 5996 04:48:53,405 --> 04:48:55,140 DIAGNOSES AND IT'S NOT SO EASY. 5997 04:48:55,140 --> 04:48:57,576 HOW DO YOU MEASURE ACCURACY AND 5998 04:48:57,576 --> 04:49:00,245 DO YOU SEE THRESHOLDS FOR 5999 04:49:00,245 --> 04:49:01,880 ACTION? 6000 04:49:01,880 --> 04:49:04,849 WHAT WOULD BE SUGGESTIVE, 6001 04:49:04,849 --> 04:49:06,351 PROBABLE, DEFINITIVE AND WORTHY 6002 04:49:06,351 --> 04:49:12,357 OF SURGERY TYPE OF STUFF. 6003 04:49:12,357 --> 04:49:14,025 >> THIS IS AN OPEN QUESTION FOR 6004 04:49:14,025 --> 04:49:17,862 THE COMMUNITY RIGHT NOW. 6005 04:49:17,862 --> 04:49:22,200 ONE THING IS TO PROCESS AND 6006 04:49:22,200 --> 04:49:26,037 ANALYZING THE LARGE SCALE DATA 6007 04:49:26,037 --> 04:49:29,074 WE REQUIRE REGULATORY SUPPORT TO 6008 04:49:29,074 --> 04:49:31,209 SEND PATIENT DATA TO CHAT GPT 6009 04:49:31,209 --> 04:49:33,345 OPEN A.I. WHICH IS NOT ALLOWED 6010 04:49:33,345 --> 04:49:34,913 IN MY INSTITUTION. 6011 04:49:34,913 --> 04:49:42,487 WE CAN USE FAKE PATIENT DATA AND 6012 04:49:42,487 --> 04:49:48,059 SET UP A THRESHOLD TO LOOK AT 6013 04:49:48,059 --> 04:49:53,865 CONFIDENCE FOR PATIENT SAFETY. 6014 04:49:53,865 --> 04:49:58,069 AND WE WANT TO LOOK AT CHAT GPT 6015 04:49:58,069 --> 04:49:59,337 FROM A SINGLE INSTITUTION AND 6016 04:49:59,337 --> 04:50:01,873 THE E.H.R. DATA IS PROBABLY 6017 04:50:01,873 --> 04:50:06,011 LIMITED SO WE LACK THE WHOLE 6018 04:50:06,011 --> 04:50:08,813 INFORMATION RECORD OF PATIENTS 6019 04:50:08,813 --> 04:50:11,082 FROM DIFFERENT DEFENSE OR SOME 6020 04:50:11,082 --> 04:50:12,150 OTHER LIFESTYLE. 6021 04:50:12,150 --> 04:50:16,721 IT DEPENDS THE USE CASE AND I 6022 04:50:16,721 --> 04:50:19,190 DON'T HAVE A DIRECT ANSWER FOR 6023 04:50:19,190 --> 04:50:19,391 THAT. 6024 04:50:19,391 --> 04:50:22,460 >> WELL, THANK YOU. 6025 04:50:22,460 --> 04:50:24,863 AS A USEFUL REMINDER THE MODELS 6026 04:50:24,863 --> 04:50:28,767 ARE DIFFERENT AND CHAT GPT 6027 04:50:28,767 --> 04:50:30,468 WHATEVER YOU PUT IN SPIES ON YOU 6028 04:50:30,468 --> 04:50:31,102 BACK SO THAT'S THE WHOLE OTHER 6029 04:50:31,102 --> 04:50:34,706 THING. 6030 04:50:34,706 --> 04:50:37,942 I'D LIKE TO INTRODUCE THE FINAL 6031 04:50:37,942 --> 04:50:40,178 SPEAKER BEFORE OUR Q&A SESSION. 6032 04:50:40,178 --> 04:50:45,216 SO PENULTIMATE. 6033 04:50:45,216 --> 04:50:48,219 WONDERFUL AND WE HAVE 6034 04:50:48,219 --> 04:50:52,190 DRDR. 6035 04:50:52,190 --> 04:50:59,397 DOCTOR PROFESSOR ALEX JARASH AT 6036 04:50:59,397 --> 04:51:03,201 NEO-4J AND A NON FOR PROFIT 6037 04:51:03,201 --> 04:51:04,836 ORGANIZATION AND HIS BACKGROUND 6038 04:51:04,836 --> 04:51:09,441 IS BIO INFORMATICS AND HIS 6039 04:51:09,441 --> 04:51:12,911 BACKGROUND IS PHARMA AND I.T. 6040 04:51:12,911 --> 04:51:14,579 AND HAS EXPERIENCE IN DATA 6041 04:51:14,579 --> 04:51:15,547 ENGINEERING AND COMBINED WITH 6042 04:51:15,547 --> 04:51:18,216 HIS DEEP KNOWLEDGE OF PHARMA AND 6043 04:51:18,216 --> 04:51:20,118 WILL TALK TO US ABOUT A 6044 04:51:20,118 --> 04:51:21,453 FASCINATING TOPIC AND HE'S 6045 04:51:21,453 --> 04:51:25,623 GOTTEN MULTIPLE AWARDS FOR 6046 04:51:25,623 --> 04:51:28,793 INNOVATIVE USE OF COMPUTING 6047 04:51:28,793 --> 04:51:31,096 INCLUDING IN THE KNOWLEDGE GAP 6048 04:51:31,096 --> 04:51:32,163 TO COMBAT WIDESPREAD DISEASE AND 6049 04:51:32,163 --> 04:51:32,464 DIABETES. 6050 04:51:32,464 --> 04:51:33,164 WELCOME AND THANK YOU FOR 6051 04:51:33,164 --> 04:51:43,441 SPEAKING TO US. 6052 04:52:03,261 --> 04:52:04,395 THANK YOU FOR TALKING ABOUT 6053 04:52:04,395 --> 04:52:04,763 HEALTH RECORDS. 6054 04:52:04,763 --> 04:52:12,537 >> THE GRAPH IS A DATA STRUCTURE 6055 04:52:12,537 --> 04:52:14,038 AND NOT A PLOT. 6056 04:52:14,038 --> 04:52:16,674 SO WHY ARE WHERE HE DOING 6057 04:52:16,674 --> 04:52:18,343 GRAPHS? 6058 04:52:18,343 --> 04:52:19,377 BASICALLY GRAPHS ARE EVERYWHERE 6059 04:52:19,377 --> 04:52:25,416 IN THE LIFE SIGCIENCE BUSINESS D 6060 04:52:25,416 --> 04:52:26,251 THE MOLECULES CAN BE PRESENTED 6061 04:52:26,251 --> 04:52:28,853 AS A GRAPH AND THE NODE AND 6062 04:52:28,853 --> 04:52:31,189 ATOMS AND THE ATOMIC BONDS 6063 04:52:31,189 --> 04:52:32,190 BETWEEN ATOMS. 6064 04:52:32,190 --> 04:52:34,859 ON THE RIGHT SIDE YOU PROBABLY 6065 04:52:34,859 --> 04:52:36,828 KNOW THE MOLECULAR PATHWAY 6066 04:52:36,828 --> 04:52:41,900 POSTER FROM RAUSCH PHARMA. 6067 04:52:41,900 --> 04:52:43,902 IT'S A GRAPH AND THE 6068 04:52:43,902 --> 04:52:45,003 RELATIONSHIPS AND ONE OF OUR 6069 04:52:45,003 --> 04:52:48,506 BEST EXAMPLES OF A GOOD GRAPH IS 6070 04:52:48,506 --> 04:52:52,777 OUR HOME HUMAN BRAIN. 6071 04:52:52,777 --> 04:52:54,813 THE PROBLEM IS THAT THIS 6072 04:52:54,813 --> 04:52:56,981 CONNECTED DATA IS VERY PROMINENT 6073 04:52:56,981 --> 04:53:00,218 IN OUR INDUSTRY WE HAVE 6074 04:53:00,218 --> 04:53:02,320 EXTREMELY HETEROGENEOUS DATA AND 6075 04:53:02,320 --> 04:53:04,889 UNSTRUCTURED DATA AND THE LEGACY 6076 04:53:04,889 --> 04:53:06,691 SYSTEMS WHAT WE COLLECT IS 6077 04:53:06,691 --> 04:53:08,626 RATHER A RELATION DATABASE WHICH 6078 04:53:08,626 --> 04:53:13,131 IS COLUMNS AND ROWS OR DOCUMENT 6079 04:53:13,131 --> 04:53:16,000 DATABASES WHICH STORE THE DATA 6080 04:53:16,000 --> 04:53:17,936 IN CONTAINERS AND DUMES. 6081 04:53:17,936 --> 04:53:28,179 -- DOCUMENTS. 6082 04:53:29,714 --> 04:53:32,016 AND THE INVENTOR OF THIS NEW 6083 04:53:32,016 --> 04:53:34,752 DATABASE CATEGORY AND THE GRAPH 6084 04:53:34,752 --> 04:53:36,154 DATA SCIENCE CATEGORY WE'RE 10 6085 04:53:36,154 --> 04:53:46,698 YEARS OLD AND THE MARKET LEADER. 6086 04:53:48,800 --> 04:53:51,636 FO 6087 04:53:51,636 --> 04:53:52,904 FOR SOME COMPANIES THEY'RE USING 6088 04:53:52,904 --> 04:53:59,210 GRAPH TECHNOLOGY OR DATA SCIENCE 6089 04:53:59,210 --> 04:54:04,883 THROUGHOUT THE DRUG LIFE CYCLE. 6090 04:54:04,883 --> 04:54:06,818 THEY'RE USING THE KNOWLEDGE 6091 04:54:06,818 --> 04:54:08,653 GRAPHS IN THE TARGET SPACE AND 6092 04:54:08,653 --> 04:54:11,389 LEAD OPTIMIZATION AND ANIMAL 6093 04:54:11,389 --> 04:54:12,523 MODELS AND TERMINOLOGY DATA AND 6094 04:54:12,523 --> 04:54:14,926 CLINICAL TRIALS IS A BIG THING, 6095 04:54:14,926 --> 04:54:19,097 REAL WORLD EVIDENCE AND UP TO 6096 04:54:19,097 --> 04:54:21,065 THE APPROVAL PART WE GOT A LOT 6097 04:54:21,065 --> 04:54:23,434 OF USE CASES BY MANUFACTURING OR 6098 04:54:23,434 --> 04:54:24,469 SUPPLY CHAIN RESILIENCE. 