I WOULD LIKE TO CALL TO ORDER THE
OPEN SESSION FOR COUNCIL FOR
COMPLEMENTARY INTEGRATIVE
HEALTH. THIS MEETING IS
CONDUCTED VIRTUALLY FOR ALL
PARTICIPANTS AND NIH STAFF AND
COUNCIL MEMBERS. THIS MEETING
IS RECORDED AND BROADCAST TO THE
PUBLIC. FIRST ORDER OF BUSINESS
IS TO APPROVE THE SEPTEMBER 22
COUNCIL MINUTES WHICH WAS
PROVIDED TO ALL OF THE COUNCIL
MEMB
MEMBERS [INDISCERNIBLE]. ARE
THERE CORRECTIONS OR REVISIONS
FOR THIS SEPTEMBER 22 COUNCIL
MEETING? PLEASE RAISE YOUR HAND
IF -- NO?
THEN MAY I HAVE A MOTION TO
APPROVE THE MEETING MINUTES FOR
THE SEPTEMBER 22 COUNCIL
MEETING? PLEASE UNMUTE
YOURSELF. I DON'T HEAR
ANYTHING. SFWL MOVED TO ACCEPT
THE MINUTES. THIS IS NAJA.
>>OKAY. THANK YOU. ANY OTHER
DISCUSSION OR CONCERNS?
OKAY. IT IS -- DO WE HAVE A
VOTING SCREEN ON THIS ONE TOO?
PERFECT. PLEASE, EVERYBODY, IF
YOU WOULD VOTE.
OKAY. THE MOTION HAS PASSED AND
IS MADE.
OKAY. MEETING MINUTES HAVE BEEN
PASSED AND APPROVED. WE CAN
MOVE ON. NEXT THING WE HAVE TO
DO FOR THIS COUNCIL MEETING IS
TO APPROVE OUR OPERATING
PROCEDURES.
WE HAVE TO GO OVER THESE FIRST.
I WILL BE DOING SO. LET ME JUST
SHARE MY SCREEN HERE.
OKAY. CAN YOU SEE THE SLIDES?
OKAY. PERFECT. SO, THIS --
OKAY. COUNCIL IS REQUIRED TO
ANNUALLY REVIEW ITS OPERATING
PROCEDURES TO DETERMINE WHETHER
THEY CONTINUE TO SERVICE THE
NEEDS OF NCCIH. WE GENERALLY DO
SO AT OUR JANUARY COUNCILS.
LET'S SEE. OKAY. NCCIH AND ALL
OF THE NIH AWARDING ICS ARE
REQUIRED TO BY POLICY ESTABLISH
STANDARD OPERATING PROCEDURES
FOR INTERACTIONS THAT ARE
BETWEEN THE ADVISORY COUNCIL AND
STAFF THAT IS RESPONSIBLE FOR
THE DAY-TO-DAY MANAGEMENT OF
EXTRAMURAL PORTFOLIOS.
WHAT YOU SEE LISTED HERE ON THE
SLIDE IS ALL OF THE
RESPONSIBILITIES OF NCCIH AND
COUNCIL IN REGARDS TO MATTERS AS
THEY RELATE TO RESEARCH
ACTIVITIES AND FUNCTIONS OF
NCCIH.
SO, FOR EXAMPLE, IT IS NCCIH'S
RESPONSIBILITY TO INFORM COUNCIL
OF CURRENT SCIENTIFIC BUDGETARY
AND LEGISLATIVE ISSUES THAT
MIGHT HAVE AN IMPACT ON NCCIH AS
WELL AS SIGNIFICANT CHANGES TO
NCCIH AND NIH THAT IS INCLUDING
PERSONNEL CHANGES.
COUNCIL CONDUBLTHS THE SECONDARY
REVIEW OF APPLICATIONS FOCUSING
ON AND CONSIDERING THE ASPECTS
AND SITUATIONS THAT YOU HAVE
LISTED HERE.
BY GOING A LITTLE BIT MORE INTO
DETAIL.
FOR EXAMPLE, IN REGARDS TO GRANT
APPLICATIONS WHERE THERE IS NO
SPECIAL CONCERNS, THEY COULD BE
APPROVED ON BLOCK.
ON BLOCK MEANS THERE IS NO
DISCUSSION OF INDIVIDUAL
APPLICATIONS AND APPLICATIONS
THAT MIGHT BE APPROVED ON BLOCK
ARE THOSE THAT ARE A RELEVANT TO
NCCIH'S MISSION AND THEY HAVE NO
CONCERNS RELATED TO HUMAN
PARTICIPANTS, ANIMALS OR
BIOHAZARDS AND NO CONCERNS
REGARDING INCLUSION.
APPLICANT COULD NOT HAVE
SUBMITTED APPEAL FOR REVIEW OF
APPLICATION AND FOR GRANTS THAT
NEED SPECIAL CONSIDERATION BY
COUNCIL WOULD BE THOSE WHO ARE
NOMINATED FOR HIGH OR LOW
PROFILE PRIORITIES AND WOULD
OBVIOUSLY BE THOSE WHO HAVE
CONCERNS RELATED TO HUMAN
SUBJECTS ANIMALS AND BIOHAZARDS
WITH FOREIGN INCLUSION THAT ARE
FOREIGN APPLICATIONS THAT WE
HAVE RECEIVED AND APPEALED FOR
BY THE APPLICANT. ALSO, FOR
APPLICATIONS, WE ARE DPI THAT
RECEIVES MORE THAN 2 MILLION
DOLLARS IN COST TO SUPPORT THAT
REQUIRES SPECIAL COUNCIL REVIEW.
OPTIONS THAT ARE AVAILABLE TO
COUNCIL WOULD BE EITHER CONCUR
WITH THE PRIMARY REVIEW AND PRO
-- LOW OR HIGH PRIORITY AND
ACTIONS CATEGORIZING OTHERS AND
CHANGES IN BUDGET AND RANGE OF
SUPPORT APPLICATION COULD BE
DEFERRED UNTIL ADDITIONAL
INFORMATION HAS BEEN RECEIVED
AND MEANING THAT IT HAS TO GO TO
DIFFERENT COUNCIL AROUND OR
DEFER IT FOR ADDITIONAL INPUT
FROM THE PRIMARY REVIEW AND
OFTEN THAT INVOLVES REVIEW OF
THE APPLICATION OR COUNCIL CAN
RECOMMEND CHANGES IN THE SCOPE,
BUDGET OR DURATION OF SUPPORT
AND COUNCIL CAN RECOMMEND ALSO
TO RECOMMEND NOT TO RECOMMEND AN
APPLICATION FOR FUNDING.
SOME SITUATIONS -- NCCIH WOULD
FOLLOW UP AFTER COUNCIL THAT
WOULD NOT REQUIRE COUNCIL
RECOMMENDATIONS AND THIS WOULD
BE, FOR EXAMPLE, IF THERE IS A
CHANGE IN THE PRINCIPLE
INVESTIGATOR OF AN APPLICATION
AND IF THERE IS A CHANGE IN
INSTITUTION BY THE PI OR
APPLICATIONS DEFERRED FOR
REREVIEW BEFORE THEY GO TO
KROUNLS CRIMINAL AND
ADMINISTRATIVE SUPPLEMENTS WE
GENERALLY DON'T BRING TO
COUNCIL'S CONSIDERATION.
NCCIH HAS RECENTLY STARTED TO
USE EXPEDITED ON BLOCK
CONCURRENCE PER NIH POLICY AND
ALSO ON BLOCK CONCURRENCE IS
SUPPOSED TO EXPEDITE FUNDING
ACTIONS.
APPLICATIONS THAT WOULD BE
ILLEGIBLE FOR ON BLOCK
CONCURRENCE, EEC, WOULD BE THESE
THAT ARE PEER REVIEW THE AND
RECEIVED MERITORIOUS SCORE
DOMESTIC APPLICATIONS THAT ARE
RELEVANT TO NCCIH'S MISSION THAT
IT OCCURS GENERALLY 6 TO 7 WEEKS
PRIOR TO REGULAR MEETING OF
COUNCIL AND ALL REGULAR MEMBERS
OF COUNCIL MAY VOTE AND
APPLICATIONS MUST RECEIVE AT
LEAST TWO VOTES FOR AND NO VOTES
TO RECEIVE CONCURRENCE THAT ARE
LEGIBLE FOR FUNDING DECISIONS BY
DIRECTOR AND SUBSEQUENT
PROCESSING. ALL EEC ACTIONS
WILL BE COMMUNICATED TO COUNCIL
DURING THE REGULAR COUNCIL
MEETING.
THERE ARE EXCEPTIONAL SITUATIONS
THAT THESE WOULD BE
CIRCUMSTANCES THAT REQUIRE
SPECIAL ACTIONS.
BASED ON PROGRAMATIC
CONSIDERATIONS AND NCCIH
DIRECTOR AFTER CONSULTATION WITH
COUNCIL MAY MAKE EXCEPTIONS TO
GUIDELINES THAT WE JUST OUTLINED
AND ALL ACTIONS TAKEN WILL BE
DOCUMENTED AND REPORTED TO
COUNCIL AT ITS NEXT MEETING IF
THIS WOULD BE NECESSARY.
WHEN DECIDING ON RESEARCH
PRIORITIES, NCCIH IS SEEKING AND
RECEIVING INPUT FROM A WHOLE
VARIETY OF SOURCES LIKE, FOR
EXAMPLE, OBVIOUSLY SCIENTIFIC
COMMUNITY AND ORGANIZATIONS AND
CONQUEST AND THIS FEEDBACK LEADS
YOU OFTEN TO THE DEVELOPMENT OF
CONCEPTS THAT ARE BEING BROUGHT
TO COUNCIL'S ATTENTION.
COUNCIL MAY EITHER RECOMMEND
APPROVAL, MODIFICATION, DEFERRAL
OR DISAPPROVAL OF A CONCEPT. IF
A CONCEPT HAS BEEN APPROVED, IT
MAY LEAD TO ONE OR MORE FUNDING
OPPORTUNITY ANNOUNCEMENTS.
OKAY. IF AN APPLICANT MAY
APPEAL THE ASSESSMENT OF THE
GRANT APPLICATION BY A
SCIENTIFIC REVIEW GROUP, WE HAVE
TO ASSESS THESE APPEALS.
RELEVANT CRITERIA FOR ASSESSING
THESE WOULD BE FOR EXAMPLE THAT
THEY HAVE TO BE EFFECT YOU'LL
ERROR DURING PRIMARY REVIEW THAT
WOULD SIGNIFICANTLY CHANGE THE
SCORE OF AN APPLICATION. FOR
EXAMPLE IF A REVIEWER WRITES
ADPI HAS 10 PUBLICATIONS AND IN
REALITY DPI HAD 11 PUBLICATIONS,
YOU KNOW, THIS MAY NOT
NECESSARILY -- IT IS EFFECT
YOU'LL ERROR BUT ONE THAT
WOULDN'T HAVE SIGNIFICANTLY
CHANGED THE SCORE.
THEY ARE LOOKING IF REVIEWER IS
BIASED OR HAD CONFLICT OF
INTEREST AND IF THERE IS
SCIENTIFIC EXPERTISE ON THE
PANEL AND CRITERIA THAT WOULDN'T
BE RELEVANT WOULD BE ERRORS OF
OMISSION. FOR EXAMPLE, IF
REVIEWERS WOULDN'T COMMENT ON
CERTAIN ASPECTS OF APPLICATION
THAT IN ITSELF IS NOT CRITERIA
FOR APPEAL AND COMING DOWN TO
ISSUES GENERALLY CONSIDERED TO
BE DIFFER CENSUS IN SCIENTIFIC
OPINION AND WHAT ARE OPTIONS
THAT ONE CAN DO WHEN NCCIH HAS
RECEIVED APPEAL. LEGIBLE
APPEALS FOR PROGRAMS AND
REVIEWING THAT APPEALS ARE
JUSTIFIED.
APPEALS OFFICER AGREES AND THEN
THESE APPLICATIONS HAVE -- THEY
ARE BEING SENT TO REREVIEW
BEFORE IT EVEN COMES TO COUNCIL.
IF, HOWEVER, THE STAFF DISAGREES
AND CENSUS APPEALS AGREES OR
SUPPORTS THE APPEAL, THIS APPEAL
IS COMING TO THE COUNCIL'S
ATTENTION FOR RESOLUTION APPEALS
CONSIDER THE TO BE ILLEGIBLE
BASED ON RELEVANT CRITERIA WOULD
APPLY AND LETTER IS APPEARING TO
COUNCIL MEMBERS VIA ELECTRONIC
COUNCIL BOOK AS AN INFORMATION
ITEM ONLY AND COUNCIL MEMBERS
SEFB AS A RESOURCE IN
DEVELOPING, RECOMMENDING AND
SETTING OF NCCIH'S POLICY AS
WELL AS RESEARCH PRIORITIES AND
ON OCCASION, SPECIAL WORKING
GROUPS MAY BE FORMED BY OR AT
REQUEST TO EXAMINE AND ADDRESS
CRITICAL SCIENTIFIC POLICY
ISSUES THAT ARE OF IMPORTANCE TO
NCCIH AND ITS CONSTITUENTS.
WITH THIS LET ME SEE. DO WE
HAVE A MOTION TO APPROVE THE
COUNCIL OPERATING PROCEDURES?
>>SO MOVED.
>>OKAY. DO WE HAVE A SECOND?
>>SECOND.
>>OKAY. THANK YOU. ANY
FURTHER COMMENTS TO OUR COUNCIL
OPERATING PROCEDURES?
IF NOT, CAN WE PLEASE HAVE THE
VOTING SCREEN?
OKAY. AGAIN, WE DO ONLY HAVE
VOTES FOR AND NOT AGAINST. WITH
THIS, WE APPROVE THE COUNCIL
OPERATING PROCEDURES AND WITH
THIS, LET ME JUST END THIS
SHARING HERE.
I WILL GET THIS BACK TO YOU.
OKAY. WE HAVE THIS. WE ARE
MOVING ON AND I'M HANDING THE
MEETING TO DR. LUNGIVAN FOR HER
DIRECTOR'S REMARKS. THANK YOU.
>>THANK YOU SO MUCH, DR.
SCHMIDT. MY GREAT PLEASURE TO
PRESENT YOU TO MY DIRECTOR'S
REPORT TO COUNCIL. ONE SECOND.
OO
OOPS.
I'M SORRY. LY HAVE TO PERHAPS
DISCONNECT FORONE SECOND.
GIVE ME ONE LITTLE GLITCH HERE
BUT IT SHOULDN'T BE LONG.
OKAY.
CAN YOU SEE MY SCREEN NOW?
>>YES.
>>OKAY. I WILL PRESENT MY
DIRECTOR'S REPORT AND AS USUAL I
WILL START WITH NEWS RELEVANT TO
NIH AS A WHOLE AND NCCIH.
WE -- OUR FIRST -- WE ARE
THRILLED TO WELCOME OUR NEW
COUNCIL MEMBER, DR. AMALA
SUMIANAS WHO IS A PROFESSOR IN
THE NEUROLOGY DEPARTMENT AT
OREGON HEALTH AND SCIENCE
UNIVERSITY IN PORTLAND, OREGON
AND SHE RECEIVED HER PHARMACY
DEGREE AND PHD FROM THE
UNIVERSITY OF LONDON IN THE UK
AND RESEARCH INVESTIGATES
TRADITIONAL MEDICINE EXPLORING
POTENTIAL USE FOR EVIDENCE-BASED
THERAPY AND AS A SOURCE OF NOVEL
CHEMICAL LEADS FOR DRUG
DEVELOPMENTS AND SHE IS DIRECTOR
OF NCCIH FUNDED BENFRA AND
BOTANICAL DIETARY
[INDISCERNIBLE] INVESTIGATES
BOTANICALS NEUROLOGICAL AND
FUNCTIONAL RESILIENCE ENGAGING
AND IS CO-DIRECTOR OF NCCIHT32
GRANT ON NEUROSCIENCE IN STRESS
AND WOULD LIKE TO WELCOME SORRY.
WE HAVE A SLIDE HERE AND WE HAVE
A NUMBER OF ADDITIONAL AD HOC
MEMBERS THAT ARE WITH US TODAY.
WE ANTICIPATE THAT THEY WILL
JOIN US AS COUNCIL MEMBERS AT
OUR NEXT MEETING IN MAY. I WILL
FULLY INTRODUCE THEM AT THAT
TIME. THESE ADDITIONAL AD HOC
MEMBERS ARE DR. ALAN BENAVITI
PROFESSOR IN THE DEPARTMENT OF
[INDISCERNIBLE] AT YALE SCHOOL
OF MEDICINE AND [INDISCERNIBLE]
WHO IS VICE PROVOST FOR RESEARCH
AT COLLEGE OF OSTEOPATHIC
MEDICINE AND DR. DANIEL
DICKERSON ASSOCIATE PSYCHIATRIST
-- AND PROFESSOR OF LAW AT
UNIVERSITY OF SAN FRANCISCO AND
ERICA WHO IS ASSOCIATE PROFESSOR
IN PEDIATRICS AT JOHN HOPKINS
UNIVERSITY SCHOOL OF MEDICINE
AND WELCOME TO ALL OF NUT
MEMBERS.
WE HAVE A LOT OF NEW ARRIVALS
AND WELL MOSTLY DEPARTURES AT
THE MOMENT AT NCCIH. LOTS OF
PEOPLE ARE RETIRING AND IT IS MY
GREAT PLEASURE TO ANNOUNCE THAT
DR. JOANEE RUTTER HAS BEEN
APPOINTED NEW DIRECTOR OF NCAPS
NATIONAL CENTER TO ADVANCE
TRANSLATIONAL SCIENCE AND DR.