6099 04:54:24,469 --> 04:54:31,075 SO RISK MITIGATION AND ALSO FDA 6100 04:54:31,075 --> 04:54:31,910 ADVERSE REPORTING. 6101 04:54:31,910 --> 04:54:33,244 WE HAVE A LOT OF USE CASES 6102 04:54:33,244 --> 04:54:41,619 THROUGHOUT THE LIFE CYCLE. 6103 04:54:41,619 --> 04:54:43,421 SO HOW DO WE STORE DATA? 6104 04:54:43,421 --> 04:54:44,656 VERY POWERFUL. 6105 04:54:44,656 --> 04:54:45,990 WE HAVE THE NOTES REPRESENTED 6106 04:54:45,990 --> 04:54:49,627 HERE AS THE SPHERES AN CAN GIVE 6107 04:54:49,627 --> 04:54:50,695 THEM LABELS. 6108 04:54:50,695 --> 04:54:52,864 CALL IT A GENE OR ENZYME OR PUT 6109 04:54:52,864 --> 04:54:54,632 MORE LABELS AND TAGS ON THEM AND 6110 04:54:54,632 --> 04:55:02,140 THE PROTEIN CAN BE AN ENZYME AND 6111 04:55:02,140 --> 04:55:03,641 THE NODE IS CONNECTED BY 6112 04:55:03,641 --> 04:55:05,743 RELATIONSHIP AND FOR BOTH OF THE 6113 04:55:05,743 --> 04:55:09,714 DATA STRUCTURES WE CAN GIVE 6114 04:55:09,714 --> 04:55:10,581 TYPES AS FOR EXAMPLE THE LABEL 6115 04:55:10,581 --> 04:55:13,518 TYPE GENE OR RELATIONSHIP TYPE 6116 04:55:13,518 --> 04:55:19,123 CODES LIKE GENES AND PROTEIN ON 6117 04:55:19,123 --> 04:55:20,992 TOP OF THAT THE NODE LEVEL AND 6118 04:55:20,992 --> 04:55:26,597 RELATIONSHIP LEVEL WE CAN SCORE 6119 04:55:26,597 --> 04:55:28,933 ANY TYPE OF SIMPLE PROPERTY LIKE 6120 04:55:28,933 --> 04:55:34,505 STRINGS AND INTEGERS AND OBJECTS 6121 04:55:34,505 --> 04:55:35,807 AND THAT'S BASICALLY IT 6122 04:55:35,807 --> 04:55:37,909 CONNECTING TO BIGGER NETWORKS. 6123 04:55:37,909 --> 04:55:39,644 I THINK YOU'VE SEEN A LOT OF 6124 04:55:39,644 --> 04:55:40,311 KNOWLEDGE GRAPHS BEFORE. 6125 04:55:40,311 --> 04:55:42,113 IF YOU GO TO THE NEXT SLIDE I 6126 04:55:42,113 --> 04:55:44,449 HAVE TWO EXAMPLES WITH ME HERE. 6127 04:55:44,449 --> 04:55:47,819 ONE IS FROM DRUG REPURPOSING OR 6128 04:55:47,819 --> 04:55:48,486 TARGETED IDENTIFICATION WHICH IS 6129 04:55:48,486 --> 04:55:49,721 WHAT EVERYBODY'S DOING. 6130 04:55:49,721 --> 04:55:52,623 WE TALK ABOUT THE MOLECULAR 6131 04:55:52,623 --> 04:55:56,294 ENTITIES LIKE CODING AND RNA AND 6132 04:55:56,294 --> 04:55:57,595 PROTEINS CAN INTERACT WITH EACH 6133 04:55:57,595 --> 04:55:59,030 OTHER IF WE THINK ABOUT 6134 04:55:59,030 --> 04:56:03,501 PROTEIN-PROTEIN INTERACTIONS. 6135 04:56:03,501 --> 04:56:05,803 THE PROTEINS ARE SOMETIMES 6136 04:56:05,803 --> 04:56:07,005 TARGETS FOR DISEASES IN CLINICAL 6137 04:56:07,005 --> 04:56:07,238 TRIALS. 6138 04:56:07,238 --> 04:56:09,140 YOU GET THE POINT. 6139 04:56:09,140 --> 04:56:10,608 ALL THE MOLECULAR IDENTIFIERS 6140 04:56:10,608 --> 04:56:12,744 ARE CONNECTED IN A NETWORK 6141 04:56:12,744 --> 04:56:13,578 STRUCTURE SO NATIVELY. 6142 04:56:13,578 --> 04:56:17,148 AND THEN ON THE RIGHT SIDE YOU 6143 04:56:17,148 --> 04:56:20,852 SEE THE TWO TERMS LIKE ONTOLOGY 6144 04:56:20,852 --> 04:56:23,654 COMING FROM ONTOLOGY DATA LIKE 6145 04:56:23,654 --> 04:56:24,922 HUMAN PHENOTYPE ONTOLOGY OR 6146 04:56:24,922 --> 04:56:28,159 WHATEVER YOU HAVE OR LIKE YOUR 6147 04:56:28,159 --> 04:56:30,128 INTERNAL TERMINOLOGIES AND YOU 6148 04:56:30,128 --> 04:56:31,396 CAN DIRECTLY CONNECT THAT TO 6149 04:56:31,396 --> 04:56:34,032 YOUR KNOWLEDGE GRAPH TO HAVE 6150 04:56:34,032 --> 04:56:36,234 STANDARDIZED TERMS FOR YOUR 6151 04:56:36,234 --> 04:56:37,568 ENTITIES. 6152 04:56:37,568 --> 04:56:38,803 ON THE LEFT SIDE IS WHAT ALL THE 6153 04:56:38,803 --> 04:56:40,038 COMPANIES ARE DOING. 6154 04:56:40,038 --> 04:56:41,239 THEY'RE INTEGRATING ALL THE 6155 04:56:41,239 --> 04:56:43,908 KINDS OF UNSTRUCTURED DATA THAT 6156 04:56:43,908 --> 04:56:45,943 THEY CAN GET FROM LITERATURE 6157 04:56:45,943 --> 04:56:48,346 LIKE PUB MED AND BIO ARCHIVE AND 6158 04:56:48,346 --> 04:56:51,015 MED ARCHIVE OR IF THEY'RE 6159 04:56:51,015 --> 04:56:52,150 COMMERCIAL THEY'RE INTERESTED IN 6160 04:56:52,150 --> 04:56:54,385 DIGITIZING PATTERNS AND PATTERN 6161 04:56:54,385 --> 04:56:56,287 DATA TO SCREEN IF THEY GET 6162 04:56:56,287 --> 04:56:58,589 INFORMATION TO CONNECTED 6163 04:56:58,589 --> 04:56:59,357 ENTITIES. 6164 04:56:59,357 --> 04:57:02,093 THAT'S THE EXAMPLE FOR THE R&D 6165 04:57:02,093 --> 04:57:02,427 PART. 6166 04:57:02,427 --> 04:57:06,164 IF YOU GO TO THE NEXT SLIDE WE 6167 04:57:06,164 --> 04:57:07,932 HAVE ANOTHER ONE A DATA MODEL 6168 04:57:07,932 --> 04:57:13,805 WHICH IS IF YOU GO ONE SLIDE 6169 04:57:13,805 --> 04:57:17,241 BACK WE HAVE ONE FROM CLINICAL 6170 04:57:17,241 --> 04:57:19,944 TRIALS OR PATIENT JOURNEY WHICH 6171 04:57:19,944 --> 04:57:21,746 IS CLOSE TO THE STANDARD WHERE 6172 04:57:21,746 --> 04:57:24,248 WE HAVE THE PATIENT CENTRIC DATA 6173 04:57:24,248 --> 04:57:26,884 MODEL WHERE A PATIENT HAS 6174 04:57:26,884 --> 04:57:28,519 ENCOUNTERS AND THEY'RE CONNECTED 6175 04:57:28,519 --> 04:57:30,054 BY THE NEXT RELATIONSHIP. 6176 04:57:30,054 --> 04:57:32,590 SO YOU SEE THE KIND OF TIME 6177 04:57:32,590 --> 04:57:35,493 SERIES OF DATA AND AT SOME OR 6178 04:57:35,493 --> 04:57:40,031 ALL OF THE ENCOUNTERS YOU CAN 6179 04:57:40,031 --> 04:57:42,600 STORE DATA, CLINICAL CONDITIONS, 6180 04:57:42,600 --> 04:57:45,236 STORING, PROCEDURES, PAYERS, 6181 04:57:45,236 --> 04:57:46,370 HOSPITALS, PROVIDERS AND SO ON 6182 04:57:46,370 --> 04:57:47,438 AND SO FORTH. 6183 04:57:47,438 --> 04:57:49,774 THESE ARE ONLY TWO EXAMPLES OF 6184 04:57:49,774 --> 04:57:50,007 GRAPHS. 6185 04:57:50,007 --> 04:57:53,444 I THINK YOU WOULD AGREE IT'S 6186 04:57:53,444 --> 04:57:56,414 EXTREMELY INTUITIVE FROM A 6187 04:57:56,414 --> 04:57:57,248 NON-COMPUTER SCIENTIST 6188 04:57:57,248 --> 04:58:00,351 PERSPECTIVE OR FROM A BUSINESS 6189 04:58:00,351 --> 04:58:00,651 PERSPECTIVE. 6190 04:58:00,651 --> 04:58:02,987 THE GOOD THING IT'S THE SAME 6191 04:58:02,987 --> 04:58:05,957 DATA MODEL FOR THE ADMIN. 6192 04:58:05,957 --> 04:58:07,592 IT'S EASY TO DEVELOP 6193 04:58:07,592 --> 04:58:08,526 APPLICATIONS OR STORE DATA OR 6194 04:58:08,526 --> 04:58:18,936 RETRIEVE DATA FROM THAT. 6195 04:58:23,941 --> 04:58:25,676 I SEE MOST THE CUSTOMERS USE 6196 04:58:25,676 --> 04:58:26,844 KNOWLEDGE GRAPH TO STORE 6197 04:58:26,844 --> 04:58:28,980 KNOWLEDGE INTERNAL, EXTERNAL. 6198 04:58:28,980 --> 04:58:39,023 STARTING WITH THE EXTERNAL DATA 6199 04:58:39,023 --> 04:58:49,567 SOURCES AND IS THEY USE THIS TO 6200 04:58:51,235 --> 04:58:54,405 CONNECT OTHER EXTERNAL DATA 6201 04:58:54,405 --> 04:58:55,439 SOURCES AS I MENTIONED. 6202 04:58:55,439 --> 04:58:57,808 ON THE LEFT SIDE YOU HAVE 6203 04:58:57,808 --> 04:58:59,911 EXTERNAL ONTOLOGIES AND WHATEVER 6204 04:58:59,911 --> 04:59:00,711 YOU HAVE. 6205 04:59:00,711 --> 04:59:03,781 AND THEN THEY USE THIS KIND OF 6206 04:59:03,781 --> 04:59:06,250 OPEN DATA TO CONNECT WITH 6207 04:59:06,250 --> 04:59:09,220 INTERNAL DATA SETS AND COULD BE 6208 04:59:09,220 --> 04:59:12,123 TERMINOLOGIES MORE GRANULAR OR 6209 04:59:12,123 --> 04:59:14,125 REAL WORLD EVIDENCE DATA OR 6210 04:59:14,125 --> 04:59:15,626 SOMETHING LIKE THAT AND SPENDS A 6211 04:59:15,626 --> 04:59:18,229 KNOWLEDGE GRAPH AND YOU CAN 6212 04:59:18,229 --> 04:59:21,666 CONNECT THAT AS A COMPOUND 6213 04:59:21,666 --> 04:59:22,934 REGISTRATION TO OTHER HIGH 6214 04:59:22,934 --> 04:59:24,969 THROUGHPUT EXPERIMENTS OR 6215 04:59:24,969 --> 04:59:26,437 CLINICAL TRIALS. 6216 04:59:26,437 --> 04:59:28,472 AND SO FORTH. 6217 04:59:28,472 --> 04:59:29,006 NEXT SLIDE. 6218 04:59:29,006 --> 04:59:31,342 THE NEXT COUPLE OF MINUTES I'LL 6219 04:59:31,342 --> 04:59:35,079 SPEND ON THE WORK THAT I'VE DONE 6220 04:59:35,079 --> 04:59:38,216 IN MY FORMER POSITION AT THE 6221 04:59:38,216 --> 04:59:39,517 GERMAN CENTER FOR DIABETES 6222 04:59:39,517 --> 04:59:42,220 RESEARCH WHERE I HEADED THE 6223 04:59:42,220 --> 04:59:52,496 PROJECT BEFORE. 6224 05:00:01,072 --> 05:00:05,810 WE COMBINE THE DATA AND WE CAN 6225 05:00:05,810 --> 05:00:08,412 ZOOM IN HERE AND OTHERWISE THE 6226 05:00:08,412 --> 05:00:10,314 SLIDES WE'LL PROVIDE LATER 6227 05:00:10,314 --> 05:00:11,916 YOU'LL SEE FOR EXAMPLE THE GENES 6228 05:00:11,916 --> 05:00:14,552 ARE CONNECTED TO THEMSELVES AS 6229 05:00:14,552 --> 05:00:16,420 WELL AS THE PROTEIN AND THE RNA 6230 05:00:16,420 --> 05:00:19,423 AND THAT MEANS THAT THE GENES 6231 05:00:19,423 --> 05:00:22,293 HAVE SYNONYMS OR IDENTIFY FROM 6232 05:00:22,293 --> 05:00:22,927 SEVERAL DATABASES. 6233 05:00:22,927 --> 05:00:27,365 AND THIS IS WHAT WE COVERED AS 6234 05:00:27,365 --> 05:00:28,165 WELL AS IN THE DATABASE. 6235 05:00:28,165 --> 05:00:31,469 EVEN HISTORICAL OR LEGACY 6236 05:00:31,469 --> 05:00:31,869 IDENTIFIERS. 6237 05:00:31,869 --> 05:00:33,704 WE CAN JUMP FROM ONE TO THE 6238 05:00:33,704 --> 05:00:35,606 OTHER AND IDENTIFY AND SEE WHAT 6239 05:00:35,606 --> 05:00:42,246 KIND OF INFORMATION. 6240 05:00:42,246 --> 05:00:45,683 I SAID WE INTEGRATED ONTOLOGIES 6241 05:00:45,683 --> 05:00:49,287 AND TAKES ME BACK TO THE LAST 6242 05:00:49,287 --> 05:00:52,490 PRESENTATION HOW WE INTEGRATE 6243 05:00:52,490 --> 05:00:56,594 DATA AND CONNECT AT THE SAME 6244 05:00:56,594 --> 05:00:58,129 TIME WITH ONTOLOGIES. 6245 05:00:58,129 --> 05:01:01,999 WE START FROM UNSTRUCTURED DATA 6246 05:01:01,999 --> 05:01:05,136 AND WE CAN DO ENTITY RESOLUTION 6247 05:01:05,136 --> 05:01:10,241 AND ANY NLP OR ADVANCED 6248 05:01:10,241 --> 05:01:16,180 ALGORITHMS TO EXTRACT ENTITIES. 6249 05:01:16,180 --> 05:01:21,952 AND THIS IS WHERE THE FORMS ARE 6250 05:01:21,952 --> 05:01:25,056 AND YOU HAVE THE ONTOLOGY OR 6251 05:01:25,056 --> 05:01:26,991 STRUCTURE WHICH IS ALSO A GRAPH. 6252 05:01:26,991 --> 05:01:33,364 AND YOU CAN CONNECT THEM BY 6253 05:01:33,364 --> 05:01:37,268 MATCHING THESE STRINGS OR CODES 6254 05:01:37,268 --> 05:01:38,636 TO CONNECT THE ONTOLOGY TO THE 6255 05:01:38,636 --> 05:01:38,836 DATA. 6256 05:01:38,836 --> 05:01:41,305 AND WHAT YOU CAN THEN DO IS THIS 6257 05:01:41,305 --> 05:01:44,909 KIND OF YELLOW LINE. 6258 05:01:44,909 --> 05:01:49,947 YOU CAN WIRE THE ONTOLOGY AND 6259 05:01:49,947 --> 05:01:51,716 DOCUMENT AND CONNECT BY THE 6260 05:01:51,716 --> 05:01:56,220 ONTOLOGY AND THAT WORKS WELL 6261 05:01:56,220 --> 05:01:57,521 BECAUSE YOU CAN PUT DIFFERENT 6262 05:01:57,521 --> 05:02:00,257 VERSIONS OF THE ONTOLOGY OR 6263 05:02:00,257 --> 05:02:02,393 DIFFERENT ONTOLOGIES NEXT TO 6264 05:02:02,393 --> 05:02:05,563 EACH OTHER AND INFER NEW 6265 05:02:05,563 --> 05:02:06,664 RELATIONSHIPS BASED ON JUMPING 6266 05:02:06,664 --> 05:02:11,769 FROM TO THE OTHER ONTOLOGY. 6267 05:02:11,769 --> 05:02:15,172 I'LL GIVE YOU ONE EXAMPLE. 6268 05:02:15,172 --> 05:02:18,242 ON THE LEFT SIDE WE HAVE GWAS 6269 05:02:18,242 --> 05:02:26,684 DATA AND INTERNAL DATA FROM TYPE 6270 05:02:26,684 --> 05:02:29,286 2 DIABETES STUDIES LINKED TO 6271 05:02:29,286 --> 05:02:30,421 PROTEINS AND FUNCTIONS AND GENES 6272 05:02:30,421 --> 05:02:33,924 AND WE HAVE ANIMAL MODEL DATA 6273 05:02:33,924 --> 05:02:36,260 FROM OUR GERMAN MOUSE CLINIC 6274 05:02:36,260 --> 05:02:37,795 WHERE WE HAVE GENES CONNECTED TO 6275 05:02:37,795 --> 05:02:38,863 PROTEINS AND THEY'RE CONNECTED 6276 05:02:38,863 --> 05:02:42,266 TO FUNCTIONS OR TO PHENOTYPES. 6277 05:02:42,266 --> 05:02:46,003 THE PROBLEM IS THAT SOMETIMES 6278 05:02:46,003 --> 05:02:48,539 WE'RE LAGGING ON THE ONTOLOGY OR 6279 05:02:48,539 --> 05:02:50,708 PHENOTYPE LEVEL WE'RE LACKING 6280 05:02:50,708 --> 05:02:53,010 THE CONNECTION THERE. 6281 05:02:53,010 --> 05:02:56,080 AND WHAT WE CAN DO WITH GRAPHS 6282 05:02:56,080 --> 05:03:05,456 EASILY WE CAN INFER DATA AND 6283 05:03:05,456 --> 05:03:11,395 A -- CAN PREDICT THIS AND THERE 6284 05:03:11,395 --> 05:03:16,333 ARE ORTHOLOGS AND WE INFER A NEW 6285 05:03:16,333 --> 05:03:21,005 RELATIONSHIP BETWEEN THE 6286 05:03:21,005 --> 05:03:23,941 PHENOTYPE TERM IN THE DATABASE 6287 05:03:23,941 --> 05:03:31,282 MARK IT'S PREDICTIVE IN SILICO. 6288 05:03:31,282 --> 05:03:40,191 IN THE END YOU CAN MAP FROM 6289 05:03:40,191 --> 05:03:42,460 HUMAN TO ANIMAL PHENOTYPES AND 6290 05:03:42,460 --> 05:03:46,063 IT TRANSLATES AND WE LOOK IN THE 6291 05:03:46,063 --> 05:03:48,933 MOUSE MODEL HOW IT LOOK AND THE 6292 05:03:48,933 --> 05:03:52,503 UNDERLYING THINGS. 6293 05:03:52,503 --> 05:03:54,572 WHERE HE USE THE KNOWLEDGE GRAPH 6294 05:03:54,572 --> 05:03:56,373 FOR DIFFERENT KINDS OF USES. 6295 05:03:56,373 --> 05:03:58,876 I INTRODUCE THREE USES WE MAINLY 6296 05:03:58,876 --> 05:04:00,444 HAD AND SHOW YOU A LITTLE BIT 6297 05:04:00,444 --> 05:04:04,248 WHAT WE'VE DONE WITH THE USERS. 