RUDER JOINED N CATS IN 2019 AS
DEPUTY DIRECTOR AND SERVED AS
NCATS ACTING DIRECTOR SINCE
APRIL OF 2021 AND PRIOR TO
JOINING NCATS DR. RUDER
ESTABLISHED SCIENTIFIC PROGRAMS
WITHIN NIH ALL OF US INITIATIVE
WE WILL HEAR ABOUT LATER THIS
AFTERNOON. WE OF COURSE ALL
KNOW THAT DR. ANTHONY FAUCI
ANNOUNCED EARLIER THIS YEAR HE
IS STEPPING DOWN AS DIRECTOR OF
NIAD. OF COURSE, YOU KNOW, HIS
ILUFT TREOUS CAREER AT NIH IS
WELL-KNOWN SERVING AS NIAD
DIRECTOR FROM 1984 TO 2022.
THAT IS 38 YEARS AND ADVISING 7
PRESIDENTS ON HIV/AIDES AND
DOMESTIC AND GLOBAL HEALTH
ISSUES INCLUDING COVID-19 AND
CAN'T THANK HIM ENOUGH TO HIS
SERVICE AND HEALTH OF AMERICANS
AROUND THE GLOBE. WE WILL MISS
YOU DR. FAUCI AND RETIRING AFTER
A LONG CAREER AT NIH IS DR. JOHN
GALEY. HE IS THE NIH ASSOCIATE
DIRECTOR FOR CLINICAL RESEARCH
AND DR. GALEN HAS HAD A LONG AND
DISTINGUISHED CAREER AT NIH
PREVIOUSLY ALSO AS SCIENTIFIC
DIRECTOR FOR INTRAMURAL RESEARCH
ACTIVITIES AT NIAID.
ANDREA NORRIS IS RETIRING AS NIH
CHIEF INFORMATION OFFICER AND
DIRECTOR OF CENTER FOR
INFORMATION TECHNOLOGY OR CIT.
AFTER SERVING IN ROLES FOR MORE
THAN A DECADE, SHE LED A $1.6
BILLION TECHNOLOGY PORTFOLIO
SUPPORTING RESEARCH OF NIH'S 27
INSTITUTES AND CENTERS INCLUDING
NICCIH AND SERVES AS RESEARCH OR
SERVED RESEARCH ERRS AT MORE
THAN 2500 UNIVERSITIES AND
MEDICAL CENTERS ACROSS THE
COUNTRY RECEIVING NIH FUNDING
SUPPORT.
DR. ROGER GLASS WILL BE RETIRING
FROM NIH AFTER MORE THAN 16
YEARS AS DIRECTOR OF FOGARTY
INTERNATIONAL CENTER AT FIC.
AND ALSO AT NIH ASSOCIATE
DIRECTOR FOR INTERNATIONAL
RESEARCH. PRIOR TO JOINING NIH,
DR. GLAS WAS A CHIEF OF VIRAL
GASTROENTERITIS UNIT AT THE
NATIONAL CENTER FOR INFECTIOUS
DISEASE AT CDC. HIS REMARKABLE
CAREER IN GLOBAL HEALTH
STRETCHES ACROSS 5 DECADES WITH
EXTENDED STAYS IN MORE THAN HALF
A DOZEN COUNTRIES.
WE WILL REALLY MISS ALL -- THIS
IS A LOT OF DEPARTURES IN A LOT
OF SENIOR LEADERSHIP AT NIH AND
WE WISH ALL OF THEM A FAREWELL
AND A LOT OF THEM RETIRING AND
GOOD HEALTH AND HAPPINESS IN
THEIR RETIREMENT AND WE WANT TO
ALSO RECOGNIZE A NUMBER OF NCCIH
AWARD STAFF FOR THEIR 2022NIH
DIRECTOR'S AWARDS AND DR. ALICE
CHESLER ANDTORI WILSON AND DAVID
SHURTLEFF FOR THEIR REMARKABLE
SERVICE IN THE PAST YEAR. WE
ALSO WANT TO MENTION THAT NIH
HAS ISSUED DATA MANAGEMENT AND
SHARING POLICY. WE HAVE BEEN
TALKING ABOUT THIS NOW FOR QUITE
A LONG TIME. NOW, IT IS HERE.
IT WILL BE EFFECTIVE JANUARY
25TH 2023. SO, JUST NEXT WEEK.
TO PROMOTE SHARING OF SCIENTIFIC
DATA.
UNDER THIS POLICY, NIH EXPECTS
THAT INVESTIGATORS AND
INSTITUTIONS, NO. 1, THEY WILL
PLAN AND BUDGET MANAGING AND
SHARING OF DATA AND SUBMIT DATA
SHARING PLAN FOR REVIEW WHEN
APPLYING FOR FUNDING. COMPLY
WITH THE APPROVED DATA SHARING
AND MANAGEMENT PLAN AND THAT THE
NIH INDIVIDUAL NIH INSTITUTE
CENTERS AND OFFICES MAY HAVE
ADDITIONAL POLICIES AND
EXPECTATIONS AND THIS IS ALL
GOING TO BE ROLLED OUT.
I'M EXPECTING THAT PEOPLE ARE --
THEY HAVE HAD A FAIR AMOUNT OF
ADVANCED NOTICE ABOUT THIS.
IT REALLY THERE HAS BEEN A LOT
OF ATTENTION TO THE DETAILS OF
IMPLEMENTING THIS PLAN. I'M
FULLY EXPECTING THAT IT ALL GOES
SMOOTHLY.
WE HAVE NOW SOME IMPORTANT STAFF
UPDATES.
IT IS, OF COURSE, WITH
TREMENDOUSLY MIXED EMOTIONS THAT
WE ANNOUNCE THE RETIREMENT OF
DR. PATEC ALSO. DR. KELSA HAS
BEEN A HUGELY IMPORTANT PART OF
NIH'S SCIENTIFIC AND SENIOR
STAFF SINCE HE JOINED THE CENTER
IN JANUARY OF 2006 AND HE BEGAN
NIH AND NCCIH CAREER AS PROGRAM
OFFICER IN DIVISION OF
EXTRAMURAL RESEARCH BRINGING
WITH HIM A WEALTH OF KNOWLEDGE
AND EXPERIENCE AS AN
INVESTIGATOR IN SENSORY
PHYSIOLOGY AND HE WAS MY PAIN
OFFICER WAY BACK WHEN I WAS AT
UNIVERSITY OF VERMONT AND 2013
BECAME DEPUTY DIRECTOR OF
EXTRAMURAL RESEARCH AND 27
TAENTOOK OVER RANGE AS DIRECTOR
OF THE DA OR DIVISION OF
EXTRAMURAL ACTIVITIES AND
EXECUTIVE SECRETARY OF NCCIH'S
COUNCIL AS MANY OF YOU KNOW HIM
IN THAT ACTIVITY. FOR NEW
COUNCIL MEMBERS THIS IS THE
FIRST COUNCIL MEETING THAT PATAK
HAS NOT BEEN THE SECRETARY. AS
DIRECTOR HE HAS SUCCESSFULLY LED
REVIEW AND GRANTS MANAGEMENT
ACTIVITIES APPLYING KEY
ATTENTION TO DETAIL AND IN-DEPTH
KNOWLEDGE OF THE GRANT PROCESS.
WE WILL ALL MISS HIM VERY MUCH
AND I'M THRILLED TO ANNOUNCE
THAT AFTER A THOROUGH SEARCH,
DR. MARTINA SCHMIDT IS APPOINTED
AS NCCIH'S NEXT DIRECTOR. SHE
IS AN EXCELLENT CHOICE FOR THE
ROLE AND SHE RECEIVED PHD IN
MICROBIOLOGY IN GERMANY IN 1997
FOLLOWED BY POST DOCTORAL
FELLOWSHIP AT NCI AND 2004
JOINED CENTER FOR SCIENTIFIC
REVIEW AS INTERN IN ONCOLOGY
[INDISCERNIBLE] AND JOINED NCCIH
IN 2005 AS A SCIENTIFIC REVIEW
OFFICER AND HAS BEEN SERVING AS
DIRECTOR OF OFFICE OF SCIENTIFIC
REVIEW SINCE 2016 AND
EFFECTIVELY LEADING AND
COORDINATING ALL ACTIVITIES
RELATED TO PEER REVIEW.
WELCOME, MARTINA. I ALSO VERY
PLEASED TO ANNOUNCE DR. JESSICA
M. HAS BEEN PROMOTED TO ACTING
DIRECTOR OF OFFICE OF SCIENTIFIC
REVIEW AND JESSICA SERVED AS A
SCIENTIFIC REVIEW OFFICER WITH
NCCIH FROM 2018 TO 2021. AFTER
WORKING AT THE DEPARTMENT OF
DEFENSE.
SHE RECENTLY RETURNED TO NCCIH
IN MAY OF 2022. JESSICA HAS A
PHD IN NEUROSCIENCE FROM THE
UNIVERSITY OF CINCINNATI
FOLLOWED BY POST DOCTORAL
FELLOWSHIP AT UNIVERSITY OF
NORTH CAROLINA CHAPEL HILL AND
ALCOHOL CONSUMPTION ON SYNAPTIC
PLASTICITY AND [INDISCERNIBLE]
AND ARE THRILLED TO WELCOME HER
TO NE HER NEW ROLE WELCOMING DR.
KEVIN MCBRIDE AS MEDICAL OFFICER
IN CLINICAL AND REGULATORY
AFFAIRS AT OKRA AT NCCIH. DR.
MCBRIDE HAS MD AT UNIVERSITY
COMPLETING RESIDENCY IN
PEDIATRICS AT ST. CHRISTOPHER'S
HOSPITAL AND [INDISCERNIBLE] AT
UNIVERSITY OF MICHIGAN. PRIOR
TO JOINING NCCIH DR. MCBRIDE
COMES WITH A WEALTH OF
EXPERIENCE FROM WORK AT NIDDCR
AND NIDDK AND AT THE FDA AND WE
ARE VERY HAPPY TO HAVE HIM ON
BOARD WITH US AT NIH AND WOULD
LIKE TO ALSO WELCOME DR.
JENNIFER GARDENER AS NEW PROGRAM
DIRECTOR IN CLINICAL RESEARCH IN
COMPLEMENTARY AND INTEGRATIVE
HEALTH GRANT IN DIVISION OF
EXTRAMURAL RESEARCH WITH A
BACKGROUND IN PSYCHOLOGY AND
COGNITIVE NEUROSCIENCE THAT IS A
WONDERFUL ADDITION TO PROGRAMS.
WELCOME.
WE ALSO HAVE NEW STAFF TO
WELCOME AS WE OFTEN DO AND IN
THE DIRECTOR AND ADMINISTRATIVE
OPERATIONS AND OKRA AND
INTRAMURAL RESEARCH AND WELCOME
TO NCCIH TO OUR NCCIH FAMILY AND
ALWAYS WELCOMING NEW PEOPLE. WE
HAVE SOME DEPARTURES IN ALL OF
THE VARIOUS ACTIVITIES.
WE WISH ALL OF THESE STAFF
MEMBERS WELL IN THEIR NEW
ENDEAVORS.
NOW, FOR BUDGET UPDATES.
WE DON'T HAVE NEW NUMBERS TO
SHARE WITH YOU FOR OUR FY23
BUDGET. I WILL PRESENT THEM TO
YOU AT OUR MAY COUNCIL.
HOWEVER, WE CAN SAY THAT WE HAVE
RECEIVED OUR BUDGET. THIS
CONSOLIDATED APROPRIATION ACT
FOR 2023 WAS SIGNED IN LATE
DECEMBER BY PRESIDENT BIDEN THAT
PROVIDED 170 MILLION 384 DOLLARS
FOR NCCIH THAT WAS AN INCREASE
IN APPROXIMATELY 6.9% OR
APPROXIMATELY $11 MILLION OVER
OUR PREVIOUS BUDGET THAT IS A
NICE INCREASE FOR US. 5 MILLION
OF THE 11 MILLION DOLLARS HAVE
BEEN SPECIFICALLY DESIGNATED FOR
PAIN RESEARCH. I THINK IT IS AN
IMPORTANT THING THAT IS -- IT
REALLY RECOGNIZES OUR LEADERSHIP
IN THIS AREA OF PAIN.
WE WILL OF COURSE BE WATCHING
VERY CAREFULLY AND WHAT HAPPENS
OVER THE COURSE OF THE FISCAL
YEAR WITH BUDGET SITUATION IN
THE FEDERAL GOVERNMENT. IF IN
THE MEANTIME, WE ARE VERY HAPPY
TO HAVE RECEIVED THIS INCREASE
OVER OUR PREVIOUS YEAR'S BUDGET.
NOW, FOR SOME PROGRAM NEWS.
SO, I'M REALLY THRILLED TO
ANNOUNCE THAT A BRIDGE TO AI
PROGRAM HAS MADE ITS FIRST
AWARD. THIS IS A PROGRAM AND
FOR BUILDING OUR CAPACITY TO DO
VERY IMPORTANT AND
TRANSFORMATIVE RESEARCH
INVOLVING ARTIFICIAL
INTELLIGENCE. THIS IS A VERY
IMPORTANT AREA FOR US ESPECIALLY
AS WE ENGAGE IN MORE COMPLEX
PROJECTS THAT ARE INVOLVING THE
WHOLE PERSON HAS ARTIFICIAL
INTELLIGENCE AND TEACHING TO
DEAL WITH LARGE DATA SETS IS
VERY, VERY IMPORTANT FOR NCCIH.
SO, THESE AWARDS AND NCCIH IS
ONE OF FIVE INSTITUTES AND
CENTERS AT NIH LEADING BRIDGE TO
PROGRAM AND DR. LANAY MUD IS ONE
OF THE PROGRAM COORDINATORS FOR
THIS PROJECT. SHE HAS BEEN
DOING A FANTASTIC JOB AT
CO-LEADING THIS.
SO, THESE ARE THE 5 DATA -- WE
CALL THEM DATA GENERATION
PROJECTS THAT HAVE BEEN
FUNNELEDED AND THEY ARE TO
GENERATE FLAGSHIP DATA SETS TO
EXAMINE A VARIETY OF DIFFERENT
AREAS OF FOCUS.
ONE AREA THAT I WANT TO POINT
OUT TO YOU OR AWARDED TO
UNIVERSITY OF WASHINGTON IS A
PROJECT ON SOLUCO GENESIS THAT
IS GENERATING A DATA SET TO
UNDERSTAND THE PROGRESS OF BOTH
SOLUCO GENESIS MEANING RETURNING
TO HEALTH IN PATIENTS THAT ARE
PREDIAGNOSED WITH DIABETES.
THIS IS VERY INTERESTING. WE
WILL BE VERY EXCITED TO FALL
UNDER THE REALM OF ALL THESE
PROJECTS AND IN PARTICULAR THIS
LEUKO GENESIS PROJECT AND IN
ADDITION THREE CENTER AWARDS
RESPONSIBLE FOR INTEGRATING
ACTIVITIES AND KNOWLEDGE ACROSS
DATA GENERATION PROJECTS AND
DISSEMINATING PRODUCTS BEST
PRACTICES AND TRAINING FOR
MATERIALS THAT ARE GOING TO BE
GENERATED FROM THIS BRIDGE TO AI
OVERALL INITIATIVE.
THIS IS REALLY MEANT TO BUILD
THE CAPACITY OF THE RESEARCH
ENTERPRISE AS A WHOLE TO REALLY
ALLOW US TO DO CAREFULLY
ANNOTATED AND COLLECT DATA SETS
THAT ARE NOT ONLY, YOU KNOW,
FOUND BUT ALSO PROPERLY
ANNOTATED TO BE USED TO DO
ARTIFICIAL INTELLIGENCE.
ALSO, I'M VERY EXCITED TO --
THAT THE AWARDS HAVE BEEN MADE
FOR THE HEAL INITIATIVE PROJECT
PROGRAM ON DEVELOPING
QUANTITATIVE IMAGING AND
RELEVANT BIOMARKERS OF MIOFACIAL
TISSUES OF CLINICAL PAIN
MANAGEMENT. THIS IS SOMETHING
LEADING COMPLETELY FUNDED BY
HEAL INITIATIVE AND THESE AWARDS
AS YOU CAN SEE HERE, THEY ARE
REALLY GOING TO BE -- THIS IS
ALL GROUNDBREAKING TO LOOK AT
MIOFACIAL TISSUES USING A
VARIETY OF DIFFERENT METHODS
INCLUDING NEW TYPES OF METHODS
USING IMAGING, MRI, ULTRASOUND
POSITIVE TRANSMITTING
LOAMOGRAPHY AND FOR EXAMPLE
SPECTROSCOPY AND IN VARIOUS
COMBINING DIFFERENT TYPES OF
VARIOUS MEASURES.
WE ARE VERY EXCITED THAT THIS IS
A VERY NEW DIRECTION FOR THE
HEAL INITIATIVE TO REALLY BE
TAKING A LOOK AT SOME MIOFACIAL
TISSUES THAT HAVE VERY MUCH BEEN
NEGLECTED IN PREVIOUS RESEARCH.
WE ARE VERY HAPPY ABOUT THAT.
ALSO, AWARDS HAVE BEEN MADE FOR
AN INITIATIVE ALSO WITHIN FIELD
FOR RESTORING JOINT HEALTH AND
FUNCTIONING TO REDUCE PAIN OR
REJOIN. THESE AWARDS YOU WILL
SEE THEY ARE DISCUSSED CHARACTER
RISING NEURONAL INNOVATION OF
HEALTHY AND INJURED JOINTS
SPECIFICALLY TEMPORAL MAN
DIBULAR JOINT AND COUNCIL
MEETINGS DISCUSSING AT NCCIH
UNDERSTANDING THE JOINT AS A
WHOLE IS VERY IMPORTANT.