6298 05:04:04,248 --> 05:04:06,016 THE FIRST USER WAS 6299 05:04:06,016 --> 05:04:07,451 STRAIGHTFORWARD WHICH WAS BIO 6300 05:04:07,451 --> 05:04:09,687 CHEMIST DOING OMICS EXPERIMENT 6301 05:04:09,687 --> 05:04:12,089 MAINLY TRANSCRIPTOMICS AND THEY 6302 05:04:12,089 --> 05:04:14,792 WERE INTERESTED IN WHAT ARE THE 6303 05:04:14,792 --> 05:04:16,227 CONNECTED MESH TERMS AND 6304 05:04:16,227 --> 05:04:20,030 PHENOTYPES IN PUB MED AND THE 6305 05:04:20,030 --> 05:04:22,333 PUBLICATIONS BASED ON MY GENES 6306 05:04:22,333 --> 05:04:24,168 FROM MY CHIP'S DATA CONNECTED 6307 05:04:24,168 --> 05:04:33,244 AND WHAT THEY COULD DO IS DRAG 6308 05:04:33,244 --> 05:04:37,181 AND DROP AND HIT THE BUTTON AND 6309 05:04:37,181 --> 05:04:39,083 AUTOMATICALLY THE GRAPH WAS 6310 05:04:39,083 --> 05:04:41,418 QUERIED AND THE OUTPUT WAS THE 6311 05:04:41,418 --> 05:04:43,153 LIST OF GENES MENTIONED IN 6312 05:04:43,153 --> 05:04:45,689 SPECIFIC PUBLICATIONS BUT ALSO 6313 05:04:45,689 --> 05:04:46,190 WITH MESH TERMS OR WITH 6314 05:04:46,190 --> 05:04:49,126 PHENOTYPES. 6315 05:04:49,126 --> 05:04:50,761 VERY STRAIGHTFORWARD. 6316 05:04:50,761 --> 05:04:54,732 ONE INPUT AND ONE OUTPUT AND THE 6317 05:04:54,732 --> 05:04:56,300 APPLICATION IS SUPER EASY. 6318 05:04:56,300 --> 05:04:58,235 WHAT ABOUT THE USERS THAT DO NOT 6319 05:04:58,235 --> 05:05:00,070 KNOW WHERE TO START IN THE HUGE 6320 05:05:00,070 --> 05:05:02,506 KNOWLEDGE GRAPH AND DON'T KNOW 6321 05:05:02,506 --> 05:05:05,075 WHERE TO PROGRESS AND USE IT AS 6322 05:05:05,075 --> 05:05:15,619 AN INVESTIGATIVE JOURNEY THERE? 6323 05:05:27,064 --> 05:05:29,266 THIS GRAPH HAD ALMOST 5 BILLION 6324 05:05:29,266 --> 05:05:32,303 RELATIONSHIPS AND THINK OF 6325 05:05:32,303 --> 05:05:33,170 TRAVERSING THAT RICH DATA IN AN 6326 05:05:33,170 --> 05:05:35,172 EASY MANNER AND VISUALLY 6327 05:05:35,172 --> 05:05:36,073 EXPLORING AND FOLLOWING THE 6328 05:05:36,073 --> 05:05:37,474 PATHS THROUGH THE DIFFERENT 6329 05:05:37,474 --> 05:05:39,543 KINDS OF DATA SETS HERE. 6330 05:05:39,543 --> 05:05:42,980 THIS IS WHERE WE CONNECTED THE 6331 05:05:42,980 --> 05:05:43,280 APPLICATION. 6332 05:05:43,280 --> 05:05:50,387 THIS IS A SUPER NICE TOOL. 6333 05:05:50,387 --> 05:05:53,023 I CAN GIVE A LIVE DEMO AND IF 6334 05:05:53,023 --> 05:05:54,291 YOU WANT TO SEE SOMETHING LIVE 6335 05:05:54,291 --> 05:05:57,061 JUST LET ME KNOW AND DROP ME AN 6336 05:05:57,061 --> 05:05:57,294 E-MAIL. 6337 05:05:57,294 --> 05:06:00,531 I'M HAPPY TO HELP YOU OUT. 6338 05:06:00,531 --> 05:06:02,766 THE THIRD USER GROUP WAS RATHER 6339 05:06:02,766 --> 05:06:06,103 DATA SCIENTISTS. 6340 05:06:06,103 --> 05:06:08,339 THEY KNOW JAVA IS A PROGRAMMING 6341 05:06:08,339 --> 05:06:08,606 LANGUAGE. 6342 05:06:08,606 --> 05:06:14,578 THEY KNOW QUERY LANGUAGES AND 6343 05:06:14,578 --> 05:06:21,018 FOR THEM WE HAD I BROWSER TO DO 6344 05:06:21,018 --> 05:06:24,922 AGGREGATION AND WORK WITH THE 6345 05:06:24,922 --> 05:06:27,691 DATA AND SO THESE ARE THE USES 6346 05:06:27,691 --> 05:06:31,395 WE HAD AND KNOW I SHOW YOU SOME 6347 05:06:31,395 --> 05:06:34,798 USE CASES. 6348 05:06:34,798 --> 05:06:36,900 SOME WERE INTERESTED IN A GENE 6349 05:06:36,900 --> 05:06:40,170 AND THEY WERE INTERESTED IN THE 6350 05:06:40,170 --> 05:06:42,640 GENE OR PROTEIN-PROTEIN 6351 05:06:42,640 --> 05:06:44,041 INTERACTION FROM GENE TO RNA 6352 05:06:44,041 --> 05:06:46,377 INTERACTION AND THE 6353 05:06:46,377 --> 05:06:48,912 PROTEIN-PROTEIN ACTION AND 6354 05:06:48,912 --> 05:06:49,947 PROTEIN-PROTEN INTERACTIONS OF 6355 05:06:49,947 --> 05:06:52,249 THE INTERACTIONS AND THE RICH 6356 05:06:52,249 --> 05:06:52,616 NETWORK. 6357 05:06:52,616 --> 05:06:55,853 WE HAVE THEM AS A SAID MAPPING 6358 05:06:55,853 --> 05:06:59,590 THE IDENTIFIERS AND THE 6359 05:06:59,590 --> 05:07:05,896 DIFFERENT PUBLIC DATABASES LIKE 6360 05:07:05,896 --> 05:07:07,898 NCBI AND SOMETHING LIKE THAT AND 6361 05:07:07,898 --> 05:07:10,634 FOR THIS EXAMPLE WE WERE 6362 05:07:10,634 --> 05:07:15,839 INTERESTED IN THE TCF7L2 AND YOU 6363 05:07:15,839 --> 05:07:18,742 SEE THE ROUGHLY 15 NODE THAT ARE 6364 05:07:18,742 --> 05:07:20,377 BASICALLY THE SAME GENE BUT HAVE 6365 05:07:20,377 --> 05:07:26,684 DIFFERENT IDENTIFIERS AND WOULD 6366 05:07:26,684 --> 05:07:31,789 YOU KNOW THIS IS TCF7L2? 6367 05:07:31,789 --> 05:07:32,990 RATHER NOT, RIGHT. 6368 05:07:32,990 --> 05:07:35,059 AND YOU CAN EASILY QUERY OVER 6369 05:07:35,059 --> 05:07:37,261 THE DATABASES EASILY. 6370 05:07:37,261 --> 05:07:40,297 AND FOR DATABASE DEVELOPER SOME 6371 05:07:40,297 --> 05:07:41,331 MAY BE DATABASE DEVELOPERS IN 6372 05:07:41,331 --> 05:07:44,668 THE AUDIENCE, THIS IS A ONE-LINE 6373 05:07:44,668 --> 05:07:45,903 QUERY WHILE THIS WOULD BE AND 6374 05:07:45,903 --> 05:07:48,439 THEN YOU GO TO THE NEXT SLIDE WE 6375 05:07:48,439 --> 05:07:52,109 DID A SIMILAR EXAMPLE ON THE 6376 05:07:52,109 --> 05:07:55,979 RIGHT SIDE ONE OR TWO ONE LINE 6377 05:07:55,979 --> 05:07:57,614 OR TWO LINE STATEMENT FOR GRAPH 6378 05:07:57,614 --> 05:08:00,284 DATABASE FOR A PROTEIN-PROTEIN 6379 05:08:00,284 --> 05:08:02,653 INTERACTION AND ON THE LEFT SIDE 6380 05:08:02,653 --> 05:08:08,358 THE CLASSIC WAY OF DATABASES. 6381 05:08:08,358 --> 05:08:13,697 IT'S NOT ONLY LONG IN THE CODE 6382 05:08:13,697 --> 05:08:19,570 BUT ALSO VERY UNPERFORMATIVE AND 6383 05:08:19,570 --> 05:08:20,904 IN NATIVE GRAPH DATABASE IS 6384 05:08:20,904 --> 05:08:23,540 POINTERS AN MEMORY AND WE'RE WAY 6385 05:08:23,540 --> 05:08:25,109 FASTER THAN NORMAL DATABASES FOR 6386 05:08:25,109 --> 05:08:31,648 SUCH CONNECTED PROBLEMS. 6387 05:08:31,648 --> 05:08:34,518 IF WE THINK WE DON'T WANT TO 6388 05:08:34,518 --> 05:08:36,153 EXPLORE ONLY GENES AND THEIR 6389 05:08:36,153 --> 05:08:40,991 SYNONYMS BUT WANT TO EXPLORE RNA 6390 05:08:40,991 --> 05:08:42,793 AND PROTEINS AND LEGACY 6391 05:08:42,793 --> 05:08:44,194 IDENTIFIERS AND GENE ONTOLOGY 6392 05:08:44,194 --> 05:08:46,263 TERMS AND ALSO SNIPS FROM GWAS 6393 05:08:46,263 --> 05:08:47,798 STUDIES AND TRAITS AND SO ON. 6394 05:08:47,798 --> 05:08:50,334 USUALLY THE USERS ARE JUMP FROM 6395 05:08:50,334 --> 05:08:52,569 ONE TO THE OTHER DATABASE USING 6396 05:08:52,569 --> 05:08:54,204 EXCEL SHEETS AND LISTS. 6397 05:08:54,204 --> 05:08:55,539 THIS WON'T HAPPEN HERE. 6398 05:08:55,539 --> 05:09:00,644 THIS IS EVERYTHING IN ONE 6399 05:09:00,644 --> 05:09:04,248 DATABASE AND YOU CAN EASILY 6400 05:09:04,248 --> 05:09:07,117 WRITE A QUERY LIKE A FIVE-LINE 6401 05:09:07,117 --> 05:09:13,757 STATEMENT AND JUNG FROM THE 6402 05:09:13,757 --> 05:09:19,963 TRAIT DIABETES MELLITUS AND IT'S 6403 05:09:19,963 --> 05:09:24,835 CONNECTED TO THE GENE AND WE 6404 05:09:24,835 --> 05:09:27,838 JUMPED FROM REF SEQ AND SHOWED 6405 05:09:27,838 --> 05:09:34,711 THE RNAs AND WE JUMPED TO THE 6406 05:09:34,711 --> 05:09:40,017 RNA LEVEL AND THE IDENTIFIER AND 6407 05:09:40,017 --> 05:09:46,623 IT'S CONNECTED TO THE GENE 6408 05:09:46,623 --> 05:09:57,134 ONTOLOGY AND WHY ARE WHERE HE 6409 05:10:01,872 --> 05:10:02,573 DOING THE GRAPH? 6410 05:10:02,573 --> 05:10:11,582 WE CONNECTED THE DATA WITH 6411 05:10:11,582 --> 05:10:14,151 CLINICAL DATA WITH PATIENTS 6412 05:10:14,151 --> 05:10:17,721 COMING FROM ECRFs. 6413 05:10:17,721 --> 05:10:20,891 WE CONNECTED THE DATA FROM THE 6414 05:10:20,891 --> 05:10:21,258 PATIENTS. 6415 05:10:21,258 --> 05:10:23,560 GOING TO THE NEXT SLIDE AND WE 6416 05:10:23,560 --> 05:10:24,995 CONNECTED TRANSCRIPTOMICS DATA 6417 05:10:24,995 --> 05:10:27,965 OF THE PATIENTS. 6418 05:10:27,965 --> 05:10:33,337 WE HAVE DEEP FINGERPRINT OF THE 6419 05:10:33,337 --> 05:10:33,637 PATIENTS. 6420 05:10:33,637 --> 05:10:36,340 VERY RICH DATA BUT HIGHLY 6421 05:10:36,340 --> 05:10:37,507 UNSTRUCTURED DATA. 6422 05:10:37,507 --> 05:10:39,409 WE CAN USE GRAPH DATA SIGNS THAT 6423 05:10:39,409 --> 05:10:41,044 TAKES INTO ACCOUNT THE 6424 05:10:41,044 --> 05:10:44,815 STRUCTURE. 6425 05:10:44,815 --> 05:10:48,252 THE PTOPOLOGY TO DO THE GRAPH AD 6426 05:10:48,252 --> 05:10:51,188 REPRESENT THE RICH DATA IN A 6427 05:10:51,188 --> 05:11:01,665 VECTOR FOR MACHINE LEARNING. 6428 05:11:10,507 --> 05:11:12,676 I CAN GO DEEPER AND PLEASE LET 6429 05:11:12,676 --> 05:11:15,178 ME KNOW IF YOU NEED MORE 6430 05:11:15,178 --> 05:11:18,649 INFORMATION ON THAT. 6431 05:11:18,649 --> 05:11:21,418 AND WE CAN NOW CONNECT THE 6432 05:11:21,418 --> 05:11:22,419 PATIENT DATA TO THE KNOWLEDGE 6433 05:11:22,419 --> 05:11:24,688 GAP I SPEAK BEFORE AND ASK THE 6434 05:11:24,688 --> 05:11:25,856 QUESTION FROM THE LEFT TO THE 6435 05:11:25,856 --> 05:11:29,793 RIGHT WE HAVE AN RNA HERE A 6436 05:11:29,793 --> 05:11:30,961 TRANSCRIPT SUPER INTERESTING AND 6437 05:11:30,961 --> 05:11:34,131 WHAT DO WE KNOW FROM THE 6438 05:11:34,131 --> 05:11:39,569 EXTERNAL DATA SOURCES IN PUB MED 6439 05:11:39,569 --> 05:11:49,813 OR IN ARCHIVE. 6440 05:11:53,050 --> 05:11:58,422 AND WITH THE LARGE LANGUAGE 6441 05:11:58,422 --> 05:12:05,796 MODELS AND CHAT GPT ARE NOT THAT 6442 05:12:05,796 --> 05:12:07,331 GOOD BECAUSE THEY HALLUCINATE 6443 05:12:07,331 --> 05:12:09,466 AND IT'S A BLACK BOX AND WE GET 6444 05:12:09,466 --> 05:12:13,804 SOMETHING BACK WE DON'T KNOW 6445 05:12:13,804 --> 05:12:15,906 WHAT IT'S CAUSING AND CAN'T 6446 05:12:15,906 --> 05:12:20,177 EXPLAIN IT AND KNOWLEDGE GRAPHS 6447 05:12:20,177 --> 05:12:26,116 AND WE CONNECT THE LARGE 6448 05:12:26,116 --> 05:12:33,724 LANGUAGE MODEL A KNOWLEDGE GRAPH 6449 05:12:33,724 --> 05:12:37,861 AND WE CAN QUERY THE DATA AND 6450 05:12:37,861 --> 05:12:42,265 USE NATURAL LANGUAGE AND WE CALL 6451 05:12:42,265 --> 05:12:49,706 THIS ROUNDING. 6452 05:12:49,706 --> 05:12:51,074 THEY'RE CONNECTED AND IT'S AN 6453 05:12:51,074 --> 05:12:56,146 EXPLAINABLE WAY TO FIND THE 6454 05:12:56,146 --> 05:13:01,718 ANSWER OF YOUR QUESTION. 6455 05:13:01,718 --> 05:13:03,186 YOU HAVE GRAPH STRUCTURES IN 6456 05:13:03,186 --> 05:13:04,654 YOUR KNOWLEDGE GRAPH HERE AND IF 6457 05:13:04,654 --> 05:13:06,390 YOU GO TO THE NEXT SLIDE YOU'RE 6458 05:13:06,390 --> 05:13:09,159 LOOKING FOR PATTERNS YOU WANT TO 6459 05:13:09,159 --> 05:13:10,761 IDENTIFY FOR EXAMPLE HERE FIVE 6460 05:13:10,761 --> 05:13:13,230 NODES JUST LIKE A RANDOM EXAMPLE 6461 05:13:13,230 --> 05:13:16,566 IN THE DATA SET THAT IS KIND OF 6462 05:13:16,566 --> 05:13:19,469 YOUR ANALYSIS OF MAYBE A PATIENT 6463 05:13:19,469 --> 05:13:20,871 JOURNEY THAT IS INTERESTING OR 6464 05:13:20,871 --> 05:13:24,074 THIS IS AWKWARD BEING AN OUTLIER 6465 05:13:24,074 --> 05:13:26,109 AND NOW FIVE PATIENTS WITH THE 6466 05:13:26,109 --> 05:13:27,944 SAME PATTERN AND YOU LOOK FOR 6467 05:13:27,944 --> 05:13:29,146 PATTERNS AND PROPERTIES AND YOU 6468 05:13:29,146 --> 05:13:30,981 DIG DEEPER AND TRY TO EXPLAIN 6469 05:13:30,981 --> 05:13:32,115 WHAT IT'S ALL ABOUT. 6470 05:13:32,115 --> 05:13:37,654 WITH THIS I'M AT THE LAST SLIDE 6471 05:13:37,654 --> 05:13:41,591 OF MY PRESENTATION. 6472 05:13:41,591 --> 05:13:44,561 LEFT SIDE IS THE DATABASE ITSELF 6473 05:13:44,561 --> 05:13:51,034 HOLDING NODES AND RELATIONSHIPS 6474 05:13:51,034 --> 05:13:58,742 ON TOP OF THE GRAPH ALGORITHMS 6475 05:13:58,742 --> 05:14:02,579 AND NEW TARGETS FOR NEW DISEASES 6476 05:14:02,579 --> 05:14:05,415 AND WE HAVE ALGORITHMS TO FIND 6477 05:14:05,415 --> 05:14:08,151 BOTTLENECKS OR ALTERNATIVE. 6478 05:14:08,151 --> 05:14:12,255 WE CAN USE PATIENT HETEROGENEITY 6479 05:14:12,255 --> 05:14:13,690 FOR CLASSIFYING PATIENT AND SO 6480 05:14:13,690 --> 05:14:17,160 ON AND SO FORTH. 6481 05:14:17,160 --> 05:14:18,962 AND THE REALLY LAST SLIDE I WANT 6482 05:14:18,962 --> 05:14:21,431 TO SUM UP WE HAVE NOW MORE THAN 6483 05:14:21,431 --> 05:14:24,167 70 ALGORITHMS HELPING YOU TO 6484 05:14:24,167 --> 05:14:25,235 MAKE MORE OUT OF YOUR DATA 6485 05:14:25,235 --> 05:14:27,104 KEEPING THE RELATIONSHIPS AND 6486 05:14:27,104 --> 05:14:31,842 THE CONNECTIONS BETWEEN YOUR 6487 05:14:31,842 --> 05:14:33,944 DATA AND MAKE MORE OF YOUR DATA. 6488 05:14:33,944 --> 05:14:36,346 WITH THIS I HOPE I'M STILL ON 6489 05:14:36,346 --> 05:14:37,781 TIME AND HAPPY TO TAKE QUESTIONS 6490 05:14:37,781 --> 05:14:39,516 AND THANK YOU FOR YOUR ATTENTION 6491 05:14:39,516 --> 05:14:41,518 AND I HOPE THAT WAS INFORMATIVE 6492 05:14:41,518 --> 05:14:44,721 AND A DIDN'T RUSH TOO MUCH. 6493 05:14:44,721 --> 05:14:48,091 >> WOW. 6494 05:14:48,091 --> 05:14:49,392 THAT WAS A WONDERFUL WAY TO HAVE 6495 05:14:49,392 --> 05:14:51,595 A CONCLUDING TALK. 6496 05:14:51,595 --> 05:14:53,630 REALLY PROVOCATIVE AND 6497 05:14:53,630 --> 05:14:53,930 THOUGHTFUL. 6498 05:14:53,930 --> 05:14:55,398 I'LL HAVE TO HAVE YOU VISIT ME 6499 05:14:55,398 --> 05:14:59,136 TO THINK OF HOW TO DO SOMETHING 6500 05:14:59,136 --> 05:15:00,504 WITH WHAT SOUNDS LIKE BOTH 6501 05:15:00,504 --> 05:15:04,508 INNOVATIVE AND POWERFUL AND YET 6502 05:15:04,508 --> 05:15:04,774 ABSTRACT. 6503 05:15:04,774 --> 05:15:06,243 >> ABSOLUTELY. 