INCLUDING THE ARTICULAR AND
PERIARTICULAR TISSUES INCLUDING
BIO MIOFACIAL TISSUES AND
UNDERSTANDING HOW INNERVATION OF
TISSUES CONTINUES TO DEVELOPMENT
OF PAIN AND LOSS OF FUNCTION AND
ALSO THE POTENTIAL TO RESTORE
FUNCTION AND PREVENT THE
DEVELOPMENT OF CHRONIC PAIN AND
WE FEEL THAT THESE ARE -- THIS
INITIATIVE IS VERY RELEVANT. I
WILL TALK A BIT LATER TO A
WORKSHOP WE WILL HOLD LATER ON
IN THE YEAR ON WHOLE JOINT HEAL
MG AND I'M VERY PLEASED TO LET
YOU KNOW THAT NIH SUPPORTED
RESEARCH ON CANNABIS, CAN
ABINNOIDS AND RELATED COMPOUND
WEBSITE WAS PUBLISHED IN EARLY
JANUARY. GIVEN THIS
CONSIDERABLE INTEREST IN
RESEARCH COMMUNITY ON RESEARCH
ON CANNABIS AND THERAPEUTIC USES
OF CANNABIS AND CONSTITUENT
COMPOUNDS THESE NEW RESOURCES
OFFERS INVESTIGATORS LOTS OF
RESOURCES TO HELP TO EXAMINE
CHEMICAL, PHYSIOLOGICAL AND
THERAPEUTIC PROPERTIES OF CAN
ABINNOIDS AND ALSO THE
PHYSIOLOGICAL SYSTEMS THAT THESE
EFFECT. I INVITE YOU IF YOU ARE
INTERESTED IN THIS FIELD TO
CHECK OUT THIS WEBSITE.
I ALSO WANT TO MENTION SOME
UPDATES ON SOUND HEALTH
INITIATIVE THAT YOU HEARD A FAIR
AMOUNT ABOUT IN PRIOR COUNCIL
MEETINGS, PARTNERSHIPS AMONG AND
BETWEEN NIH AND NATIONAL
ENDOWMENT FOR THE ARTS AND
KENNEDY CENTER FOR PERFORMING
ARTS AND NATIONAL SYMPHONY
ORCHESTRA OCTOBER SECOND AND
THIRD AT KENNEDY CENTER DR.
COLLINS HOSTED EVENT FEATURING
ROSTER OF WORLD CLASS ARTISTS
PERFORMANCE AND CONVERSATION
WITH MUSIC THERAPISTS
RESEARCHERS AND SCIENTISTS
INCLUDING DR. EDWARDS AND DR.
CHEN FROM NCCIH AND DR. EDWARDS
AND CHEN WERE PART OF SOCIETY
FOR NEUROSCIENCE SYMPOSIUM LAST
NOVEMBER CALLED MUSIC AND BRAIN
CIRCUITRY STRATEGIES FOR
STRENGTHENING EVIDENCE BASED
BRAIN RESEARCH AND WE HAVE
[INDISCERNIBLE] THAT RECENTLY
CLOSED BACK IN DECEMBER ON
RESEARCH NETWORKS TO PROMOTE
MULTI-DISCIPLINARY MECHANISTIC
STUDIES ON MUSIC FOR PAIN AND
ALZHEIMER'S DISEASE AND
ALZHEIMER'S DISEASE RELATED
DEMENTIA AND WE WILL BE
REVIEWING THE APPLICATIONS IN
UPCOMING MONTHS.
NOW, SOME IMPORTANT NEWS AND
UPDATES REGARDING OUR EFFORTS
TOWARDS DIVERSITY AT NIH.
SO, THE -- ON SEPTEMBER 29TH,
2022, THE NIH PUBLISHED THE
FIRST PROGRESS REPORT OF THE
UNITE INITIATIVE.
AND IT WAS LAUNCHED IN FEBRUARY
2021.
AND UNIT IS A VERY, VERY
IMPORTANT PROGRAM AT NIH THAT
ACTS AS A THINK TANK TO PROMOTE
EQUITY, GENERATE BOLD IDEAS AND
INITIATE ACTIONS TO IDENTIFY AND
ADDRESS STRUCTURAL RACISM.
PROGRESS REPORT FOR UNITE IS --
IT CAN BE FOUND AT THE LINK
SHOWN OR BY SEARCHING FOR UNITE
PROGRESS REPORT AT NIH WEBSITE
AND I STRONGLY ADVISE YOU TO
CHECK OUT THIS REPORT AND WE
WILL BE UPDATING THIS
FREQUENTLY.
I ALSO WANT TO DRAW YOUR
ATTENTION TO A NEW -- AN
INITIATIVE SPEARHEADED BY THE
NIH OFFICE OF DISEASE
PREVENTION, ODP, THAT PERTAINS
TO THE CURRENT US MENTAL HEALTH
CRISIS THAT DISPROPORTIONATELY
IS EFFECTING UNDERSERVED
COMMUNITY ON THIS NIH INITIATIVE
IS CALLED ADVANCE OR ADVANCING
RESEARCH FOR HEALTH EQUITY.
THERE HAS BEEN RECENTLY A
PUBLISHED RFI OR REQUEST FOR
INFORMATION TO SEEK INPUT FROM
THE COMMUNITY ABOUT PREVENTION
AND PREVENTIVE INTERVENTION
STRATEGIES ADDRESSING SOCIAL
DETERMINANTS OF HEALTH TO
PREVENT MENTAL HEALTH
POPULATIONS THAT ARE
EXPERIENCING HEALTH DISPARITIES
AND DUE DATES PROVIDING FEEDBACK
ON THIS RFI IS MARCH FIRST.
I WANT TO ALSO BRING TO YOUR
ATTENTION A COMMENTARY PAPER IN
THE JOURNAL TRANSLATIONAL
BEHAVIOR MEDICINE THAT IS BY
STAFF FROM OBSSR AND NIMHD AND
NIDA AND NICCH CALLING FOR
COMPREHENSIVE RESEARCH TO
PROMOTE DIGITAL EQUITY AND
JUSTICE AND AUTHORS MAKE FIVE
SPECIFIC RECOMMENDATIONS THAT
HAVE A NUMBER OF PRACTICE,
POLICY, AND RESEARCH
IMPLICATIONS.
FIRST, CENTERING EQUITY IN
RESEARCH TEAMS AND THEORETICAL
APPROACHES. SECOND, FOCUSING ON
ISSUES OF DIGITAL HEALTH
LITERACY ENGAGEMENT. THIRD,
USING METHODS ELEVATING
PERSPECTIVES AND NEEDS OF
UNDERSERVED POPULATIONS.
4TH, ENSURING ETHICAL
APPROACHES FOR COLLECTING AND
USING DIGITAL HEALTH DATA.
FINALLY, DEVELOPING STRATEGIES
FOR INTEGRATING DIGITAL HEALTH
TOOLS WITHIN AND ACROSS SYSTEMS
AND SETTINGS.
NOW, LET'S TAKE A LOOK AT SOME
RECENT HIGHLIGHTS.
OOPS.
MY SLIDES ARE NOT ADVANCING
ANYMORE. WHAT IS HAPPENING?
THERE. SOME RESEARCH HIGHLIGHTS
AND RESEARCH THAT NCCIH HAS
EITHER FUNDED OR CO-FUNDED.
FIRST, THIS IS A STUDY FROM THE
UNIVERSITY OF TEXAS THAT IS
SUPPORTED ABOUT I U41 GRANT.
AND BY DR. JOHN MCMULLIN'S GROUP
FROM UNIVERSITY OF TEXAS AND DR.
MCMULIN USED TO BE ON THIS
COUNCIL. THIS IS A VERY
INTERESTING STUDY LOOKING AT
MECHANISMS OF DEVELOPING REALLY
IMPORTANT METHODS TO STUDY THE
MECHANISMS OF ACTIONS OF NATURAL
PRODUCTS THAT IS VERY
CHALLENGING WHEN YOU ARE DOING
HIGH THROUGHPUT SCREENING AND
NATURAL PRODUCTS TO COMBINE THIS
WITH SORT OF LOOKING AT WHAT THE
TYPES OF MECHANISMS THAT THESE
PRODUCTS MIGHT BE CONNECTED TO.
THIS RESEARCH TEAM DEVELOPED A
COMPREHENSIVE PLATFORM THAT USES
A VERY NOVEL COMBINATION OF GENE
EXPRESSION PROFILING AND
IMAGE-BASED PHENOTYPIC SCREENING
AND MASS SPECK ANALYSIS. WHAT
THEY HAVE DONE IS BY COMBINING
ALL THESE EFFORTS TOGETHER AND
TECHNIQUES TOGETHER, THEY ARE
ABLE TO MAP, FOR EXAMPLE,
UNKNOWN SUBSTANCES ON TO A SORT
OF A LIST OF COMPOUNDS AND SORT
OF DETERMINE THE WHERE -- THE
PROPERTIES FOR THEM -- THE
COMBINED PROPERTIES FOR AN
UNKNOWN SUBSTANCE IN
RELATIONSHIP TO UNKNOWN MET
ABOLOITS. THIS IS VERY
INTERESTING AND IS A VERY NOVEL
METHOD THAT HOPEFULLY WILL BE OR
HAVE BROAD APPLICATIONS.
THIS OTHER STUDY, A VERY
INTERESTING STUDY BY THE GROUP
LED BY CHRISTINE GERTZ. IT IS
VERY -- IT IS A SECONDARY
EXAMINATION OF MULTI-SITE
PRAGMATIC CLINICAL TRIAL
COMPARING USUAL MEDICAL CARE TO
USUAL CARE PLUS CHIROPRACTIC
CARE. IN THE PREVIOUS
PUBLICATION, THERE HAD ALREADY
BEEN A REPORT THERE WERE
BENEFICIAL EFFECTS OF THIS
COMBINATION ON PAIN AND THESE
ARE PATIENTS WITH LOW BACK PAIN
AND SO LOW BACK PAIN AND
DISABILITY AND THIS NEW STUDY
EXTENDED THIS BY SHOWING
BENEFICIAL IMPACTS OF
CHIROPRACTIC CARE EXTENDS
THROUGH MULTIPLE ASPECTS OF
HEALTH INCLUDING PHYSICAL
FUNCTION PAIN INTERFERENCE SLEEP
DISTURBANCE ANXIETY AND
DEPRESSION WITH SOCIAL ROLES.
THIS IS VERY, VERY IMPORTANT AS
WE ARE STARTING TO LOOK AT
EFFECTS OF DIFFERENT
INTERVENTIONS ON MULTICOMPONENT
AND ALSO MULTISYSTEM OUTCOMES
AND THIS NEXT STUDY IS VERY
INTERESTING AND IMPORTANT. IT
LOOKS -- IT IS -- IT IS A -- ONE
-- A NEW -- TWO RECENT
PUBLICATIONS FROM THE VITAL
TRIAL THAT IS A VERY LARGE
CLINICAL TRIAL THAT IS INVOLVING
MORE THAN 20,000 PARTICIPANTS
LOOKING AT VITAMIN D AND O-MEGA
3 FATTY ACIDS. THE PRINCIPLE
USE OF ESPECIALLY VITAMIN D IS
ESTIMATED THAT 60 YEARS -- AT
LEAST 1/3 OF US ADULTS OVER 60
YEARS OF AGE TAKE VITAMIN D
SUPPLEMENTS AND ONE OF THE MAJOR
REASONS PEOPLE TAKE VITAMIN D
SUPPLEMENTS IS TO PREVENT
FRACTURES THAT HAS BEEN SO
ENGRAINED AND SUCH AN ACCEPTED
PART OF OUR RECOMMENDATIONS TO
PATIENTS.
AND SO MUCH SO THAT IN THE PAST
YEARS, WE HAVE ACTUALLY RISEN
OUR RANGE WHAT IS CONSIDERED TO
BE A HEALTHY VITAMIN D LEVEL.
WHAT THIS STUDY HAS SHOWN IS IN
FACT THERE IS NO DIFFERENCE OR
BENEFICIAL EFFECTS OF VITAMIN D
ON FRACTURES.
AND ALSO IN THE MOST RECENT
STUDY ON FRAILTY IN OLDER
ADULTS. THIS IS CONCERNING
BECAUSE WE -- THIS IS VERY
IMPORTANT TO KNOW THAT AT --
THIS IS QUITE A DEFINITIVE STUDY
AND IS EXTREMELY
WELL-CONTROLLED. WE HAVE TO
THINK ABOUT THIS CAREFULLY ABOUT
OUR PERHAPS RECOMMENDATIONS AS
TO WHETHER VITAMIN D SHOULD BE
RECOMMENDED FOR PREVENTION OF
FRACTURES SPECIFICALLY.
LET'S SEE.
NOW, SOME FUNDING OPPORTUNITIES.
FIRST, WE HAVE A NOTICE OF
SPECIAL INTEREST OR NO SEE FROM
THE BRAIN INITIATIVE THAT IS A
NOTICE OF SUPPORT FOR RESEARCH
ON INTERRECEPTION CIRCUITS WITH
MULTIPLE DUE DATES BEFORE THE
EXPIRATION DATE OF OCTOBER 3RD,
2024.
NEXT, WE HAVE A HEAL INITIATIVE
RFA FOR SLEEP PROTECH TORS OF
OPIOID USE DISORDER AND
TREATMENT OUTCOMES PROING GRACHL
WITH DUE DATE OF FEBRUARY 10TH,
2023.
HERE IS ANOTHER HEAL INITIATIVE
RFA FOR INTEGRATED BASIC AND
CLINICAL TEAMS BASED RESEARCH IN
PAIN WITH MULTIPLE DUE DATES
BEFORE THE EXPIRATION DATE OF
MARCH 12TH, 2024.
I ALSO WANT TO BRING YOUR
ATTENTION TO THE ALL OF US
PROGRAM WITH AN RFA ENHANCING
THE USE OF ALL OF US RESEARCH
PROGRAM DATA WITH A DUE DATE OF
MARCH 1ST.
WE WILL BE HEARING MORE ABOUT
THE ALL OF US INITIATIVE AND
OPPORTUNITIES TO PARTICIPATE
THIS AFTERNOON.
ALSO, THERE IS A -- ANOTHER RFA
FOR SMALL GRANTS TO ENHANCE THE
USE OF THE ALL OF US RESEARCH
PROGRAM DATA THAT ARE CALLEDANCE
ILLARY STUDIES. I WANT TO
MENTION PAST ACTIVITIES AND
EVENTS.
WE HELD FIRST STAKEHOLDER
MEETING ON RESEARCH FOR PERSON
WITH [INDISCERNIBLE] HEALTH
2,000 PARTICIPANTS WIDE VARIETY
OF COMPLEMENTIVE APPROACHES AND
HEALTH CARE PROVIDERS
RESEARCHERS POLICY MAKERS
ADVOCATES AND BUSINESS COMMUNITY
AS WELL AS PATIENTS A TRULY
OUTSTANDING MEETING CLEARLY
DEMONSTRATING CONCEPT OLD PERSON
HEALTH CAN BRING COMPLEMENTARY
AND INTEGRATED HEALTH COMMUNITY
TOGETHER. THIS IS A SNAPSHOT OF
ORGANIZATIONS REPRESENTED.
CLEARLY TRULY REMARKABLE. WE
HAD NOT ONLY REPRESENTATIVES OF
COMPLEMENTARY INTEGRATIVE HEALTH
AND PREVENTION SUCH ASSACU
PUNCTURE OSTEOPATHY CHIROPRACTIC
MASSAGE MUSIC THERAPY AND ENERGY
PSYCHOLOGY AND ALSO A VARIETY OF
ORGANIZATIONS THAT ARE -- THEY
ARE REALLY CONCERNED ABOUT OLD
PERSON HEALTH ALREADY SUCH AS
THE WHOLE HEALTH INSTITUTE
INTEGRATED POLICY CONSORTIUM AND
INTEGRATED MEDICINE AND NOEFA
INSTITUTE AND AMERICAN COLLEGE
OF LIFESTYLE MEDICINE AND KAISER
PERM AN ENTEE AND LIST GOES ON
AND PATIENT ADVOCACY
ORGANIZATIONS AND GOVERNMENT
ORGANIZATION SUCH AS VA, CDC,
CHAMP, NEA. THIS WAS A TRULY
REMARKABLE MEETING THAT WE
REALLY LOOK FORWARD TO FOAL
OWING UP WITH ALL THESE
ORGANIZATIONS AS THEY COME
TOGETHER AND REALLY SORT OF CAN
COALESCE AROUND THE CONCEPT OF
WHOLE PERSON HEALTH.
LET'S SEE. WE ARE ALSO HOSTING
A NUMBER OF EVENTS FOR
INVESTIGATORS OR TRAINEES ONLY
SUCH AS OUR FELLOWS AND TRAINEES
WORKSHOP IN SEPTEMBER.
ALSO, OUR -- LET'S SEEIN VEST
GATOR'S MEETING ON FUNCTIONAL
NEUROCIRCUITS OF INTERCEPTION
AND TECHNICAL ASSISTANCE WEBINAR
FOR REPOSITORY AND DATABASE FOR
AN TOM CAL AND PHYSIOLOGICALACU
PUNCTURE POINTS AND PROGRAMS.
THIS WAS AN OPEN MEETING, THIS
PARTICULAR ONE. IF INTERESTED
IN THIS AND YOU WERE NOT ABLE TO
ATTEND A SUMMARY OF THE MEETING
IS AVAILABLE AND ALSO ON OUR
WEBSITE.
OUR 2022 STEVE STRAUSS LECTURE
WE WERE PLEASED TO HAVE LAURA
PRESENT FROM HER TITLE OF MOUTHS
OF THE BABES AND RESEARCH ON
BABIES MOMS STRESS AND SUBSTANCE
USE TELL ABOUT RESILIENCE AND WE
HAD OVER 500 ATTENDEES. IT WAS
A GREAT SUCCESS AND RECORDING IS
AVAILABLE ON OUR WEBSITE AND
UPCOMING EVENTS WE HAVE HEAL
GRANT MEETING AND PEOPLE WITH
LIVED EXPERIENCE AND OTHER
STAKEHOLDERS TO SHARE RESEARCH
FINDINGS EXPLORED TRENDS AND
SHARED INTERESTS AND IDENTIFYING
OPPORTUNITIES TO ADVANCE THE
GOALS OF THIS INITIATIVE THAT IS
FEBRUARY 21ST AND 22ND. WE WILL
HOST THE SECOND ANNUAL EMOTIONAL
WELLBEING INVESTIGATOR MEETING
MARCH 27TH FOR INVESTIGATORS
ONLY AND PAIN MANAGEMENT
COLLABORATORY MEETING ALSO FOR
INVESTIGATOR. WHOOPS. SORRY.
I DON'T KNOW WHAT HAPPENED HERE.
ALSO, FOR INVEST GAITIOR ONLY IN
MAY 9TH AND 10TH. NOW, THESE
INVESTIGATOR MEETINGS ARE VERY
IMPORTANT AND REASON I MENTIONED
THEM IS BECAUSE WHENEVER WE HAVE
A GROUP OF INVESTIGATORS WHO ARE
WORKING IN A COMMON INITIATIVE,
IT IS VERY IMPORTANT THEY HAVE
AN OPPORTUNITY TO GET TOGETHER
AND SHARE FINDINGS AND REALLY
FORM A, YOU KNOW, A CLEEJIAL
GROUP SO THEY CAN EXCHANGE AND
-- INFORMATION AND IDEAS AND
ISSUES THEY ARE HAVING. SO, WE
ARE FINDING THIS IS A VERY
IMPORTANT PART OF FUNDING AWARDS
IS TO CONTINUE AND FACILITATE
MEETINGS AMONG INVESTIGATORS AND
COLLABORATORY HAS MEETING OF
INVESTIGATORS OF PRISM PROJECTS
IN MAY. ALSO, I WANT YOU AS I
MENTIONED EARLIER, WE WILL HOLD
A WORKSHOP IN JULY 25TH AND 6TH.
PLEASE SAVE THE DATE FOR THIS ON
WHOLE JOINT HEALTH THAT IS
REALLY THE NEXT STEP FOLLOWING
THE REJOIN INITIATIVE THAT
REALLY KIND OF STARTED BY
LOOKING AT SENSORY INNERVATION
OF THE JOINTS AND WE WANT TO NOW
EXTEND THIS TO UNDERSTAND
PATHOPHYSIOLOGY HOW A JOINT GOES
FROM BEING HEALTHY TO LESS
HEALTHY AND EVENTUALLY TO
GENERATE; RIGHT?
WE WANT TO REALLY LOOK AT THAT
ENTIRE SPECTRUM LOOKING AT THE
WHOLE JOINT AND IN THE CONTEXT
OF THE WHOLE PERSON AND WE
ENCOURAGE YOU TO REALLY CHECK
OUT THIS WORKSHOP AS INFORMATION
BECOME AS VAILABLE TO OUR
WEBSITE. NIH CONSORTIUM FOR
ADVANCING RESEARCH ON BOTANICALS
AND NATURAL PRODUCTS CARBON
MEETING THAT WILL BE JULY 27TH.
OUR NEXT MEETING OF NCCIH
COUNCIL WILL BE MAY 12TH 2023.
PLEASE SAVE THE DATE FOR THAT.
I WILL STOP HERE. LY STOP
SHARING MY SLIDES.
WELCOME ANY COMMENTS OR
QUESTIONS.
>>THIS IS A TINY PIECE OF WHAT
YOU SPOKE ABOUT. I AM CURIOUS
ABOUT THE STUDY WITH THE
CHIROPRACTOR VERSUS NO VISIT
WITH THE CHIROPRACTOR AND WONDER
IF THEY CONTROL FOR IN-PERSON
VISITS WITH ANYBODY IN THAT
STUDY. LOOKS LIKE IT HAD A
REALLY PRETTY DECENT IMPACT AND
NOT SURE.
>>YEAH. RIGHT. THIS -- THERE
WAS NO CONTROL FOR THE -- IF
ASKING FOR THE ADDITIONAL
ATTENTION.
>>EXACTLY.
>>IS THAT WHAT YOU ARE SAYING?
NO. THIS IS NOT THE INTENT OF
THAT. YOU KNOW, THIS IS REALLY
TO SEE -- THIS IS VERY PRAGMATIC
IN DESIGN. TO SEE IF YOU JUST
ADD CHIROPRACTIC CARE IN THE
REAL WORLD, YOU KNOW, TO, YOU
KNOW, FIRST OF ALL, IS THIS --
DOES THIS HAPPEN? HOW DOES THIS
HAPPEN?
IS IT FEASIBLE, ET CETERA?
THE NEXT STEP IS DOES IT
ACTUALLY HELP?
SO, IT IS NOT MEANT TO LOOK FOR
WHAT IS IT ABOUT THE
CHIROPRACTIC CARE THAT IS MAKING
THE DIFFERENCE? YOU KNOW?
THERE IS A LOT OF REPORTS.
THIS IS NOT A MYSTERY THAT
PATIENTS WHO SEE A CHIROPRACTOR
REPORT BETTER SATISFACTION WITH
CARE THAT THEY RECEIVE.
THEN WITH CONVENTIONAL CARE AND
IS SOMETHING THAT HAS BEEN
PUBLISHED SO I THINK THIS COULD
BE A BIG PART OF THIS. YOU
KNOW?
BUT, IT IS PART OF CARE AND WHAT
HAPPENS WHEN YOU SEE A
PRACTITIONER.
IT IS VERY INTERESTING, I THINK.
YES. DR. MCGEE?
>>THANK YOU, MY DEAR. I REALLY
APPRECIATE IT, THIS PART OF THE
PROGRAM AND YOUR REPORT. I'M
CURIOUS. I HAVE NOT HAD A
CHANCE TO READ THE PROGRESS
REPORT ON THE UNITE PROJECT.
I'M EXCITED AND LOOK FORWARD TO
READING IT.
I'M JUST CURIOUS IF THERE ARE
ANY HIGHLIGHTS FROM THAT SUMMARY
REPORT THAT ARE KIND OF TOP OF
MIND OR YOU WOULD LIKE US TO
THINK ABOUT IN TERMS OF, YOU
KNOW, THE -- THE SUMMARY AND THE
PROGRESS REPORTS THAT ARE
INDICATIONS FOR WHAT THIS
PARTICULAR ORGANIZATION MIGHT
KEEP IN MIND AND FOCUS ON OR
CELEBRATE. I AM JUST WONDERING
IF THERE IS ANY PARTICULAR WAY
THAT YOU WOULD LIKE US TO KIND
OF PICK OFF SOME OF WHAT YOU
LEARN WHEN YOU TOOK IN THE
PROGRESS REPORT AS IT APPLIES TO
OUR WORK. THANK YOU MUCH.
>>WELL, THANK YOU. WE HAVE
BEEN TALKING ABOUT THE UNITE
INITIATIVE FOR MANY PREVIOUS
COUNCILS, YOU KNOW?
THIS IS -- THIS IS -- THIS IS
SOMETHING THAT WE HAVE BEEN
BUILDING ON THROUGHOUT THE YEAR.
THERE IS VARIOUS COMPONENTS TO
THIS UNITE INITIATIVE. I CAN
HIGHLIGHT, PERHAPS, TOO, THAT I
FIND OUT ARE REALLY KEY. ONE,
THIS REALLY ADDRESSES BOTH THE
EXTRAMURAL ENVIRONMENT AS WELL
AS INTRA-NIH ENVIRONMENT. WE
ARE TAKING THIS TWO-PRONGED
APPROACH TO KIND OF LOOKING AT
ADDRESSING EQUITY AND IN BOTH
THE RESEARCH THAT WE FUND TO
MAKING SURE THAT THE GRANT
DOLLARS IT THAT WE FUND ARE
DISTRIBUTED IN A WAY THAT
MAXIMIZES EQUITY.
AND WITH SPECIFIC ATTENTION TO
UNDERSERVED COMMUNITIES AND
UNDERSERVED INSTITUTIONS AND
UNDERSERVED GROUPS.
THE OTHER THING WE ARE DOING IS
LOOKING AT INTERNAL NIH
ENVIRONMENT TO MAKE SURE WE ARE
APPLYING. YOU KNOW, DIVERSITY,
EQUITY, INCLUSION AND
ACCESSIBILITY PRINCIPLES TO
HIRING PRACTICES AND OUR
PROMOTION AND, YOU KNOW, MAKING
SURE THAT PEOPLE HAVE EQUAL
ACCESS TO PROGRESSING IN THEIR
CAREERS AT NIH.
SO, THIS IS LOOKING AT THE
ENTIRE ENVIRONMENT OF HOW WE
FUNCTIONA
FUNCTION AT NIH. THERE IS MORE
TO THE UNITE INITIATIVE, BUT
THIS IS REALLY, I THINK, TWO
ASPECTS WE HAVE BEEN ABLE TO
MAKE CONSIDERABLE PROGRESS
ALREADY.
BOTH AT NIH AS A FULL AND I'M
PROUD TO SAY AT NCCIH
INTERNALLY. WE ARE CONSTANTLY
-- YOU KNOW, WE HAVE A -- A --
WHAT WE CALL A REAP, YOU KNOW,
KIND OF PLAN THAT WE HAVE PUT
TOGETHER TO -- TO IMPLEMENT OUR
-- OUR PRINCIPLES OF HOW WE WILL
MAKE SURE THAT THESE ARE NOT
JUST IDEAS AND GREAT PLANS BUT
ALSO ACTIONS.
AND ALSO TO MAKE SURE THAT WE
HOLD OURSELVES ACCOUNTABLE FOR
THESE ACTIONS. WE MAKE SURE
THAT -- THAT THE ACTIONS BEAR
FRUIT AND RESULT IN SUSTAINED
CHANGE.
SO, THAT IS WHAT I WOULD
HIGHLIGHT.
>>YES. ONE QUICK FOLLOWUP.
>>SURE.
>>THANKS SO MUCH FOR THOSE
HIGHLIGHTS.
I'M JUST CURIOUS GIVEN YOUR
EXPERIENCE SO FAR AND WHAT IS TO
COME. IF THERE MIGHT BE ONE OR
TWO AREAS OF CONCERN THAT HAVE
ALREADY BUBBLED UP FROM THE
COMMUNITY OR TO INTEGRATE OR
APPLY AND IMPLEMENT ANY OF THE
PLANS AND GOALS.
>>WELL, THE CONCERNS, I MEAN, I
CAN SAY THAT THE AREAS WHERE
THERE HAS BEEN DEBATE.
SO, I THINK THAT ONE AREA THAT
WE ARE REALLY LOOKING AT VERY
CAREFULLY IS MAKING SURE EFFORTS
TO PROMOTE DIVERSITY ARE
DISTRIBUTED ACROSS, YOU KNOW,
THE VARIOUS AREAS THAT NEED
ATTENTION; RIGHT?
WE STARTED A FEW YEARS AGO AND
PEOPLE AND LOTS OF FOCUS WAS ON
GENDER EQUITY; RIGHT?
IT WAS A BIG FOCUS AT FIRST.
THEN WITH THE GEORGE FLOYD
INCIDENT BROUGHT GREAT ATTENTION
TO RACE; RIGHT?
THIS WAS SOMETHING THAT WAS
OVERDUE AND WE KIND OF BROUGHT
TO THE ATTENTION. THERE IS A
LOT OF OTHER AREAS WHERE WE NEED
TO PAY ATTENTION TO EQUITY AND
THAT PEOPLE WITH DISABILITIES,
FOR EXAMPLE.
RIGHT?
SO, I THINK THAT THIS IS AN AREA
WHERE WE HAVE TO REALLY BE VERY
THOUGHTFUL AND IN MAKING SURE
THAT OUR EF ORTS TOWARDS
ENSURING DIVERSE, YOU KNOW,
EQUITY AND -- AND IS -- PAYS
ATTENTION TO ALL OF THESE AND
DOESN'T CREATE INEQUITIES.
RIGHT?
SO, THAT IS AN AREA THAT HAS --
WHERE THERE HAS BEEN A LOT OF
DEBATE AND HEALTHY DEBATE, I
WOULD SAY.
>>WONDERFUL. THE INCLUDING ALL
OF US MAKES MY HEART SINK.
THANKS SO MUCH.
>>GREAT. THANK YOU. DR.
HELEN? YES?
>>YES. I HAVE TWO QUESTIONS.
ONE IS ON WHERE DO YOU THINK
THAT THIS STAKEHOLDER MEETING
WILL GO FORWARD? YOU KNOW, WHAT
ARE THE LESSONS AND WHAT ARE THE
CONSEQUENCES OF THAT MEETING?
>>THANK YOU FOR THE QUESTION.
SO, THE STAKEHOLDER MEETING WAS
THE MOTIVATION FOR THE
STAKEHOLDER MEETING WAS THAT
THERE IS A LOT INSTITUTES AT NIH
THAT ARE COALITIONS OR FRIENDS
GROUPS; RIGHT?
THESE ARE GROUPS OF PEOPLE WHO
HAVE INTEREST IN RESEARCH
CONDUCTED AT THAT INSTITUTE AND
MEET AND DO VARIOUS FORMS OF,
YOU KNOW, ADVOCACY AND, YOU
KNOW, NCCIH NEVER HAD A GROUP
LIKE THAT. WE FELT THAT ONE OF
THE REASONS FOR THAT IS THAT
THERE -- THE -- THE KINDS OF --
THE STAKEHOLDERS, YOU KNOW, IN
THE COMMUNITY, THEY WERE KIND OF
FRAGMENTED AND YOU HAD VARIOUS
PROFESSIONS AND YOU HAD
ACUPUNCTURES AND CHIROPRACTORS
AND MASSAGE THERAPISTS AND
PEOPLE WHO DID MINDFULNESS AND
MEDITATION. IT WAS KIND OF NOT
UNITED AND NOT -- THERE WAS NO
COMMON GOALS TO ALL OF THE
VARIOUS GROUPS OF PEOPLE. AND
WHEN WE EMBARKED ON OUR NEW
STRATEGIC DIRECTION TOWARDS
WHOLE PERSON HEALTH, WE ACTUALLY
HAD A BIT OF A HYPOTHESIS THAT
-- THE THEME OF WHOLE PERSON
HEALTH MIGHT BE SOMETHING THAT
ALL OF THE VARIOUS PEOPLE MIGHT
AGREE IS A UNIFYING THEME THAT
THEY COULD ALL GET BEHIND.
AND -- AND -- SO, THE
STAKEHOLDER MEETING WAS ACTUALLY
TESTING THAT HYPOTHESIS. WE
INVITED ALL THESE VARIOUS GROUPS
AND ACTUALLY IT WAS AN OPEN
INVITATION.
WE WERE QUITE PLEASED BY THE
RESPONSE THAT WE HAD. NOT ONLY
WE HAD ALL THESE GROUPS THAT
JOINED INCLUDING LOTS OF GROUPS
THAT ARE ALREADY INTERESTED IN
WHOLE PERSON HEALTH BUT NOT ALL
OF THEM. AT THE END OF THE
MEETING, QUESTION WE ASK PEOPLE
IS WHAT DO YOU THINK? YOU KNOW?
IS THIS -- IS WHOLE PERSON
HEALTH SOMETHING THAT YOU CAN
ALL GET BEHIND?
THE ANSWER WAS OVERWHELMINGLY
NEXT. WHAT WILL HAPPEN NEXT IS
UP TO THE GROUP OR UP TO THE
STAKEHOLDER GROUP. WE WILL MEET
WITH THEM AND THEIR
REPRESENTATIVES AND FIND OUT
WHAT THEY WANT TO DO. SO, WE
ARE VERY PLEASED WITH THAT. IT
IS JUST A FIRST STEP. YOU KNOW,
I WILL BE REPORTING BACK TO THIS
COUNCIL AS TO WHAT HAPPENS NEXT.
>>OKAY. MY SECOND QUESTION IS
THE STATE OF THE AFFAIRS WAS THE
LONG COVID FUNDING AND REASON
I'M ASKING IS THAT FOR THE PAST
YEAR I HAVE BEEN WORKING WITH
THIS. I FIND THAT FUNDING IS
NON-EXISTENT OR VERY LOW TO
EXIST FOR FUNDING ACROSS
DIFFERENT NIH INSTITUTES.
YET INTEGRATIVE MEDICINE CAN
ACTUALLY LEAD THAT DIRECTION
BECAUSE IT IS ABOUT
COMPLEMENTARY INTEGRATIVE WHOLE
PERSON HEALTH.
>>THAT IS RIGHT. I -- I -- WE
HAVE ALL BEEN WAITING PATIENTLY
FOR THE RECOVER INITIATIVE TO
ISSUE OPPORTUNITIES FOR TESTING
COMPLEMENTARY AND INTEGRATIVE
INTERVENTIONS THAT IS PART OF
THE PLAN.
BUT, IT HAS BEEN DIFFICULT
GETTING THE RECOVERED COHORT OFF
THE GROUND TO SAY THE LEAST.
ONE PROBLEM WITH THIS IS WE ARE
WORKING WITH A MOVING TARGET AND
THE PANDEMIC HAS CHANGED AND
EVOLVED SO DYNAMICALLY AS ITS
START AND YOU NEVER KNOW WHAT
WILL COME NEXT AND FACT THAT WE
ARE FINDING THAT THE PHENOTYPE
OR PHENOTYPIC MANIFESTATION OF
LONG COVID SEEMS TO BE MOVING
ALONG WITH THE PANDEMIC THAT IS
MAKING THIS TASK VERY COMPLEX.
I SHARE YOUR FRUSTRATION. I --
WE WILL JUST HAVE TO WAIT AND
SEE UNTIL THESE BECOME AVAILABLE
IS ALL I HAVE TO SAY RIGHT NOW.
>>THANK YOU.
>>DR. SUMIANA?
>>YES. HI. THANK YOU. THANK
YOU AGAIN FOR THAT REALLY NICE
REPORT AND VERY RECENT
DISCUSSION YOU JUST HAD. MY
QUESTION ACTUALLY RELATES TO
THIS INITIATIVE WITH WHOLE
PERSON HEALTH AND THINK WE ALL
AGREE IT IS REALLY IMPORTANT AND
THE WAY TO GO. THAT IS
REFLECTED BY THE INTEREST IN THE
DID SHALL THAT YOU HAVE HAD.
MY -- SO, I WOULD LIKE TO
UNDERSTAND A BIT MORE ABOUT HOW
YOU SEE NATURAL PRODUCTS GOING
INTO THE WHOLE PERSON HEALTH
INITIATIVE.