6504 05:15:06,243 --> 05:15:10,280 AND SORRY TO BE SO ENTHUSIASTIC. 6505 05:15:10,280 --> 05:15:13,817 I WAS A CUSTOMER SIX YEAR AND SO 6506 05:15:13,817 --> 05:15:14,451 ENTHUSIASTIC ABOUT THE 6507 05:15:14,451 --> 05:15:17,354 TECHNOLOGY BECAUSE I HAD SO MANY 6508 05:15:17,354 --> 05:15:20,023 I HAD IN MY CAREER BEFORE AND IN 6509 05:15:20,023 --> 05:15:22,292 THE PHARMA INDUSTRY I WAS STUCK 6510 05:15:22,292 --> 05:15:24,127 IN THE RIGID TABLES AND THEY 6511 05:15:24,127 --> 05:15:27,330 WERE SPARSE BECAUSE THE DATA IS 6512 05:15:27,330 --> 05:15:28,465 HETEROGENOUS AND YOU CAN'T STORE 6513 05:15:28,465 --> 05:15:34,137 IT SO EASILY AND THE GRAPH THING 6514 05:15:34,137 --> 05:15:36,106 AND I WAS SUPER SURPRISED. 6515 05:15:36,106 --> 05:15:38,341 DO YOU KNOW THE MOST POPULAR 6516 05:15:38,341 --> 05:15:40,110 EXAMPLE FOR THE GRAPH DATABASE? 6517 05:15:40,110 --> 05:15:42,979 >> THE MOST POPULAR EXAMPLE? 6518 05:15:42,979 --> 05:15:46,016 >> THE MOST POPULAR IN HOW DO 6519 05:15:46,016 --> 05:15:49,986 YOU SAY IN THE INTERNET IS THE 6520 05:15:49,986 --> 05:16:00,597 PANAMA PAPERS WERECYTERR -- WER 6521 05:16:08,805 --> 05:16:17,914 CIPHERE D AND THE PERFORMS AND 6522 05:16:17,914 --> 05:16:18,548 MAKING IMPLICIT RELATIONSHIPS 6523 05:16:18,548 --> 05:16:20,050 BETWEEN THE ENTITIES NOW 6524 05:16:20,050 --> 05:16:21,918 EXPLICIT IN YOUR DATABASE IS THE 6525 05:16:21,918 --> 05:16:22,552 GAME CHANGER AND THE PERFORMANCE 6526 05:16:22,552 --> 05:16:28,258 ON A LARGE SCALE. 6527 05:16:28,258 --> 05:16:29,726 >> IT MAKES SENSE. 6528 05:16:29,726 --> 05:16:31,194 TO ME IT'S NICE TO END ON TOOLS 6529 05:16:31,194 --> 05:16:33,096 AND FOR ME THE KEY IS WHICH 6530 05:16:33,096 --> 05:16:43,640 TOOLS ARE FIT FOR WHAT PURPOSE? 6531 05:16:56,286 --> 05:16:57,354 I THINK WE MAY BE TOWARDS THE 6532 05:16:57,354 --> 05:16:59,656 END SO WE MAY BE READY TO WRAP 6533 05:16:59,656 --> 05:17:00,023 UP. 6534 05:17:00,023 --> 05:17:01,658 IF PEOPLE TURN ON THEIR CAMERAS 6535 05:17:01,658 --> 05:17:12,168 I'D LOVE IT TO SEE THE GROUP. 6536 05:17:24,581 --> 05:17:27,317 >> GRAPH IS A STRUCTURE TO STORE 6537 05:17:27,317 --> 05:17:29,352 DATA AND HAVE A MEANING BETWEEN 6538 05:17:29,352 --> 05:17:34,591 THE ENTITIES. 6539 05:17:34,591 --> 05:17:38,628 A CORRELATION NETWORK IS A GRAPH 6540 05:17:38,628 --> 05:17:44,067 AND A CORRELATION NETWORK I 6541 05:17:44,067 --> 05:17:47,570 THINK YOU MEAN SOMETHING LIKE 6542 05:17:47,570 --> 05:17:48,405 CORRELATING TO EACH OTHER. 6543 05:17:48,405 --> 05:17:53,109 I WOULD SAY IT'S A GRAPH. 6544 05:17:53,109 --> 05:17:55,145 IT'S A GENERIC GRAPH WITH ONE 6545 05:17:55,145 --> 05:17:57,947 TYPE OF LINK AND ONLY NUMBERS 6546 05:17:57,947 --> 05:18:00,083 FOR THE LINK WHEREAS IT SEEMS 6547 05:18:00,083 --> 05:18:01,751 YOU ALLOW FOR DIFFERENT LINK AND 6548 05:18:01,751 --> 05:18:02,886 CLASSES OF OBJECTS. 6549 05:18:02,886 --> 05:18:11,294 >> YEAH. 6550 05:18:11,294 --> 05:18:14,631 I OFTEN WHY AREN'T I DOING 6551 05:18:14,631 --> 05:18:15,765 SOMETHING IN X BUT IF YOU WANT 6552 05:18:15,765 --> 05:18:18,702 TO INTEGRATE BILLIONS OF NODE 6553 05:18:18,702 --> 05:18:22,605 AND RELATIONSHIP AND PERSIST 6554 05:18:22,605 --> 05:18:25,475 THAT THIS IS WHY YOU USE A GRAPH 6555 05:18:25,475 --> 05:18:25,742 DATABASE. 6556 05:18:25,742 --> 05:18:27,977 IF YOU HAVE SMALLER NETWORKS 6557 05:18:27,977 --> 05:18:33,149 LIKE 1,000 NODES AND SEVERAL 6558 05:18:33,149 --> 05:18:36,186 THOUSANDS RELATIONSHIPS, USE 6559 05:18:36,186 --> 05:18:38,521 WITH YOUR R APPLICATION BUT THE 6560 05:18:38,521 --> 05:18:41,358 BIG CUSTOMERS OF OURS AND WE 6561 05:18:41,358 --> 05:18:44,094 HAVE 75% OF THE FORTUNE 100 FROM 6562 05:18:44,094 --> 05:18:49,132 THE DIFFERENT INDUSTRIES THEY'RE 6563 05:18:49,132 --> 05:18:54,904 ALL USING THIS AND THE MEMORY IS 6564 05:18:54,904 --> 05:18:58,007 MASSIVE AND YOU HAVE TO HAVE 6565 05:18:58,007 --> 05:19:04,848 INTELLIGENT ALGORITHMS. 6566 05:19:04,848 --> 05:19:09,352 >> IF WE CAN REMOVE THE SLIDES 6567 05:19:09,352 --> 05:19:16,459 BECAUSE I'D LIKE TO SEE THE AL- 6568 05:19:16,459 --> 05:19:16,760 ALGORITHMS. 6569 05:19:16,760 --> 05:19:17,994 ARE THERE MULTIPLE STUDIES AND 6570 05:19:17,994 --> 05:19:19,896 THERE'S CONCERN THEY MAY LIVE IN 6571 05:19:19,896 --> 05:19:24,167 DIFFERENT PLACES, CAN WE HAVE 6572 05:19:24,167 --> 05:19:25,235 YOUR GEOGRAPHY LEARN FROM EACH 6573 05:19:25,235 --> 05:19:26,770 STUDY AND INTEGRATE IN SOME WAY 6574 05:19:26,770 --> 05:19:28,805 WITHOUT HAVING THE DATA MOVE? 6575 05:19:28,805 --> 05:19:30,573 >> ABSOLUTELY. 6576 05:19:30,573 --> 05:19:39,182 AND I DIDN'T WANT TO BE TOO 6577 05:19:39,182 --> 05:19:41,718 TECHNICAL. 6578 05:19:41,718 --> 05:19:44,421 I CAN'T SPEAK FOR COMPETITORS 6579 05:19:44,421 --> 05:19:47,624 THEY DO THEIR OWN WAY WE HAVE A 6580 05:19:47,624 --> 05:19:48,958 FEDERATED VERSION SO YOU CAN 6581 05:19:48,958 --> 05:19:53,663 SPREAD THAT EVEN IF WE THINK OF 6582 05:19:53,663 --> 05:19:55,765 GDPR IT MAKES SENSE TO SCATTER 6583 05:19:55,765 --> 05:19:59,235 IT SOMEWHERE ELSE AND IF THINK 6584 05:19:59,235 --> 05:20:00,370 OF FINANCIAL DATA AND COMMERCIAL 6585 05:20:00,370 --> 05:20:05,942 DATA THIS IS ALSO A USE CASE 6586 05:20:05,942 --> 05:20:06,309 THERE. 6587 05:20:06,309 --> 05:20:09,379 SO YES AND WE CAN HAVE HYBRID 6588 05:20:09,379 --> 05:20:12,282 SOLUTIONS SAYING WE HAVE A 6589 05:20:12,282 --> 05:20:15,018 RELATIONSHIP ON YOUR CLUSTER AND 6590 05:20:15,018 --> 05:20:18,221 HAVE A HYBRID SOLUTION WHERE 6591 05:20:18,221 --> 05:20:19,222 NON-SENSITIVE DATA ARE NOT SO 6592 05:20:19,222 --> 05:20:20,924 MUCH RELEVANT DATA IS SITTING IN 6593 05:20:20,924 --> 05:20:21,925 ANY CLOUD. 6594 05:20:21,925 --> 05:20:23,927 >> THERE'S ANOTHER QUESTION 6595 05:20:23,927 --> 05:20:26,930 ABOUT CAN WE CHECK FOR CAUSAL 6596 05:20:26,930 --> 05:20:27,630 RELATIONSHIPS USING THE DATABASE 6597 05:20:27,630 --> 05:20:27,931 TECHNOLOGY. 6598 05:20:27,931 --> 05:20:35,138 >> ABSOLUTELY. 