IN A WAY THAT -- YOU KNOW, THE
FORMER DIVISION INTO MIND, BODY
AND NATURAL PRODUCTS. THE MIND
BODY MIGHT BE SEEN AS BEING MORE
IN TUNE WITH WHOLE PERSON HEALTH
BECAUSE OF MORE WHOLE PERSON
BENEFIT WE EXPECT WHERE NATURAL
PRODUCTS TEND TO HAVE MORE VERY
DIRECTED SPECIFIC EFFECTS ON
PARTICULAR PARTS OF THE BODY AND
WHERE DO YOU SEE NATURAL
PRODUCTS FITTING INTO THE WHOLE
PERSON HEALTH STUDY?
WOULD YOU SEE THEM MORE AS BEING
PART OF MULTI-INTERVENTION
APPROACHES?
>>WELL, GREAT QUESTION. THAT
IS A GREAT QUESTION. AND, THE
ANSWER MIGHT SURPRISE YOU. SO,
WHEN WE -- A COUPLE YEARS AGO WE
DID A PORTFOLIO ANALYSIS ON
GRANTS THAT WE WERE ALREADY
FUNDING AND BOTH ON THE MIENLD
AND BODY AND THE NATURAL
PRODUCTS AND WE WANTED TO SEE
HOW MANY OF THESE -- OF THESE
PROJECTS ADDRESS MULTISYSTEMS.
A BIG IMPORTANT PART OF WHOLE
PERSON HEALTH IS TO STUDY
INTERCONNECTIONS OF SYSTEM IT'S
HAS NOT JUST MULTICOMPONENT
INTERVENTIONS BUT UNDERSTANDING
HOW DIFFERENT SYSTEMS OF THE
BODY INTERACT WITH EACH OTHER SO
WE ARE NOT JUST LOOKING AT ONE
ORGAN AT A TIME. TO OUR
SURPRISE, WE FOUND A LOT OF
ACTUALLY MORE OF OUR NATURAL
PRODUCTS PORTFOLIO THAT WAS
ADDRESSING MULTIPLE SYSTEMS AND
THEY WERE LOOKING AT -- SOME
WERE LOOKING AT THE GUT AND
IMMUNE SYSTEM OR THE BRAIN OR,
YOU KNOW, BUT A LOT OF THEM WERE
ACTUALLY LOOKING AT MORE THAN
ONE.
SO, TO US, THIS INDICATED THAT
THIS ACTUALLY THIS IS A NICE WAY
THAT OUR NATURAL PRODUCTS
PORTFOLIO COULD BE INCORPORATED
INTO OUR OVERALL PRIORITIES FOR
LOOKING AT MULTISYSTEMS OUTCOMES
AND THE OTHER IMPORTANT WAY THAT
NATURAL PRODUCTS COULD BE
INCORPORATED IS LOOKING AT WHEN
PEOPLE TAKE FOR EXAMPLE A
DIETARY SUPPLEMENT IN THE
CONTEXT OF THE PERSON'S DIET,
SEE -- SEE, I THINK THAT LOTS OF
TIMES THAT DOESN'T HAPPEN. WE
ARE STUDYING DIETARY SUPPLEMENTS
ON ITS OWN. BUT, THEIR EXAMPLES
ARE OUT THERE SO FAR THAT ARE
STARTING TO COME OUT WHERE IT IS
PRETTY CLEAR THAT THE EFFECT OF
THE NUTRITIONAL DIETARY
SUPPLEMENT IS VERY DEPENDENT ON
WHAT YOU ARE ACTUALLY EATING.
SO, THIS IS ANOTHER AREA THERE
COULD BE INTEGRATION IN THE AREA
OF NUTRITION AND OF COURSE
LOOKING AT MULTICOMPONENT
INTERVENTIONS INCLUDING
NUTRITIONAL, PSYCHOLOGICAL, AND
PHYSICAL INTERVENTIONS AND
NUTRITIONAL INTERVENTIONS COULD
INCLUDE NATURAL PRODUCTS; RIGHT?
SO, I THINK THERE IS LOTS OF
WAYS IN WHICH IT CAN BE
INTEGRATED, ABSOLUTELY.
>>YEAH. NO. THOSE ARE GREAT
POINTS.
I THINK THAT IS DEFINITELY TRUE
THAT SOME OF THE BIOLOGICAL
EFFECTS IT THAT WE SEE WITH
NATURAL PRODUCTS ARE ACTUALLY
APPLICABLE TO MULTIPLE ORGANS
AND LIKE ANTIOXIDANT EFFECTS TO
PICK A VERY BROAD EXAMPLE SFWL
YEAH.
>>GOING BACK TO DR. NADIA'S
QUESTION IT MIGHT BE NICE TO SEE
RFAS RELATED TO FINDING THE ROLE
OF NATURAL PRODUCTS LOOKING AT
INTERACTIONS BETWEEN SUPPLEMENTS
AND DIETS AND SO ON COMING UP.
>>YEAH. POINT VERY WELL TAKEN.
YEAH. THANKS.
>>OKAY.
>>SO, HOW ARE WE DOING FOR
TIME, REGINA?
>>I JUST WANTED TO HAVE A VOICE
THAT WE ARE ESSENTIALLY -- WE
STARTED OUR LUNCH BREAK AT 12:45
IS WHAT WE WERE SCHEDULED.
>>ALREADY HAVING LUNCH, OKAY.
>>THIS WAS AN INTERESTING
DISCUSSION AND CERTAINLY DIDN'T
WANT TO INTERRUPT. I WOULD
SUGGEST WE ARE BREAKING FOR
LUNCH NOW. I WOULD LIKE TO
INVITE COUNCIL MEMBERS AS WELL
AS NCCIH STAFF TO JOIN US IN OUR
VIRTUAL BREAKOUT ROOM. WE WILL
RECONVENE AT 1:30.
I WOULD LIKE TO WELCOME EVERYONE
BACK TO THE SECOND PART OF THE
SESSION AND HOPE EVERYBODY WAS
ABLE TO HAVE A NICE AND RELAXING
LUNCH BREAK. FIRST, ON THE
AGENDA THIS AFTERNOON, WE HAVE A
PRESENTATION BY DR. LANGEVIN AND
I'M HANDING IT OVER TO DR.
LANGEVIN WHO WILL INTRODUCE OUR
SPEAKER. THANK YOU.
>>THANK YOU VERY MUCH, MARTINA.
IT IS MY GREAT PLEASURE WE HAVE
TWO INTERESTING TALKS THIS
AFTERNOON ON TWO PROGRAMS THAT
ARE RELEVANT IN EFFORTS IN WHOLE
PERSON HEALTH. ONE IS THE ALL
OF US PROGRAM AND OTHER IS ECHO
PROGRAM ENVIRONMENTAL INFLUENCES
ON CHILD HEALTH OUTCOME. IT IS
MY GREAT PLEASURE TO INTRODUCE
OUR FIRST SPEAKER WHO IS THE
CHIEF EXECUTIVE OFFICER OF
NATIONAL INSTITUTES OF HEALTH
ALL OF US RESEARCH PROGRAM. ALL
OF US SEEKS TO ENROLL AT 1
MILLION DIVERSE PARTICIPANTS TO
BUILD AN INDEPENCIBLE RESOURCE
ACCELERATING PRECISION MEDICINE
FOR ALL POPULATIONS. JOSH HAS
BEEN INVOLVED SINCE THE
PROGRAM'S INCEPTION AND MEMBER
OF NIH PRECISION MEDICINE
INITIATIVE THAT DEVELOPED
PROGRAM'S INITIAL SCIENTIFIC
[INDISCERNIBLE] AND LED INITIAL
PROTOTYPING PROJECTS AND ALL OF
US DATA AND RESEARCH CENTER.
JOSH IS NAMED CEO OF ALL OF US
IN JANUARY OF 2020. BEFORE
JOINING NIH HE WAS A PRACTICING
PHYSICIAN AT VANDERBILT
UNIVERSITY PROFESSOR OF
BIOINFORMATICS IN MEDICINE AND
VICE PRESIDENT FOR
[INDISCERNIBLE]. AT VANDERBILT
HE LED DISCOVERY AND
IMPLEMENTATION PROJECTS IN
FARMICO GIN ETICS AND HE WAS A
-- INCLUDING THE INITIAL
DESCRIPTIONS OF FEEN OHMWIDE
ASSOCIATION STUDIES AND
PHENOTYPIC SCORES AND -- TITLE
OF THE TALK TOED IS ALL OF US
RESEARCH PROGRAM IMPROVING
HEALTH THROUGH DIVERSE
TECHNOLOGY HUGE COHORTS AND
PRECISION MEDICINE AND THANKS SO
MUCH FOR JOINING US, JOSH.
>>YEAH. I'M MUTED HERE.
THANKS SO MUCH FOR THE WARM
INTRODUCTION. PLEASURE TO BE
WITH ALL OF YOU TODAY.
REALLY, I APPRECIATE THE
OPPORTUNITY TO SPEAK WITH YOU
ABOUT THE ALL OF US RESEARCH
PROGRAM AND THINK ABOUT, YOU
KNOW, THE BROAD SET OF USE CASES
AND THAT ALL OF US COULD APPLY
TO TOWARDS HOLISTIC HEALTH AND
ALL OUR INDIVIDUAL HEALTH
JOURNEYS THAT IS REALLY TOWARDS
ALL POPULATIONS THAT IS A REAL
PLEASURE TO HEAR THE DISCUSSION
EARLIER THAT IS AROUND UNITE AND
HOW WE CAN THINK ABOUT DIFFERENT
ELEMENTS PLAYING OUT AND
CERTAINLY ALL OF US THAT IS
REALLY SOFT FROM THE BEGINNING
TO BROADEN APPLICABILITY OF
RESEARCH. I'M GOING TO GO
THROUGH HERE AND TALK SOME ABOUT
ALL OF US RESEARCH PROGRAM AND
FRAME IT AND WE WILL HAVE PLENTY
OF TIME FOR DISCUSSION IN THE
END.
THINKING ABOUT ALL OF US BACK IN
REALLY THE INITIATION OF THE
THOUGHTS IN 2014 AND 2015 REALLY
RIDING OUT THE BLUEPRINT OF THE
PROGRAM, WE THOUGHT A LOT ABOUT
HOW OBSERVATIONAL COHORTS HAVE
REALLY BEEN FOUNDATIONAL AND
TRANSFORMATIONAL TOWARDS OUR
UNDERSTANDING OF HEALTH AND
DISEASE AND FRAMING HAM PART
STUDY IS ONE OF SO MANY AND THEY
HAD COMMONALITIES THAT IN THIS
CASE IS A RELATIVELY SMALL
NUMBER OF MEN AND WOMEN WHO ARE
RECRUITED IN 1948 INITIALLY.
AND, YOU KNOW, REALLY HAS BEEN
TRANSFORMATIONAL TOWARDS THINGS
LIKE CHOLESTEROL AND BLOOD
PRESSURE AND HABITS LIKE SMOKING
AND EXERCISE AND HOW THESE
THINGS CAN EFFECT HEALTH. WITH
COHORTS AND INTERVENABLE RISK
FACTORS SEEN CONCOMMITANT
REDUCTIONS FROM CONDITIONS LIKE
HEART DISEASE AND CANCER AND SO
MANY THINGS AS WE DEVELOPED
TREATMENTS AND INTERVENTIONS IT
THAT HELPED US IN THESE
THERAPIES.
WE WANTED TO THINK ABOUT THIS
BROADLY AND COHORTS LIKE THIS
STARTED WITH THINGS LIKE CUSTOM
SURVEY INSTRUMENTS AND CUSTOM
EXAMS AND BIOSPECIMENS THAT HAVE
DRAWN AND -- DEVELOPMENT OF
GENOMEWIDE ASSOCIATION STUEDDY
AND GENOTYPING ARRAYS AND
ELECTRONIC HEALTH RECORDS BECAME
TO BE A MORE COMMON PART OF ANAL
CEASE SINCE 2010 AND WIDER
ADOPTION OF ELECTRONIC HEALTH
RECORDS ACROSS THE UNITED STATES
AND MOBILE TECHNOLOGIES THAT
HAVE BEEN SOMETHING THAT IS
THOUGHT ABOUT MORE RECENTLY AND
IS SO MANY OTHER WAYS WE CAN
LOOK AT INDIVIDUAL HEALTH.
OF COURSE, WE DON'T THINK ABOUT
THIS JUST AS, YOU KNOW,
PERSONALIZED MEDICINE OR
PRECISION MEDICINE BUT REALLY
HEALTH AND HOLISTIC APPROACH TO
HOW WE CAN IMPROVE OUR JOURNEYS
OF WLI LIFE AND HEALTH OF LIFE
ENVIRONMENT AND GENE ENVIRONMENT
INTERACTIONS AND GENOME SPATIAL
DATA AND THINGS TO ASSESS OTHER
SOCIO DEMOGRAPHIC AND SOCIO
DETERMINANTS OF HEALTH AND FOOD
DESERT ARE IMPORTANT PARTS OF
THE HEALTH PICTURE AND RESEARCH
PROGRAM IS BUILT WITH THAT IN
MIND TOWARDS ACCELERATING HEALTH
RESEARCH AND BREAKTHROUGHS AND
PREVENTIBLE HEALTH AND STARTS
WITH PARTNERSHIP OF PARTICIPANTS
AND A MILLION PARTICIPANTS
REFLECTING DIVERSITY OF THE
UNITED STATES THAT IS
LONGITUDINAL AND WE TELL
PARTICIPANTS TO EXPECT PROGRAM
TO LAST FOR DECADES AND HOPE YOU
ARE WITH USING IN FOR THE LONG
HALL AND WE HAVE TO TAKE
BIOMEDICAL DATA SET DELIVERING
TO AS MANY RESEARCHERS HAND ASS
AS WE CAN AND SECURE WAYS THAT
WE CAN ENSURE TRUST WITH
PARTICIPANTS AND HOW DATA IS
BEING USED AND WE HAVE TO REALLY
FACILITATE EXERCISE GETTING
RESEARCHERS ABLE TO USE DATA AND
THINK OF IT AS AN ECOSYSTEM OF
COMMUNITIES RESEARCHERS AND
FUNDERS MAKING DATA
INDISPENSABLE PART OF HEALTH
RESEARCH AND WE HAVE A SET OF
CORE VALUES WE ESTABLISHED FROM
THE BEGINNING OF THE PROGRAM AND
PARTICIPATION THAT IS OPEN TO
ALL UNITED STATES AND
PARTICIPANTS REFLECT DIVERSITY
OF THE UNITED STATES AND
PARTICIPANTS ARE PARTNERS WITH
US THAT IS AN IMPORTANT ONE AND
PARTICIPANTS AND POTENTIAL
PARENTANTS HAVE BEEN PART OF
PROGRAMS FROM THE BEGINNING IN
ALL LEVELS OF GOVERNANCE HELPING
SET FOUNDATION HOW ENGAGE
PARTICIPANTS AND IMPORTANT TO
THEM AND RETURNING VALUE AND
WANT PARTICIPANTS TO HAVE ACCESS
OF INFORMATION WE GAIN WHEN IT
IS CLINICALLY RELEVANT AND WANT
IT TO BE DAH I TO DAY ACCESSIBLE
BROADLY AND SECURITY AS WE CAN
SECURITY PRIVACY ARE THINGS WE
PERSISTENTLY HEAR AS ISSUES WITH
PARTICIPANTS AND WANT TO BE
POSITIVE CHANGE WRIT LARGE FOR
RESEARCH AND STARTED TO LAUNCH
ORIGINALLY IN 2018 NATIONALLY
AND ENROLLED 580,000
PARTICIPANTS AND PEOPLE AS THEY
JOIN CAN JOIN ANYWHERE IN THE US
OR US TERRITORIES AND IN THAT
CONDITION PEOPLE PARTICIPATE IN
DIFFERENT WAYS AND TIMES COMMON
CONSENT PROGRAM THEY WORK
THROUGH IF NOT LARGE MEDICAL
CENTER PART OF THE PROGRAM OR
ANOTHER FACILITIES YOU MAY NOT
HAVE SAME ABILITY TO DONATE A
BIO SAMPLE WE CAN REACH ALL 50
STATES IN US TERRITORIES THROUGH
A VARIETY OF MEANS IT THAT WE
DIDN'T ADDITIONALLY HAVE BEFORE
THIS POINT AND COVID BROUGHT
BIOSPECIMEN COLLECTION TO A
HALT.
WE CAME OUT OF COVID IN A WAY
THAT IS MORE MATURE AND IN
ABILITY TO REACH PEOPLE IN MORE
WAYS ACROSS THE UNITED STATES.
AS I MENTIONED, WE HAVE HAD
LONGSTANDING FOCUS ON DIVERSITY
AND ONE WAY TO THINK OF IT IS
RACE AND ETHNICITY
SELF-IDENTIFIED RACE AND
ETHNICITY AND 50% RACE AND
ETHNICITIES IDENTIFYING AS OTHER
THAN WHITE AND SO MANY
CATEGORIES OF DIVERSITY THINKING
ABOUT AGE AND SEX AT BIRTH AND
GENDER IDENTITY SEXUAL
ORIENTATION AND EDUCATION AND
ONE OF THE MOST COMMONLY AND ONE
THAT WE ADDED RECENTLY WAS
DISABILITY AND THAT IS A
LONGITUDINAL COHORT AND ABILITY
TO RECONTACT PARTICIPANTS WE
DIDN'T HAVE A GOOD QUESTIONNAIRE
OUT THERE TO ASSESS DISABILITY.
ONE THING WE DID AS WE ADDED NEW
METRIC WE RELAUNCHED A SURVEY
THAT CAUGHT PEOPLE WHO HADN'T
ORIGINALLY FILLED OUT METRICS ON
DISABILITY.
OVERALL, MORE THAN 80% OF
PARTICIPANTS ARE
UNDER-REPRESENTED IN BIOMEDICAL
RESEARCH. IN SOME CASES WE
DON'T ACTUALLY KNOW IF THE
POPULATIONS ARE IN MEDICAL
RESEARCH COMMONLY. QUESTIONS
ARE NOT ASKED. IN SOME CASES,
WE KNOW THEY ARE NOT WELL
REPRESENTED THAT IS ESPECIALLY
TRUE FOR DEMOGRAPHIC
INFORMATION.
ONE REASON WE HAVE BEEN SO
SUCCESSFUL IN ENROLLING DIVERSE
POPULATIONS IS OUR PARTNERS AND
MENTION BEGINNING WITH
PARTICIPANT ENGAGEMENT AND
NUMBER OF MEDICAL CENTERS ACROSS
THE UNITED STATES AND NUMBER OF
PARTNERS REPRESENTING INDUSTRY
CONNECTIONS IN THE HEALTH SPACE
AS WELL AS PARTICIPANT GROUPS
YOU WILL SEE ON THE NEXT SLIDE
AND IN A NUMBER OF PEOPLE THAT
HELP TO COLLECT BIOSMES MENS AND
INCREDIBLE LOGISTICS ENTERPRISE
TO GET SAMPLES TO BIOBANK R
REALLY IN THE SAME-DAY PROCESS
TO START PROCESSING IN RAPID
FASHION FROM MORE THAN AT SOME
POINT MORE THAN 400 DIFFERENT
CLINICS ACROSS THE COUNTRY AND
GENOME AND DATA PARTNERS ARE
CRITICAL AND THEY ARE ENGAGEMENT
PARTNERS THAT ARE SO CRITICAL IN
DELIVERING MESSAGES AND BECOMING
TRUSTED ENTITIES TO OUR
PARTICIPANTS AND POTENTIAL
PARTICIPANTS THAT ARE VALIDATING
THE IMPORTANCE OF OUR MISSION TO
REACH TO THEM. AND BECOMING
PART OF THE COMMUNITY AND
GETTING US REALLY IMPORTANT
ADVICE HOW WE THINK ABOUT THINGS
LIKE EXPANDING ACCESS.
THE DATA COLLECTOR INVOLVES BEST
PARTICIPANTS IS SIMILAR NO
MATTER HOW YOU COME INTO THE
SYSTEM AND STARTS WITH A COMMON
CONSENT PROCESS THAT IS BASED ON
VIDEO AS WELL AS ABILITY TO READ
OF COURSE LONG-FORM DOCUMENTS
AND WE INCLUDE ACCESS TO
ELECTRONIC HEALTH RECORDS AS
PART OF THAT AND THERE IS
DIFFERENT CONSENTS THAT HAPPEN
ALONG THE WAY GENOMICS CONSENT
PROCESSES AS WELL. WE HAVE A
SET OF SURVEYS IN INITIAL
COMPONENT AND RELEASE
APPROXIMATELY A NEW SURVEY EACH
YEAR. WE HAVE A SET OF PHYSICAL
MEASURES THAT IS FAIRLY LIMITED
IN THE IN-PERSON SETTING BECAUSE
LOTS OF THESE INFORMATION WILL
COME FROM THINGS LIKE ELECTRONIC
HEALTH RECORDS. WE COLLECT
BIOSAMPLES THAT IS DNA AT A
MINIMUM. IN PERSON FOR BLOOD
COLLECTION INCLUDES RNA,
[INDISCERNIBLE] DNA SERUM PLASMA
AS WELL AND YOU'RIN AND WE HAVE
SALIVA KITS OUT AND WEARABLE AND
MOBILE TECHNOLOGIES PEOPLE CAN
LINK IN OWN FITBIT AND OTHER
DEVICES THROUGH APPLE HEALTH FOR
INSTANCE AND WE ALSO STARTED A
PILOT WHERE WE GIVE OUT 20,000
FIT BIT DEVICES AND ON THE RIGHT
YOU SEE ONE OF THE SCREENSHOTS
OF ONE OF THE PARTICIPANT FACING
APPLICATIONS. WE HAVE
SMARTPHONE APPS AS WELL AS
WEBSITES THAT IS ACTUALLY
LINKAGE OF MY HEALTH RECORD FROM
TWO OF MY PROVIDERS THAT I WAS
FORMALLY AS AT VANDERBILT AND
NOW GET DATA FROM HOPKINS
AFFILIATED INSTITUTIONS AND SO
OUR PROVIDERS AND SO I CAN LINK
THEM IN AND VISUALIZE THOSE
INFORMATION. IN ADDITION TO
MEDICAL CENTERS DIRECTLY
DONATING DATA INTO OUR DATA AND
RESEARCH CENTER IN HARMONIZED
FORMATS WE PULL TOGETHER, WE
ALLOW ALSO PARTICIPANTS TO LINK
IN OWN MEDICAL RECORDS AND
PROVIDERS THAT MAY NOT BE PART
OF THAT THAT IS A RELATIVELY NEW
TECHNOLOGY AND WE ARE FRANKLY
SEEING GREATER ADOPTION THAN I
EXPECTED WITH THAT.
WHEN WE TALK TO PARTICIPANTS,
ONE OF THE KEY VALUES WE SAW WAS
HOW TO RETURN VALUE TO THEM THAT
WAS IMPORTANT TO THEM. THERE
ARE MANY WAYS AND MANY REASONS
THAT PEOPLE JOINED.
THE FIRST IS ALTRUISTIC. HOW
CAN WE FURTHER HEALTH OR, YOU
KNOW, FOR OURSELVES AND OUR
FAMILIES AND COMMUNITIES FOR THE
WORLD?
HOW CAN WE RETURN INFORMATION
AND MAKE THEIR TIME VALUABLE AND
OF THAT KIND OF INFORMATION THE
MOST IMPORTANT CONSISTENTLY HAS
BEEN GENETIC INFORMATION THAT
ESPECIALLY IS HEALTH RELATED
GENETIC INFORMATION AND OTHER
KINDS OF INFORMATION YOU KNOW
SUCH AS LISTED HERE WE ARE
RETURNING AS WELL. YOU SAW A
PICTURE OF HR DATA WE ARE
RETURNING IN LIMITED FASHIONS
NOW THAT WE HOPE TO EXPAND AND
SURVEY DATA THAT YOU CAN SEE
COMPARES TO OTHERS AND SENDING
INFORMATION ABOUT STUDIES TO
PARTICIPANTS AND WHAT HAS
HAPPENED IN THE PROGRAM. FIRST
THING WE LAUNCHED ON GENETICS
WERE NON-HEALTH RELATED GENETIC
TRAITS RELATED AROUND GENETIC
ANCESTRY NOT HEALTH TRAITS YOU
CAN SEE IN THE FIRST BAR HERE.
THOSE LAUNCH THE IN THE END OF
2020.
WE DEVELOPED HEALTH INFORMATION
RETURN. THIS IS AN FDA APPROVED
PROCESS THROUGH INVESTIGATIONAL
DEVICE EXCEPTION THAT WE WORKED
OUT THROUGH THEM AND WE HAVE A
NUMBER OF PARTNERS IN THE
PROCESS THAT STARTS WITH BOTH
GENERATION OF HEREDITARY DISEASE
REPORTS AND MEDICINE IN DNA OR
FARMICO GENETIC REPORTS THAT
GIVES YOU A SENSE OF WHAT THE
GENETIC ANCESTRY AND TRAITS
LOOKS LIKE. WE HAVE GIVEN
NOTIFICATION OF ANCESTRY AND
TRAITS TO NEARLY 190,000
PARTICIPANTS SO FAR AND 70% OF
FOLKS GOING THROUGH THE PROCESS
TO VIEW THESE AND OF COURSE NO.
WE GIVE EVERYONE THE OPTION
WHETHER THEY WANT THIS KIND OF
INFORMATION BACK FIRST OF ALL.
NOT EVERYONE CHOOSES TO RECEIVE
SUFFICIENT INFORMATION AND
COMMONLY VIEWED OF THIS IF THEY
VIEW SOMETHING IS GENETIC
ANCESTRY THAT IS 10% MORE OR
NEARLY 100% OF PEOPLE THAT VIEW
SOMETHING VIEW GENETIC ANCESTRY.
ON TO HEALTH RELATED WE
ANNOUNCED THE LAUNCH OF THIS IN
DECEMBER OF 2022. AFTER
PILOTING FOR A COUPLE OF MONTHS
WITH OUR EARLIEST PARTICIPANTS
AND RIGOROUS TESTS OF THE
SYSTEM.
YOU CAN SEE A SCREENSHOT OF AN
ACMG59 DISEASE RISK REPORT FOR
BACKA 1 THAT IS PART OF THAT.
WE HAVE A VERSION THAT IS BOTH
MORE FRIENDLY TOWARDS PROVIDERS
AND ONE MORE FOR PARTICIPANTS
AND THEN A FARMICO GENETIC
REPORT THERE. PARTICIPANTS
IMPORTANTLY CAN CHOOSE WHAT THEY
WANT TO SEE IF THEY WANT TO SEE
ANYTHING. ONCE THEY CHOOSE THAT
THEY WANT RESULTS, THEN WE
INTERPRET THEIR GENOME.
FOR ACMG59 RESULTS WE VALIDATE
FROM A SECOND SAMPLE PULLED FROM
BIOBANK AND CLINICAL
LABORATORIES AND ESSENTIALLY
ORTHOGONAL APPROACHES ALL THOSE
APPROACHES ARE RETURNED THROUGH
GENETIC COUNSELORS AND SO FAR WE
HAVE NOTIFIED OVER 10,000
PARTICIPANTS THAT THEY CAN
CHOOSE THIS PROCESS AND OVER
4,000 HAVE SEEN THEIR RESULTS.
WE TELL ABOUT ANOTHER 1,000
PARTICIPANTS OR SO EVERY WEEK
THAT THEY CAN CHOOSE THIS. WE
BEGIN THIS PROCESS OF
INTERPRETING THEIR GENOMES AND
RELEASING REPORTS.
THIS GIVES YOU A SENSE OF HOW WE
THINK ABOUT RESEARCHER DATA
ACCESS.
WE GET A TON OF DATA COMING IF
IN FROM MANY DIFFERENT POINTS OF
PHYSICIANS THAT ARE AROUND RAW
DATA REPOSITORIES.
AND THE -- AS DATA COMES IN,
THEY ARE ALL HARMONIZE THE
AGAINST DIFFERENT COMPONENTS AND
WE OF COURSE PRESERVE OR APPLY
PRIVACY METHODOLOGIES DOING QA
AND QC EFFORTS ON THOSE AND HAVE
DIFFERENT TIERS OF ACCESS
STARTING WITH PUBLIC TIERS
ANYONE CAN ACCESS THROUGH WHAT
WE CALL DATA BROWSER THAT ALLOWS
YOU TO GET ESSENCES OF COUNTS ON
DISEASES OR MEDICATIONS OR
DISTRIBUTION OF LAB VALUES OR
SURVEY RESPONSES.
YOU COULD DIVE INTO, YOU KNOW,
SUBSTANCE USE AND OTHER
COMPONENTS THROUGH THESE KINDS
OF THINGS AND THERE IS ELEMENTS
AROUND TRAVEL HISTORY AND A
NUMBER OF COMPONENTS GIVING A
SENSE OF WHAT DATA IS THERE OR
WHETHER OR NOT YOU HAVE ENOUGH
PEOPLE TO BEGIN TO ANSWER A
QUESTION YOU MIGHT BE INTERESTED
IN. YOU CAN COME IN AND GET
INDIVIDUAL DATA ACCESS THROUGH
STUDY WORK RESEARCHERS BENCH IN
ALL CASES WE REMOVE OBVIOUS
PERSONALLY IDENTIFYING
INFORMATION AND WE HAVE GENOMIC
DATA, OF COURSE.
AND OTHER MORE IDENTIFYING DATA
IN THE CONTROLLED TIER. OVER
TIME I WILL TALK IN THE END A
LITTLE ABOUT SUPPORTING MORE
ANCILLARY STUDIES INVOLVING
ACTUAL INDIVIDUAL PARTICIPANT
RECONTACT BY BIOSPECIMEN
RESEARCH AND PUBLIC DATA LOOKING
LIKE ANYONE CAN USE NOW
FOLLOWING THIS Q.R. CODE THAT
GIVES A SENSE WHAT WE DO TO PULL
DATA TOGETHER.
MANY ARE FAMILIAR WITH THE
CLINICAL WORLD THAT KNOWS A LOT
OF CODES COMING IN ICD9 CODES
TRANSITIONED TO ICD10 AND 2015
AND WE HAVE PROBLEM ES CODES AND
NOMED AND TERMINOLOGIES THAT
DATA IS ENTERED IN AND HARMONIZE
THEM INTO DIFFERENT APPROACHES.
FOR INSTANCE SEARCHING FOR
CANCER YOU GET THOSE DATA MAPPED
INTO A HIERARCHY ACROSS THE
DIFFERENT TERMINOLOGIES AND DIVE
INTO BREAST CANCER AND DIFFERENT
UNDERLYING SYSTEMS ARE PULLED
TOGETHER YOU CAN SEE THOSE
AMALGAMATIONS OF COUNTS THERE
AND THIS REQUIRES OF COURSE NO
LOG IN TO GET IN. IF YOU APPLY
FOR DATA ACCESS YOU HAVE ACCESS
TO RESEARCH ERR WORK BENCH WHERE
YOU DO ANALYSIS AND STUDIES AND
DATA NOT AGGREGATED HIGHER
LEVELS ACROSS TABULATIONS YOU
MIGHT WANT TO DO IN A PROTECTED
SECURE SPACE AND ALL ANALYSIS IS
DONE IN OUR CLOUD AND WE -- YOU
DON'T DOWNLOAD DATA IN HERE AND
DO ANALYSIS AND TOOLS TO SUPPORT
THIS AND I WILL WALK THROUGH A
LITTLE IN DETAILED FUTURE THAT
IS A PASSPORT ACCESS MODEL. AS
USERS COME IN THEY ARE
AUTHENTICATED WITH SPONSORING
INSTITUTION AND THEY CAN
GENERATE NEW WORK SPACES ON THE
FLY FOR NEW STUDIES THEY WANT TO
DO. YOU CAN SEE EXAMPLES ON THE
TOP AND DO A STUDY ON DEMENTIA
AND SWITCH TO DO STUDY ON
DIABETES AND DESCRIBE PROCESS
WHY YOU ARE DOG AND WHAT YOU ARE
LOOKING AT AND POTENTIAL
OUTCOMES ARE AND THOSE ARE
POSTED -- INFORMATION THAT IS
POSTED ONLINE AND OTHER ELEMENTS
ON THAT ARE AVAILABLE FOR REVIEW
BIORESOURCE ACCESS PORTAL. WHEN
YOU CREATE THAT SPACE YOU CAN
START WORK IMMEDIATELY AND CAN
START A NEW PROJECT IN 20
MINUTES. THERE IS NO IRB
APPROVAL REQUIRED. WE HAVE DONE
THE IRB APPROVAL FOR THE PROGRAM
IN GENERAL. YOU CAN JUST GET
STARTED WORKING THAT IS
CURRENTLY OPEN TO US NON-PROFITS
AND OTHER ACADEMIC AND HEALTH
CARE INSTITUTIONS.
WE ARE WORKING TO EXPAND THIS TO
BROADER AUDIENCES RIGHT NOW.
AND HOPE TO BE ABLE TO DO THAT
WITHIN THE NEAR FUTURE.
AS WE THINK ABOUT THE DATA THAT
WE HAVE AND THE RESEARCHER WORK
BENCH, AS WE PULL IN THINGS LIKE
ELECTRONIC HEALTH RECORD AND
SURPRISING FITBIT DATA THERE IS
A BIT OF LONGITUDENALITY TO THAT
DATA. PARTICIPANTS STARTED TO
ROLL IN EARLY PILOT FASHION IN
2017 AND LARGER NUMBERS IN 2018
AND HR DATA GOING BACK 40 YEARS
ON SOME PARTICIPANTS AND FITBIT
DATA GOING BACK A BIT OF A
DECADE OR MORE ON PARTICIPANTS
AS WELL. YOU CAN SEE A QUANTITY
OF DATA THAT WE HAVE HERE. OF
COURSE, DATA AND RESEARCH
WORKBENCH LAGS SOME BEHIND AND
DATA SOURCES THAT WE HAVE
ACTUALLY A NUMBER OF
PARTICIPANTS ENROLLED.
IN 2022, WE LAUNCHED THE FIRST
CONTROL TIER AND FIRST SET OF
GENOMIC DATA THAT INCLUDES
100,000 GENOME SEQUENCES AND
165,000 ARRAYS IT THAT IS
AVAILABLE NOW AND IN THIS DATA
SET WE OBSERVED 600 MILLION
APPROXIMATELY UNIQUE VARIANTS.
OF THOSE 400 MILLION VARIANTS WE
OBSERVED OCCURRED AT LEAST ONE
PARTICIPANT NOT IN NOMAD THAT
YOU KNOW IS A COMMONLY USE THE
CLINICALLY AND RESEARCHWISE
AGGREGATION SERVICE OF LOTS OF
SEQUENCE DATA. 400 MILLION
VARIANTS ESSENTIALLY HAD NO THE
BEEN PRACTICALLY SEEN IN A WAY
THAT WE CAN USE THEM IN OTHERS
AND KNOW MUCH ABOUT THEM. 100
MILLION OF THOSE VARIANTS OCCUR
IN AT LEAST THREE PEOPLE IN OUR
PARTICIPANT DATA SET AND
IMPORTANTLY WE ARE WORKING ON
THE NEXT RELEASE THAT WILL BE
230,000 GENOMES.
AND INVITE YOU TO SIGN UP FOR
UPDATES FROM OUR PROGRAM. VIA
THIS URL IF YOU ARE INTERESTED
IN LEARNING MORE ABOUT THAT.
SO, YOU WILL HEAR AS THAT COMES
OUT.