6599 05:20:35,138 --> 05:20:37,040 AND WE KNOW THE DATA IS HIGH 6600 05:20:37,040 --> 05:20:37,907 QUALITY DATA. 6601 05:20:37,907 --> 05:20:41,578 THE SHORT ANSWER IS GARBAGE IN, 6602 05:20:41,578 --> 05:20:43,847 GARBAGE OUT AND IF YOU HAVE HIGH 6603 05:20:43,847 --> 05:20:45,281 QUALITY DATA AND DO CAUSAL 6604 05:20:45,281 --> 05:20:47,116 RELATIONSHIPS AND WE HAVE ONE 6605 05:20:47,116 --> 05:20:49,419 EXAMPLE THEY HAVE CAUSAL 6606 05:20:49,419 --> 05:20:51,020 RELATIONSHIPS BUT ALSO 6607 05:20:51,020 --> 05:20:52,222 CORRELATIONS BETWEEN SO TWO 6608 05:20:52,222 --> 05:20:53,990 DIFFERENT RELATIONSHIPS BETWEEN 6609 05:20:53,990 --> 05:20:56,659 TWO NODES AND YOU KNOW YOU CAN 6610 05:20:56,659 --> 05:20:58,828 SAY BETWEEN THESE TWO I WANT 6611 05:20:58,828 --> 05:20:59,796 RELATIONSHIP THAT'S A CAUSAL 6612 05:20:59,796 --> 05:21:03,166 RELATIONSHIP OR A CORRELATION. 6613 05:21:03,166 --> 05:21:04,767 SO YES. 6614 05:21:04,767 --> 05:21:07,170 >> I LIKE I GUESS THERE WAS A 6615 05:21:07,170 --> 05:21:07,904 MODIFICATION YOU'RE SAYING IF 6616 05:21:07,904 --> 05:21:10,106 YOU PUT CAUSAL RELATIONSHIP YOU 6617 05:21:10,106 --> 05:21:12,141 CAN GET CAUSAL RELATIONSHIPS. 6618 05:21:12,141 --> 05:21:13,343 IF YOU PUT IN ASSOCIATION YOU 6619 05:21:13,343 --> 05:21:16,880 BETTER THINK ABOUT ALL THE 6620 05:21:16,880 --> 05:21:17,981 THINGS CALLED SCIENCE BEFORE YOU 6621 05:21:17,981 --> 05:21:18,848 CONCLUDE CAUSE. 6622 05:21:18,848 --> 05:21:20,550 >> EXACTLY. 6623 05:21:20,550 --> 05:21:22,652 AND IT HIGHLY DEPENDS WHAT TYPE 6624 05:21:22,652 --> 05:21:24,220 OF DATA YOU'RE INTEGRATING IF 6625 05:21:24,220 --> 05:21:25,188 YOU'RE INTEGRATING CAUSAL DATA 6626 05:21:25,188 --> 05:21:27,690 BECAUSE YOU KNOW THE DATA IS 6627 05:21:27,690 --> 05:21:29,826 CONNECTED LIKE THES, WELL, YOU 6628 05:21:29,826 --> 05:21:30,593 HAVE YOUR CAUSALITY. 6629 05:21:30,593 --> 05:21:35,698 >> EXCELLENT. 6630 05:21:35,698 --> 05:21:36,633 THERE'S TECHNICAL QUESTIONS 6631 05:21:36,633 --> 05:21:37,667 ABOUT GRAPHING. 6632 05:21:37,667 --> 05:21:38,735 I DON'T KNOW THERE. 6633 05:21:38,735 --> 05:21:39,802 MORE AND MORE PEOPLE I LOVE 6634 05:21:39,802 --> 05:21:43,506 HAVING PEOPLE COME ON. 6635 05:21:43,506 --> 05:21:45,642 WE STILL HAVE 83 PEOPLE. 6636 05:21:45,642 --> 05:21:53,783 I THINK WE'RE READY FOR CLOSING 6637 05:21:53,783 --> 05:21:55,685 REMARKS BY PROFESSOR DUNN AND 6638 05:21:55,685 --> 05:21:57,787 MYSELF BUT I SEE ERIC BOERWINKLE 6639 05:21:57,787 --> 05:22:01,591 AS A DEAN I SEE YOU'RE TAKING 6640 05:22:01,591 --> 05:22:04,627 THE TIME TO ATTEND MULTIPLE 6641 05:22:04,627 --> 05:22:04,894 SESSIONS. 6642 05:22:04,894 --> 05:22:05,695 I ALWAYS LEARN HAVING LOOKED AT 6643 05:22:05,695 --> 05:22:07,497 THIS FOR A WHILE. 6644 05:22:07,497 --> 05:22:10,099 >> FIRST I'LL SAY THIS IS MORE 6645 05:22:10,099 --> 05:22:18,007 INTERESTING THAN BEING A DEAN. 6646 05:22:18,007 --> 05:22:19,742 CLEARLY, MY IMPRESSION IS THIS 6647 05:22:19,742 --> 05:22:20,977 SHOULD BE CONSIDERED THE FIRST 6648 05:22:20,977 --> 05:22:28,017 OF MULTIPLE SESSIONS LIKE IT. 6649 05:22:28,017 --> 05:22:31,888 THIS IS CLEARLY AN EMERGING 6650 05:22:31,888 --> 05:22:34,290 FIELD AND IN SOME WAYS IT'S A 6651 05:22:34,290 --> 05:22:35,325 SUCCESSFUL MEANING IDENTIFYING 6652 05:22:35,325 --> 05:22:37,493 CHALLENGES AND SOLUTIONS. 6653 05:22:37,493 --> 05:22:40,964 AND SO I THINK YOU ALL SHOULD 6654 05:22:40,964 --> 05:22:44,067 CONSIDER THIS A VERY SUCCESSFUL 6655 05:22:44,067 --> 05:22:44,300 MEETING. 6656 05:22:44,300 --> 05:22:45,535 >> THANK YOU VERY MUCH. 6657 05:22:45,535 --> 05:22:47,136 I'LL CALL ON GABRIEL FOR A 6658 05:22:47,136 --> 05:22:49,005 MOMENT BECAUSE HE CALLED ME A 6659 05:22:49,005 --> 05:22:50,840 FEW MONTHS AGO AND I WAS LIKE 6660 05:22:50,840 --> 05:22:54,077 OH, MY GOD ONE MORE THING TO DO. 6661 05:22:54,077 --> 05:22:55,845 BUT YOU DID A WONDERFUL BEING 6662 05:22:55,845 --> 05:22:57,080 WONDERFUL JOB OF DOING SO MUCH 6663 05:22:57,080 --> 05:23:00,116 OF THE HEAVY LIFTING THAT I KNOW 6664 05:23:00,116 --> 05:23:01,951 JESSILYN AND MYSELF ARE MOST 6665 05:23:01,951 --> 05:23:04,354 GRATEFUL AND I REALLY DO THINK 6666 05:23:04,354 --> 05:23:08,524 WE HAD A LOVELY MEETING SPANNING 6667 05:23:08,524 --> 05:23:10,293 REALLY A VERY WIDE ARRAY OF 6668 05:23:10,293 --> 05:23:10,693 SCIENCE. 6669 05:23:10,693 --> 05:23:13,162 ANY WORDS, GABRIEL? 6670 05:23:13,162 --> 05:23:14,397 >> NOPE. 6671 05:23:14,397 --> 05:23:16,566 THANK YOU, EVERYONE SO MUCH FOR 6672 05:23:16,566 --> 05:23:17,834 PARTICIPATING IN THE WORKSHOP. 6673 05:23:17,834 --> 05:23:21,404 WE DID A LOT OF WORK TO TRY TO 6674 05:23:21,404 --> 05:23:27,443 BRING LAKE DR. KORE CAN -- 6675 05:23:27,443 --> 05:23:30,079 DR. CORESH MENTIONED CAST A WIDE 6676 05:23:30,079 --> 05:23:32,815 NET AND SCIENCE IS SO BROAD AND 6677 05:23:32,815 --> 05:23:34,884 WE'RE WORK IN OUR SPECIFIC SWIM 6678 05:23:34,884 --> 05:23:36,819 LANES SOMETIMES BUT ALL THE DATA 6679 05:23:36,819 --> 05:23:42,058 WE ARE TRYING TO BRING IT 6680 05:23:42,058 --> 05:23:47,897 TOGETHER AND I GET TOO MUCH 6681 05:23:47,897 --> 05:23:51,367 INFORMATION AND WE HAVE SO MANY 6682 05:23:51,367 --> 05:23:52,602 MISSING DIAGNOSES AND ISSUES. 6683 05:23:52,602 --> 05:23:54,737 WARE TRYING TO INTEGRATE ALL THE 6684 05:23:54,737 --> 05:23:56,506 DIFFERENT DATA SOURCES TO 6685 05:23:56,506 --> 05:23:59,208 ULTIMATELY PROVIDE A BENEFIT TO 6686 05:23:59,208 --> 05:23:59,909 THE POPULATION. 6687 05:23:59,909 --> 05:24:01,911 THAT'S THE BIG PICTURE AND I 6688 05:24:01,911 --> 05:24:06,749 APPRECIATE EVERYONE'S 6689 05:24:06,749 --> 05:24:09,285 PARTICIPATION AND HOPEFULLY LIKE 6690 05:24:09,285 --> 05:24:10,019 DR. BOERWINKLE SAID HOPEFULLY 6691 05:24:10,019 --> 05:24:11,454 THE FIRST OF MANY. 6692 05:24:11,454 --> 05:24:12,288 >> THANK YOU. 6693 05:24:12,288 --> 05:24:15,158 PROFESSOR DUNN. 6694 05:24:15,158 --> 05:24:21,364 >> I WANT TO ECHO THE THANK YOU 6695 05:24:21,364 --> 05:24:23,900 TO GABE, GINA, THE NIH TEAM FOR 6696 05:24:23,900 --> 05:24:25,334 MAKING THIS WORKSHOP HAPPEN. 