I THINK THAT ONE OF THE REASONS
WHY WE ARE SEEING SO MANY NEW
VARIANTS THAT HAVEN'T BEEN
STUDIED BEFORE IS THE DIVERSITY
OF OUR SAMPLE AND MANY PROBABLY
KNOW GLOBAL GENOMEWIDE
ASSOCIATION STUDIES HAVE HEAVILY
BIASED PEOPLE TOWARDS EUROPEAN
ANCESTRY AND OVERALL IS
CONSISTENTLY OVER 90% THAT IS
GENERALLY OVER THE LAST DECADE
GROWN MORE BIASED OF PEOPLE OF
ANCESTRY IN GENOMIC STUDIES AND
YOU SEE DIVERSITY HERE, YOU
KNOW, OVERALL, YOU KNOW,
WORLDWIDE IS SPENDING LESS THAN
1% REPRESENTING BLACK AND
AFRICAN AMERICAN AND 1% LATINO
AND SPANISH AND IS AROUND 20% OF
EACH OF THOSE IN OUR POPULATION.
WE HOPE TO CONTINUE TO ADD AND
DIVERSIFY GLOBAL GENOMIC
RESEARCH BY VIRTUE OF THE STUDY
AND 4,000 RESEARCHERS SIGNED UP
TO JOIN THE PROGRAM AND ACTIVELY
ARE DOING WORK ON -- WITHIN ALL
THIS DATA AND OF REPRESENTING
AND COMING FROM 460
ORGANIZATIONS.
THAT INCLUDES 30HBCUS AT THIS
POINT AND 39 HISPANIC SERVING
INSTITUTIONS.
AND THEY ARE ALSO ANOTHER
NON-PROFITS IN THAT SETTING.
SO, I WANTED TO JUST GIVE YOU A
EXAMPLE WHAT IT LOOKS LIKE TO DO
GENOMEWIDE ASSOCIATION STUDY
THAT IS WALKING THROUGH TYPE 2
DIABETES.
SO, YOU KNOW, I -- I WAS PART OF
A NETWORK CALLED THE EMERGED
NETWORK SPONSORED BY NHDRI. ONE
OF THE EARLY PHENOTIECHS WE DID
AROUND EMERGE WAS TYPE 2
DIABETES TAKING US BETWEEN 2 AND
3 YEARS TO EXECUTE ALGORITHM
WITHIN EHR ACROSS 5 DIFFERENT
SITES TO EMAL GAMMATE DATA AND
WHEN I DID GWASS I BUILT
INFRASTRUCTURE AND SENSITIVITY
OF THE DATA AND COUPLE OF NODES
THAT COSTS $100,000 FOR ME TO
BUILD THAT WAS EXPENSIVE
UNDERTAKING TAKING A LONG TIME
TO WORK THROUGH THIS AND WAS
LOTS OF CODING BY LOTS OF PEOPLE
TO ACTUALLY WRITE QUERIES AND
PULL DATA AND HARMONIZE THEM
ACROSS DIFFERENT EHR AND YOU HAD
TO DO THINGS LIKE MANUALLY
CODING MISSPELLINGS OF WORDS
INTO OUR QUERIES.
NOW WE HAVE A NUMBER OF TOOLS
FOR THIS. IN THIS CASE, YOU
COME IN AND DESCRIBE YOUR WORK
SPACE YOU WANT TO DO IN ALL OF
US IN THIS CASE IN TYPE 2
DIABETES THAT TAKES 20 OR 30
MINUTES AND THEN YOU -- YOU GET
STARTED AND SO YOU ACTUALLY HAVE
WEB-BASED TOOLS THAT YOU CAN
BUILD COHORTS USING COMMON
BOOLEAN AND/OR NOT COUNTING
LOGIC AND THINGS LIKE THAT.
YOU CAN BUILD THIS TYPE 2
DIABETES ALGORITHM THAT IS
THERE. THEY ARE TOO SMALL TO
READ ON THE BOTTOM LEFT. YOU
CAN BUILD IT IN THE INTERFACE
POINTING AND CLICKING AND YOU
CAN ACTUALLY BUILD A DATA SET
THAT YOU WANT WITH A KEY
VARIABLES THAT YOU WANT TO
EXPORT AND ANALYZE IN YOUR
NOTEBOOK THAT IS WITH POINT AND
CLICK TOOLS AS WELL. WHEN YOU
WANT TO ACTUALLY DO ANALYSIS AT
THIS POINT YOU ARE DROPPED INTO
A JUPITER NOTEBOOK USING R OR
PYTHON AND WE ARE LOOKING TO
EXPAND TOOLS OVERTIME AND WE
HAVE A NUMBER OF DEMONSTRATION
NOTEBOOKS AS WELL INCLUDING ONES
HOW TO DO A GWAS. YOU CAN TAKE
GWAS NOTEBOOK WE BUILT AND TAKE
DATA SETS AND COHORTS AND CODE
IS WRITTEN THERE FORYOU AND YOU
CAN INSERT PIECES IN THE RIGHT
PLACES AND DO GWAS.
IN THIS CASE, WE HAVE BUILT THAT
COHORT AND WE HAVE BUILT DATA
SETS AND HAVE DONE ANALYSIS IN A
JUPITER NOTEBOOK AND IF FAMILIAR
WITH TYPE 2 DIABETES ONE OF THE
STRONGEST SIGNALS EARLY
IDENTIFIED WAS TCL702 YOU SEE
THAT THERE AND 23 MILLION SNIPS
IN THIS ANALYSIS AND 20,000
PARTICIPANTS AND CASES AND
CONTROLS TAKING TWENTD MINUTES
TO RUN AND TAKE POINT AND CLICK
AND SCALE UP TO A COUPLE HUNDRED
CPUS IF YOU WANT AND PICK THAT
AND TELLS YOU HOW MUCH IT COSTS
AND THIS ANALYSIS COSTS $3 SEVEN
TO RUN AND THIS WHOLE PROCESS
FROM START TO END TOOK THREE
DAYS.
SO, ONE PERSON THAT I HAVE IN MY
LAB THAT I CHARGED TO GO DO THIS
TO SEE HOW LONG IT WOULD TAKE
DIDN'T ACTUALLY -- DIDN'T TELL
HIM I WAS TIMING CAME BACK SO
FAST I KEPT TRACK HOW LONG IT
TOOK HIM TO DO AND DID IN 3 DAY
AND FASTER THAN BEFORE AND
DIDN'T HAVE TO MAP IT ACROSS ALL
THESE DIFFERENT YOU KNOW
ELECTRONIC HEALTH RECORD SETS.
SO, HERE IS JUST COUNTS OF
DIFFERENT DISEASES THAT ARE IN
ALL OF US THAT YOU CAN SEE HERE
JUST HOW MANY PARTICIPANTS WE
HAVE. SOME ARE MAYBE BROADER
AND WOW DO HEART DISEASE OF
73,000 PEOPLE AND YOU WOULD WANT
TO PROBABLY SUBTYPE THAT 20,000
PEOPLE WITH COPD AND THINGS LIKE
HEARING LOSS AND 30,000 PEOPLE
HAVE THAT IN THE RECORD AND
FALLS 25,000 PEOPLE HAVE THAT
NOTED AND COVID CAN BE ATTRACTED
MANY DIFFERENT WAYS AND WILL
TALK MORE ABOUT COVID LATER.
IN THIS SLIDE, ACTUALLY.
WE PARTNERED WITH RECOVER AND
HEARD THAT CAME UP IN THE
EARLIER QUESTION AND ANSWER
PERIOD. I JUST PULLED SOME OF
THIS. WE PARTNERED WITH RECOVER
AND THEY HAD DEVELOPED THROUGH
N3C NODE OF RECOVER AN ALGORITHM
TO IDENTIFY PARTICIPANTS OR
PATIENTS IN THEIR SYSTEM USING
MACHINE LEARNING APPROACHES THAT
MIGHT HAVE LONG COVID AND
TRAINED IT BASED ON SUBSET OF
LONG COVID PATIENTS THAT GED
ICD10 CODE FOR LONG COVID. WE
PARTNERED WITH THEM AND THEY
ADAPTED THEIR ALGORITHM FOR ALL
OF US. FORTUNATELY WE USE THE
SAME BASIC UNDERLYING DATA MODEL
AS N3C AND AMONGST PARTICIPANTS
AT TIME THAT HAS RUN ON 15,000
COVID POSITIVE PATIENTS THAT
COUNT THE AS POSITIVE BASED ON
DEFINITION AND OF THOSE ABOUT
1800 IDENTIFIED AS POSSIBLY
HAVING LONG COVID. I WILL
HIGHLIGHT HOOER AS MANY OF YOU
KNOW WITH LONG COVID THAT ICD10
CODE THAT IS ACTUALLY RELATIVELY
NEW.
AND IT TURNED OUT WHEN THIS
ANALYSIS WAS DONE 30 PEOPLE HAD
THAT ICD10 CODE AND MANY PEOPLE
OF COURSE THE VAST MAJORITY OF
PEOPLE THAT LOOK LIKE THEY HAVE
LONG COVID DON'T HAVE ICD10 CODE
IN OUR DATA SET THAT IS REALLY
NOT THAT SURPRISING.
WE DO SEE TIME FOR THINGS TO
BECOME ADOPTED AND BECOME PART
OF BILLING PRACTICE.
AND ADDITIONALLY, YOU KNOW,
ICD10 CODES HAVE FALSE POSITIVE
AS WELL AS FALSE NEGATIVE. THIS
HAS BECOME A DEMONSTRATION
WORKSPACE THAT WE CALL IT. IF
YOU ARE A USER YOU CAN GO RIGHT
THROUGH THIS HERE AND GET ANYONE
WHO IS A -- WHO IS OF THOSE
4,000 RESEARCHERS THAT ARE
CURRENTLY ON THE SYSTEM IT THAT
CAN GO GRAB THIS NOTEBOOK
BUILDING OFF IT AND DOING
RESEARCH ON LONG COVID THAT IS
THERE TO BE USED, CLONED,
COPIED, MODIFIED FOR YOUR
RESEARCH.
WHAT DOES IT LOOK LIKE TO GAIN
ACCESS TO THE SYSTEM?
SO, THERE IS A -- THERE IS A FEW
STEPS HERE THAT STARTS WITH YOU
KNOW LIKE I TALKED TO YOU ABOUT
USING A DATA BROWSER AND SEEING
WHAT IS THERE AND AFTER THAT
YOUR INSTITUTION HAS TO HAVE AN
AGREEMENT WITH US AND VAST
MAJORITY OF INSTITUTIONS SIGN
MASTER AGREEMENTS MEANING THAT
ANY NEW USER HOWEVER THEY WANT
TO VALIDATE THAT USER CAN GET
STARTED IMMEDIATELY. THEY HAVE
A BLANKET AGREEMENT FOR THAT NEW
USER THAT TAKES A MEETING OF A
MONTH TO ONBOARD A NEW
INSTITUTION GOING THROUGH THAT
MASTER AGREEMENT PROCESS. IT IS
FAST AS FAR ASS THEY THIENGS GO
AND FROM A NEW RESEARCHER COMING
FROM THAT INSTITUTION THEY COME
ON AND APPLY FOR WORK RESEARCHER
BENCH ACCOUNT AND GO THROUGH
THAT PROCESS VALIDATE THEIR
IDENTITY AND COMPLETE TRAINING
THAT TAKES 1 TO 2 HOURS OF
SPECIFIC TRAINING AS WELL AS
GENERAL HUMAN SUNTS TRAINING AND
CAUGHT UP IN STUFF THEY NEED TO
KNOW RELEVANT TO USING ALL OF US
AND SIGN A CODE OF CONDUCT HOW
THEY WILL WORK WITH THAT SYSTEM
AND FOR INSTANCE NOT
RE-IDENTIFYING WITH PEOPLE AND
UNDERSTANDING THEIR DATA OR
WORKSPACES COULD BE AUDITED IF
THEY SEE OR IF WE SEE TYPES OF
ACTIVITY THAT SEEMS SUSPICIOUS
AND THINGS LIKE THAT. THEY ARE
READY TO GET STARTED AND CREATE
A NEW WORK SPACE AND DO WORK. A
NEW USER THAT COMES TO THE WORK
BENCH FOR THE VERY FIRST TIME
FROM ONE OF THE 430 INSTITUTIONS
CAN ACTUALLY SIGN IN FOR THE
FIRST TIME. THEY CAN BILL THEIR
FIRST ANALYSIS IN ABOUT TWO
HOURS AND GO THROUGH THIS WHOLE
PROGRAM AND WILL HAVE BEEN
APPROVED AS A NEW RESEARCHER.
THEY CAN START TO DO WORK. I
HAD A FORMER PHD STUDENT WHO WAS
ABLE TO REPLICATE ANALYSIS HE
SPENT A COUPLE YEARS WORKING ON
IT AT VANDERBILT AND PRODUCED
RESULT REPLICATING IT IN ALL OF
US FROM START OR FROM FIRST
APPLICATION TO FIGURE THAT WAS
READY FOR A MANUSCRIPT IN ABOUT
A WEEK.
SO, WHAT KINDS OF RESEARCH CAN
ALL OF US SUPPORT?
YOU CAN'T SUPPORT EVERYTHING.
WE ARE NOT A REPRESENTATIVE US
SAMPLE.
WE DON'T HAVE UNIFORM FOLLOW UP
OF ALL VARIABLES.
WITHIN THAT CONTEXT THERE IS ALL
SORTS OF THINGS WE CAN SUPPORT
AND ASSOCIATIONS BETWEEN
DISEASES MEDICATIONS BEHAVIORS
AND MANY OTHER FACTORS SOCIAL
DETERMINANTS OF HEALTH RECENT
MODULE WE LAUNCH ABOUT THAT.
HEALTH DISPARITIES WE ARE VERY
INTERESTED IN PROMOTING HEALTH
EQUITY THROUGH OUR SYSTEM AND
ACROSS HISTORICALLY
UNDER-REPRESENTED POPULATIONS
THINKING ABOUT BROADLY WHAT
TERMS MIGHT MEAN ASSESSING IT
BROADLY WITHIN OUR POPULATION
GENOMICS FARMICO GENOMICS
MEDICATIONS OVER TIME DRUG
RESPONSE PHENOTYPE AS PART OF
THAT MAPPING GENOMICS ON DRUG
TARGET DISCOVERY AND PREVENTION
AND HEALTH SCREENING EFFORTS
LOOKING AT COMPARING HOW SOME
DATA AND COMPARING TO IN HANES
FOR INSTANCE AND CIRCUMSTANCES
SOME OTHER PUBLISHED ON OTHER
TOPICS AND GEOSPATIAL LINKAGES
RIGHT NOW AVAILABLE 3 DIGIT --
YOU CAN DO WIDE VARIETY OF
ANALYSIS FROM BASIC STATISTICS
TO PREDICTIVE ANALYSTICS TO
ARTIFICIAL INTELLIGENCE
STATISTICS AND MANY MOR AND
SCATTERED PUBLICATIONS IT THAT
HAVE HAPPENED MORE RECENTLY IT
THAT I WILL TALK ABOUT A FEW IN
MORE DETAIL. YOU SEE A NUMBER
OF DIFFERENT THINGS BEING DONE
ACROSS THE PROGRAM. THIS IS ONE
LOOKING AT THE SO-CALLED LATINO
EPIDEMIOLOGICAL PARADOX WHERE
THERE IS OR HAS BEEN SOME
EVIDENCE THAT IS OF THAT
PARTICIPANTS WHO IDENTIFY AS
HISPANIC LATINO AND WHO HAVE
LOWER INCIDENTS OF
CARDIOVASCULAR DISEASE IN
CERTAIN CIRCUMSTANCES AND IN
THIS CASE FOUND HIGHER INSTANCES
OF CARDIOVASCULAR DISEASE TO
WHITE PARTICIPANTS AND SOMETIMES
BLACK PARTICIPANTS IN CASES AND
WERE ABLE TO DO THIS. ONE THING
I LIKED ABOUT THIS IS IT WAS LED
BY A RESIDENT AT MIAMI. SO,
JUST SHOWING ABILITY TO INVOLVE
PEOPLE IN EARLIER STAGES OF THE
CAREER. IN FACT, THERE IS A
RECENT HIGH SCHOOL SCIENCE
COMPETITION AWARDEE WHO USED ALL
OF US. WE ARE EXCITED TO SEE
SOME OF THE EARLIER ENGAGEMENTS
OF PEOPLE ALONG THE TRAINING
STAGES.
THIS HAS BEEN ONE OF THE MORE
RECENT PAPERS OUT LOOKING AT
STEP COUNT AND INFLUENCE ON
HEALTH.
WHAT THEY DID IS LOOKED AT STEP
COUNT AND QUANTITY FICTION OF
THAT OF COURSE FROM FITBIT DATA
AND INCIDENT DIAGNOSIS OVER TIME
STARTING AT 6 MONTHS FOLLOWING
THAT AND DID THIS THROUGH A
NUMBER OF COX MODELING HAZARD
RATIOS OVER TIME YOU SEE HERE
NOT SURPRISINGLY A NUMBER OF
DISEASES HAVE A PROTECTIVE
EFFECT. SOME OF THE BIGGEST
ONES SO BASICALLY MORE STEPS
EQUAL LESS LIKELIHOOD OF
OCCURRING ARE THINGS LIKE
OBSTRUCTIVE SLEEP APP KNEE AH
OBESITY AND TYPE 2 DIABETES AND
THINGS LIKE THAT. THEM FASIZES
FEN OHMWIDE APPROACH AVAILABLE
THROUGH RESOURCES IT THAT
CAPTURE COMPREHENSIVE PHENOTYPIC
DATA ACROSS A NUMBER OF DOMAINS
BOTH IN THIS CASE SURVEY AND
ELECTRONIC HEALTH RECORD AND IN
THIS ANALYSIS THEY USE
ELECTRONIC HEALTH RECORD AND
BOTH ARE OF COURSE AVAILABLE.
ONE THING REASSURING TO ME AS A
PRIMARY CARE PROVIDER ONCE UPON
A TIME WAS THAT YOU SEE THAT YOU
DON'T NECESSARILY HAVE TO GET TO
10,000 TO SEE INFLUENCES ON
HEALTH. YOU LOOK AT THE RIGHT
FIGURE. YOU KNOW?