6697 05:24:25,334 --> 05:24:26,936 I THINK ONE OF THE THINGS I 6698 05:24:26,936 --> 05:24:30,573 FOUND SO COOL ABOUT THE 6699 05:24:30,573 --> 05:24:32,675 STRUCTURE WAS THAT WE HAVE 6700 05:24:32,675 --> 05:24:34,010 EXAMPLES OF LARGE DATA SETS. 6701 05:24:34,010 --> 05:24:39,148 WE HAVE EXAMPLES OF HANDS-ON 6702 05:24:39,148 --> 05:24:40,650 TUTORIALS AND METHODS AND THE 6703 05:24:40,650 --> 05:24:43,786 IDEA IS TO TRY AND SYNTHESIS ALL 6704 05:24:43,786 --> 05:24:46,789 THE PIECES TOGETHER SO WE'VE HAD 6705 05:24:46,789 --> 05:24:47,757 A LOT OF SPECIFIC QUESTIONS WELL 6706 05:24:47,757 --> 05:24:49,692 IF I WANTED TO BE ABLE TO ACCESS 6707 05:24:49,692 --> 05:24:49,892 DATA. 6708 05:24:49,892 --> 05:24:54,831 IF I WANTED TO APPLY A NEW 6709 05:24:54,831 --> 05:24:57,100 METHOD HOW CAN I DO THAT? 6710 05:24:57,100 --> 05:25:00,303 THE HOPE IS WITH THE VARIETY OF 6711 05:25:00,303 --> 05:25:02,271 RESOURCES AND VARIETY OF 6712 05:25:02,271 --> 05:25:03,206 CONTACTS THAT WE'VE INCLUDED 6713 05:25:03,206 --> 05:25:05,007 TODAY PEOPLE START TO CONNECT 6714 05:25:05,007 --> 05:25:07,977 AND HOPEFULLY CONNECT THE DOTS 6715 05:25:07,977 --> 05:25:11,247 SO THAT WE'RE ADVANCING AT A 6716 05:25:11,247 --> 05:25:12,648 MUCH FASTER PACE. 6717 05:25:12,648 --> 05:25:16,119 AGAINST THE CONTACT INFORMATION 6718 05:25:16,119 --> 05:25:17,587 IS AVAILABLE FOR ANYONE OF THE 6719 05:25:17,587 --> 05:25:17,854 SPEAKERS. 6720 05:25:17,854 --> 05:25:18,688 IF YOU HAVE ANY QUESTIONS ABOUT 6721 05:25:18,688 --> 05:25:20,690 HOW TO GET IN TOUCH, PLEASE 6722 05:25:20,690 --> 05:25:24,560 DON'T HESITATE TO REACH OUT TO 6723 05:25:24,560 --> 05:25:25,962 THE ORGANIZERS, CHAIRS. 6724 05:25:25,962 --> 05:25:31,067 WE HOPE THIS IS A CATALYST TO 6725 05:25:31,067 --> 05:25:32,535 START OFF MORE CROSS POLL NATION 6726 05:25:32,535 --> 05:25:36,606 BETWEEN THE METHODOLOGISTS AND 6727 05:25:36,606 --> 05:25:47,116 THE DATA GENERATORS -- CROSS 6728 05:25:48,551 --> 05:25:48,785 POLLINATION. 6729 05:25:48,785 --> 05:25:54,524 >> I MAY TAKE THE PREROGATIVE OF 6730 05:25:54,524 --> 05:25:54,757 CLOSING. 6731 05:25:54,757 --> 05:25:59,095 SO LET'S TRY A MINUTE OF 6732 05:25:59,095 --> 05:25:59,896 SUMMARIZING THE DATA. 6733 05:25:59,896 --> 05:26:02,665 TODAY WE STARTED WITH THE DATA 6734 05:26:02,665 --> 05:26:04,534 THEMSELVES AND IT'S HUMBLING AND 6735 05:26:04,534 --> 05:26:06,669 AMAZING TO LOOK AT WHAT U.K. BIO 6736 05:26:06,669 --> 05:26:08,571 BANK, ALL OF US AND MVP ARE 6737 05:26:08,571 --> 05:26:08,771 DOING. 6738 05:26:08,771 --> 05:26:10,506 I THINK IT'S IMPORTANT TO DO 6739 05:26:10,506 --> 05:26:15,178 THINGS BIG, MEDIUM AND SMALL AND 6740 05:26:15,178 --> 05:26:19,816 CONNECT THEM. 6741 05:26:19,816 --> 05:26:28,157 WE HAD A CHARGED TALK BY BRUCE 6742 05:26:28,157 --> 05:26:34,263 PSATY AND WHEN YOU EMPHASIZE THE 6743 05:26:34,263 --> 05:26:36,032 SCIENTISTS AND NOT JUST THE DATA 6744 05:26:36,032 --> 05:26:37,099 AND REALIZE THERE'S PEOPLE 6745 05:26:37,099 --> 05:26:38,801 BEHIND IT IT GROWS AND THRIVES. 6746 05:26:38,801 --> 05:26:43,873 WE HAVE TO MAKE SURE WE DON'T 6747 05:26:43,873 --> 05:26:47,176 UNDER VALUE THE PEOPLE IN 6748 05:26:47,176 --> 05:26:49,078 THINKING ABOUT THE DATA. 6749 05:26:49,078 --> 05:26:52,215 THEN WE WENT INTO THE AFTERNOON 6750 05:26:52,215 --> 05:26:53,616 WITH NEW TOOLS, ERIC HAD WORDS 6751 05:26:53,616 --> 05:26:57,053 OF WISDOM WHICH I THOUGHT WERE 6752 05:26:57,053 --> 05:26:58,187 GREAT AND THEN IT WAS 6753 05:26:58,187 --> 05:27:01,457 INTERESTING TO SEE ALL THE 6754 05:27:01,457 --> 05:27:06,896 DIFFERENT TOOLS AND THE 6755 05:27:06,896 --> 05:27:11,467 MIND-BOGGLING GRAPH AND THIS 6756 05:27:11,467 --> 05:27:12,668 GETS ME TO THE POINT THAT I 6757 05:27:12,668 --> 05:27:16,205 THINK WE'RE CREATING A NEW 6758 05:27:16,205 --> 05:27:16,505 LANGUAGE. 6759 05:27:16,505 --> 05:27:19,909 SO TO SOME EXTENT MY FAMILY IS 6760 05:27:19,909 --> 05:27:22,578 MORE INTO HUMANITIES. 6761 05:27:22,578 --> 05:27:25,615 MY WIFE DREW THIS PAINTING WHICH 6762 05:27:25,615 --> 05:27:27,617 REPRESENTS THE SCIENCE THE HEAT 6763 05:27:27,617 --> 05:27:30,186 MAP FROM LOW GRF TO HIGH RISK 6764 05:27:30,186 --> 05:27:31,220 AND IT'S INTERESTING TO SEE 6765 05:27:31,220 --> 05:27:33,089 BROAD THINKERS AND I'M LOOKING 6766 05:27:33,089 --> 05:27:34,123 AT ERIC. 6767 05:27:34,123 --> 05:27:36,125 OFTEN THERE'S DETAILED STOP AND 6768 05:27:36,125 --> 05:27:41,297 THEN THERE'S THE BIGGER PICTURE 6769 05:27:41,297 --> 05:27:42,465 THAT GIVES CONTEXT. 6770 05:27:42,465 --> 05:27:44,967 IT USED TO BE PEOPLE NEEDED TO 6771 05:27:44,967 --> 05:27:47,336 LEARN A FOREIGN LANGUAGE LIKE IF 6772 05:27:47,336 --> 05:27:48,504 YOU LEARN ENGLISH YOU SHOULD 6773 05:27:48,504 --> 05:27:54,143 LEARN SPANISH OR FRENCH. 6774 05:27:54,143 --> 05:27:55,177 I THINK COMPUTER SCIENCE SAY 6775 05:27:55,177 --> 05:27:57,113 LANGUAGE AND WAY OF THINKING 6776 05:27:57,113 --> 05:27:57,880 THAT NOW SHOULD BECOME MANDATORY 6777 05:27:57,880 --> 05:28:08,124 FOR ALL OF US. 6778 05:28:08,457 --> 05:28:10,760 MACHINE LEARNING AND A.I. IS SO 6779 05:28:10,760 --> 05:28:13,362 IMPORTANT AND NOT FORGOTTEN THE 6780 05:28:13,362 --> 05:28:17,033 DISCIPLINES OF MEDICINE, 6781 05:28:17,033 --> 05:28:21,971 SOCIOLOGY, ANTHROPOLOGY AND 6782 05:28:21,971 --> 05:28:25,474 PUBLIC HEALTH ALL OF SCIENCE IS 6783 05:28:25,474 --> 05:28:25,741 TOGETHER. 6784 05:28:25,741 --> 05:28:27,710 I'LL CONCLUDE WITH A COUPLE 6785 05:28:27,710 --> 05:28:32,915 PROPOSALS I LOOKED UP ABOUT 6786 05:28:32,915 --> 05:28:33,149 SCIENCE. 6787 05:28:33,149 --> 05:28:37,486 THERE'S ONLY FOUR, WELL, FIVE 6788 05:28:37,486 --> 05:28:39,522 ONE IS TWO SENTENCES. 6789 05:28:39,522 --> 05:28:42,825 THE FIRST ONE IS SCIENCE IS THE 6790 05:28:42,825 --> 05:28:46,996 GREAT ANECDOTE SO THE POISON OF 6791 05:28:46,996 --> 05:28:48,564 ENTHUSIASM AND SUPERSTITION. 6792 05:28:48,564 --> 05:28:52,068 I THINK ENTHUSIASM'S GREAT BUT 6793 05:28:52,068 --> 05:28:53,703 APPLIES IN SCIENCE. 6794 05:28:53,703 --> 05:28:57,039 AND THEN BY A SCIENTIST I READ 6795 05:28:57,039 --> 05:29:03,679 ABOUT AS A KID MARIE COURI, 6796 05:29:03,679 --> 05:29:06,115 NOTHING IN LIFE IS TO BE FEARED 6797 05:29:06,115 --> 05:29:07,283 BUT ONLY UNDERSTAND AND WE HAVE 6798 05:29:07,283 --> 05:29:08,884 TO THINK ABOUT THAT AND THIS WAS 6799 05:29:08,884 --> 05:29:15,725 BACK WHEN RADIATION WAS NEW I 6800 05:29:15,725 --> 05:29:19,295 THINK HUMANITY WOULD DRAW MORE 6801 05:29:19,295 --> 05:29:21,364 GOOD THAN EVIL FROM NEW 6802 05:29:21,364 --> 05:29:21,664 DISCOVERIES. 6803 05:29:21,664 --> 05:29:26,969 WE HAVE TO BE HOSPIOPTIMISTIC AE 6804 05:29:26,969 --> 05:29:29,538 GOOD THING ABOUT SCIENCE WHETHER 6805 05:29:29,538 --> 05:29:30,840 OR NOT YOU BELIEVE IT IS THE 6806 05:29:30,840 --> 05:29:34,410 LAST QUOTE. 6807 05:29:34,410 --> 05:29:36,145 AT LATEST I GOT ERIC AMUSED. 6808 05:29:36,145 --> 05:29:37,480 THANK YOU EVERYONE FOR ATTENDING 6809 05:29:37,480 --> 05:29:39,582 AND UNLESS I MADE A MISTAKE, 6810 05:29:39,582 --> 05:29:49,582 THIS IS THE END OF OUR TWO DAYS.