DOUBLING YOUR ACCOUNT FROM 2,000
TO 4,000 A DAY AND ACTUALLY HAS
AN EFFECT ON A NUMBER OF HEALTH
OUTCOMES AND YOU CAN IMAGINE
THIS IN ANY CONTINUOUS FASHION.
ACTUALLY, WE NEED MORE DATA LIKE
THESE TO LOOK AT A LOT OF THE
OBSERVABLE ATTRIBUTES TO MEASURE
NOW TO KNOW IF THEY REALLY HAVE
CLINICAL IMPACTS OR NOT IN A
WEARY AND SURE WAY. I WANT TO
TALK ABOUT SOME OF THE THINGS
THAT ARE COMING IN THIS YEAR
THAT WE WILL REALLY HAVE MORE
DEVELOPMENTS IN THE MENTAL
HEALTH SPACE IN PARTICULAR.
WE ACTUALLY DID MENTAL HEALTH
SURVEYS IN REPEATED MEASURE
AROUND COVID-19 DURING 2020 AND
EARLY 2021. IT ALSO INCLUDED OF
COURSE AROUND THINGS LIKE COVID
AND WE WILL INVEST IN MORE OF
THAT THIS YEAR LAUNCHING SURVEY
MODULE AROUND MENTAL HEALTH AND
WELL BEING THIS YEAR AND COMING
FROM A NUMBER OF DIFFERENT
DOMAINS LIKE ALL STUDIES AND
SURVEYS WE TRY TO BORROW FROM
ESTABLISHED WELL VALIDATED
INSTRUMENTS AND ALL CONTENT IS
IN ENGLISH AND SPANISH. WE WILL
TRY TO RETURN INFORMATION FROM
THIS AS WELL. WE STARTED A
PILOT OF SOMETHING THAT IS A
LITTLE MORE INTERACTIVE AND MORE
FUN THAT ASSESSES QUANTITATIVE
INSTRUMENT AND ELEMENTS THAT ARE
AROUND MENTAL HEALTH. IT MAY
REALLY GET AT MORE DETAILED
PROGNOSTIC FACTORS TO THINK
ABOUT AND ASSOCIATE WITH
DIFFERENT DISEASE STATES AND
HEALTH STATES AND RESILIENCE IN
DIFFERENT CONDITION AND LAUNCHED
FOUR OF THEM CALLED EXPLORING
THE LINE. YOU CAN SEE WHAT SOME
ARE THINGS LIKE ASSESSING
WHETHER OR NOT LOOKING AT
PROBABILISTIC REWARD ELEMENT
HERE WHETHER OR NOT THERE ARE
MORE THAN 24 DOTS ON THE SCREEN
OR NOT IN A VERY RAPID FASHION
OR RECOGNIZING EMOTION THAT IS
PORTRAYED IN A DIVERSE SET OF
PICTURES OF DIFFERENT PHASES.
THESE ELEMENTS ARE -- PROVIDE
QUANTITATIVE MEASURES THAT CAN
BE ASSOCIATED WITH ALL KINDS OF
ELEMENTS WE HAVE THAT IS A
PARTNERSHIP WITH NIMH. I WANT
TO TELL YOU A BIT ABOUT WHAT
5-YEAR GOALS ARE THAT WE
ESTABLISHED IN 2021 AND BY END
OF 2026 WE WANT TO REACH A
MILLION DIVERSE PARTICIPANTS
THAT HAVE ENROLLED ACROSS THE
LIFESPAN THAT MEANS LAUNCHING
PEDIATRIC COHORT AND ENROLLMENT
AND SHARED ALL BASELINE
ELEMENTS.
AND WE, OF COURSE, WANT TO KEEP
LONGITUDINAL ENGAGEMENT WITH
THEM AND WANT TO EXPAND DATA
AVAILABLE THROUGH 1 MILLION
PARTICIPANTS TO, OF COURSE,
INCLUDE CURRENT DATA AND EXPAND
THAT TO CONTINUE TO LAUNCH NEW
SURVEYS AND IMPORTANTLY ONE AREA
THAT I KNOW WE ARE MISSING AND
WANT TO BOLSTER WOULD BE
ENVIRONMENTAL DATA AND CONTINUE
TO GROW THAT.
A NEW COMPONENT OF OUR GOALS FOR
OUR PROGRAM ARE ANCILLARY
STUDIES AND STUDIES WILL BILTD
ON COHORT LIKE EXPLORING OF MIND
THAT I WILL TELL YOU ABOUT
ANOTHER ONE IN A SECOND AND
BUILDING OFF THIS COHORT WILL
USE IT FOR THINGS LIKE
PARTICIPANT RECONTACT OR
BIOSPECIMENS HAVING PEOPLE
BRINGING IDEAS AND PARTNERSHIPS
WITH NIH INSTITUTES AND CENTERS
TO REALLY BUILD OFF OUR PROGRAM.
WE WANT TO GROW RESEARCHERS
LOOKING AT THERE IS NOT A LOT OF
PRIOR ART IN DATA AND WHEN WE
SET THEM IN 2021 LOOKING AT
AVAILABLE DATA AND NUMBER OF
RESEARCHERS AND STUDIES IN UK
BIOBANK WE SET GOAL AS 10,000
RESEARCHERS. WE HAVE 4,000
ALREADY.
YOU KNOW, I THINK WE WILL BLOW
THROUGH THE GOAL AND WHAT WE SET
OR WHAT WE THOUGHT WAS ACTUALLY
A SOMEWHAT, YOU KNOW, AMBITIOUS
NUMBER. WE STILL HAVE TO EXPAND
THAT GLOBAL OR COMMUNITY TO BE A
GLOBAL COMMUNITY OF RESEARCHERS
AS WELL AND THEN PARTICIPANT
VALUE. WE WANT TO CONTINUE TO
RETURN PARTICIPANT VALUE AND
EXPAND IT AND SETTING IN 2021 WE
JUST STARTED NON-HEALTH RELATED
GENOMIC RETURN AND NON-EHR
RETURN AND YOU SEE OF COURSE WE
ARE DOING HEALTH RELATED GENOMIC
RETURN THAT IS REALLY IMPORTANT
IN THINKING ABOUT HOW WE MAKE A
DIFFERENCE AND THINGS LIKE
HEALTH PRACTICE IN THIS COUNTRY
AND UP TO A MILLION DIVERSE
PARTICIPANTS WITH GENOMIC
RESULTS TAKING THEM TO PROVIDERS
THINKING ABOUT ULTLE MEATALLY
PRESCRIBING CARE AND/OR HEALTH
SCREENING BASED ON THESE.
WE WILL PROMOTE PRECISION
MEDICINE ACROSS THE COUNTRY THAT
IS MY HOPE AND SEEING CHANGES
WITHIN HEALTH CARE INSTITUTIONS
ALREADY THINKING ABOUT HOW TO
READY THEMSELVES FOR
PARTICIPANTS GETTING THIS SORT
OF DATA AND MENTIONED ANCILLARY
STUDIES AND I WILL TALK ABOUT A
LARGE ONE KICKING OFF SHORTLY
FOR ENROLLMENT PART OF NIH
COMMON FUND PROJECTS CALLED
NUTRITION FOR PRECISION HEALTH
THAT IS IMBEDDED WITHIN THE ALL
OF US PROGRAM.
IT HAS THREE DIFFERENT MODULES
STARTING WITH ENROLLMENT OF
10,000 PARTICIPANTS THAT WILL
UNDERGO MORE EXTENSIVE
QUESTIONNAIRES AND EXAMINING OF
A MEAL CHALLENGE THAT IS AROUND
THEIR DIET AND UNDERSTANDING
WHAT THEY ARE EATING AND IT
INCLUDES SOME ARTIFICIAL
INTELLIGENCE COMPONENTS AS WELL
TO PREDICT AND UNDERSTAND WHAT
THEY ARE EATING BASED ON
COMBINATIONS AND INTERLINKAGE OF
DIFFERENT KINDS OF DATA AND MOVE
TO SURVEY AND SORRY. SUB-2
MODULES OF THAT THAT WILL
EXAMINE CONTROLLED FEEDING
STUDIES BOTH EXTERNALLY LIVING
IN THE WORLD AND ACTUALLY
DOMICILE CONTROLLED FEEDING
STYLES AS WELL AND GETTING AN
ANSWER TO WHAT SOME DIETS ARE
AND WHAT EFFECT THEY HAVE IN A
BROAD WAY AND ACROSS MICROBIOME
AND OTHER METABOLOMIC MEASURES
IN OTHER COMPONENTS AS WELL
GIVING A SENSE OF DATA AND
BUILDING ON DATA THAT ALL OF US
NEED TO GET SEQUENCING AND DON'T
HAVE TO CAPTURE ELECTRONIC
HEALTH RECORDS AND THEY CAN
BUILD OFF THAT AND DO MORE FOCUS
SURVEYS RELATED TO THIS AND GET
DIET INFORMATION AND SOME
COMPONENTS WE MAY DECIDE TO
ADOPT MORE BROADLY AND DEVELOP A
COOL TOOL TO TAKE A PICTURE AND
ASSESS DIETS AND SOMETHING THAT
WE CAN INSTILL TO ALL
PARTICIPANTS AND SUBSET OF
PARTICIPANTS WILL BE DEEPLY
ANALYZE THE IN THERE.
THEN YOU HAVE HEARD ABOUT THESE
BEFORE. I WANT TO LET YOU KNOW
THAT WE IN PARTNERSHIP WITH 2NIH
INSTITUTES AND OTHERS HAVE
RELEASED RFAS R21 AND R23 DATA
AND NCIH IS ONE OF THOSE. WE
ARE VERY INTERESTED IN HOW IN
PROMOTING HOW DATA ARE USED AND
THINK THAT THE GOALS OF THE
INSTITUTE ARE REALLY IN LINE
WITH OURS THINKING BEYOND JUST,
YOU KNOW, INDIVIDUAL DISEASE
STATES TOWARDS MORE HOLISTIC
UNDERSTANDINGS OF HEALTH AND
INFLUENCE OF SO MANY
MULTIPLICITIES OF FACTORS
TOWARDS HEALTH IN GENERAL. WITH
THAT, I WILL SAY THANK YOU.
THESE ARE REAL PARTICIPANTS.
EVERYONE EXCEPT FOR MY DAUGHTER,
WHO IS, YOU KNOW, NOT YET
ELIGIBLE TO BE A PARTICIPANT BUT
THAT IS GOING TO BE CHANGING.
THANKS SO MUCH FOR YOUR TIME.
I'M HAPPY TO TAKE TIME AND HAVE
SOME QUESTIONS AND DISCUSSION.
>>OKAY. YES. THANK YOU VERY
MUCH.
WE DO HAVE TIME FOR QUESTIONS.
SO, LET US JUST GO AHEAD.
DR. HANY, SEE YOU FIRST.
>>AMAZING AND SO EXCITING AND
WHAT A RICH DATA SET. I REALLY
-- I APOLOGIZE. I DON'T
REMEMBER HEARING ABOUT THIS
BEFORE. IT IS REALLY AMAZING
AND LOVE THE DIVERSITY OF THE
DATA AND PARTICIPANTS AND
RESEARCHERS BUT I MIGHT HAVE
MISSED IT AND CLEARLY SUBSTANCE
USE EFFECT EFFECTS OUTCOME
MEASURES AND AREA OF INTEREST
AND DIDN'T SEE LOTS OF IT AND
THERE WAS SOME ALCOHOL. IS
THERE MORE DATA ON SUBSTANCE
USE?
>>GREAT QUESTION. YES, THERE
IS. EASY ANSWER.
WE HAVE SOME -- THAT IS SOME OF
THE QUESTIONNAIRES THAT PEOPLE
FILL OUT WOULD BE ON THAT TOPIC
BOTH, YOU KNOW, LEGAL AND IN
LEGAL SUBSTANCE USE AND THERE IS
QUANTITY FICTION IN THAT. SOME
OF THOSE ARE ACTUALLY ALSO
CAPTURED IN REPEATED SURVEYS WE
DID DURING COVID THAT ARE ABLE
TO LOOK AT CHANGES IN ALCOHOL
AND SMOKING, ET CETERA, USAGE TO
ENROLLMENT IN THE PANDEMIC.
THERE WILL PROBABLY BE
REASSESSMENTS OF THOSE THAT COME
IN THE FUTURE AS WELL.
>>THAT IS GREAT. DO YOU DO
[INDISCERNIBLE].
>>ONLY DATA NOW WE ARE
GENERATING ON BIOSPECIMENS ARE
GENOMICS.
WE ARE LOOKING FOR PARTNERSHIPS
AND THESE ANCILLARY STUDIES TO
HELP BUILD OUT WHAT OTHER KINDS
OF ASSESSMENTS WE WILL DO.
CERTAINLY THAT IS ONE POTENTIAL
USE CASE AMONG MANY THAT WOULD
BE CONSIDERED. I WILL ALSO ECHO
THOUGH THAT WE WOULD HAVE
ANYTHING THAT IS IN THE HR. YOU
KNOW, CERTAINLY UDSS AND THINGS
LIKE THAT WOULD BE IN THE EHR.
>>OKAY. DR. [INDISCERNIBLE].
>>HI. THANKS FOR THIS
FANTASTIC PRESENTATION AND
TELLING US ABOUT THIS AMAZING
INITIATIVE AND COUPLE QUESTIONS
I HAVE AND APOLOGIZE IF YOU
MENTIONED THIS. ARE
BIOSPECIMENS AVAILABLE FROM THE
STUDY IS THE FIRST QUESTION.
SECOND QUESTION IS DO YOU ALSO
RECORD THEUTION OF DIETARY
SUPPLEMENTS INCLUDING BOTANICAL
DIETARY SUPPLEMENTS?
>>AS WE OPEN ANCILLARY STUDIES
THEY WILL FIRST BE AVAILABLE TO
THINGS WE DEVELOPED IN
PARTNERSHIP WITH INSTITUTES AND
CENTERS.
WE ARE ENCOURAGING INDIVIDUAL
RESEARCHERS TO HAVE IDEAS AND
QUESTIONS TO PARTNER AND
POTENTIALLY TALK TO ICS FOR
IDEAS IN THAT SPACE.
EVENTUALLY, WE WILL PROBABLY
OPEN UP SOME AVAILABILITY TO
INDIVIDUAL RESEARCHERS BUT DON'T
KNOW WHAT THE PROCESS WILL LOOK
LIKE. THE SECOND QUESTION AND
I'M -- I APOLOGIZE I THOUGHT FOR
SURE I WOULD REMEMBER IT.
>>WHETHER YOU RECORD THE USE OF
DIETARY SUPPLEMENTS INCLUDING
BOTANICAL DIETARY SUPPLEMENTS.
>>AT THIS POINT WE DON'T
ACTUALLY HAVE A MODULE WHERE
SOMEONE FILLS OUT WHAT THEY TAKE
MEANING THAT THE MEDICATION
QUOTE INFORMATION IT THAT WE
HAVE WOULD BE WHATEVER WAS
ENTERED INTO THE ELECTRONIC
HEALTH RECORDS SYSTEM.
>>RIGHT.
>>THOSE TEND TO BE AS YOU KNOW
AS WELL AS I THEY TEND TO BE
UNDERRECORDED IN HR AND
SOMETIMES YOU GET THEM BUT IT IS
NOT UNIVERSAL YOU GET THEM.
>>OKAY. HOPEFULLY WE CAN
ENCOURAGE MORE PEOPLE TO DECLARE
THEM TO THEIR HEALTH CARE
PROFESSIONALS. THANKS SO MUCH.
>>YEAH. IT IS ALSO MAYBE A
DIRECTION TO GO THROUGH IN THE
FUTURE. MAYBE THAT IS IMPORTANT
TRANSITION.
>>TO ME IT IS. THANK YOU.
>>OH, YEAH. I UNDERSTAND IT.
>>THANKS.
>>OKAY. DR. JOHN LOUIE.
>>GREAT PRESENTATION AND VERY
INFORMATIVE AND PERHAPS I MISSED
THIS BUT DID YOU SAY THAT
HOPEFULLY THE TYPE OF DATA THAT
THE BANK HAS WOULD BE ABLE TO
HAVE ACCESS TO THOSE IN THIS
DATA SET?
>>THAT RESEARCHERS
INTERNATIONAL RESEARCHERS
TALKING ABOUT BROADER
RESEARCHERS ACCESS TO OUR DATA
SET?
>>NO. TYPE OF GENOMICS DATA
THAT BIO BANK HAS THAT ALL OF US
WOULD HAVE BEEN ABLE TO
[INDISCERNIBLE] AT SOME POINT.
>>YES. DEFINITELY. NEXT --
RIGHT NOW IS 100,000 WHOLE
GENOMES ARE AVAILABLE IN OUR
DATA SET. OF COURSE, WE HAVE
MUCH MORE DIVERSE DATA THAN WHAT
IS IN THE UK BIOBANK AND OUR
NEXT RELEASE THAT WILL BE OUT
SHORTLY WILL HAVE OVER 230,000
GENOMES IN IT.
>>THAT IS OUTSTANDING. THANK
YOU.
>>WE ARE AIMING FOR A MILLION
WHOLE GENOMES ON A WHOLE 1
MILLION.
>>DR. MCGEE HAS HER HAND UP
ALSO.
>>HI. THANK YOU SO MUCH. I
REALLY APPRECIATE THIS
PRESENTATION. I DON'T EVEN --
I'M SURE I CAN'T FORMULATE ALL
QUESTIONS THAT WILL COME AND
THIS WAS TOTALLY MIENTD-BLOWING
FOR ME. I'M CURIOUS IF THERE
ARE SPECIFIC MODULES OR WAYS FOR
GATHERING INFORMATION ALREADY
THAT FOCUS ON OR PROVIDE
INFORMATION ABOUT CONTEMPLATIVE
PRACTICE ENGAGEMENT WHETHER
MINDFULNESS OR YOGA OR SOMETHING
IN THE TO COME MAYBE BUCKET OF
PROJECTS?
>>YOU KNOW, THAT IS A REALLY
GREAT QUESTION. CERTAINLY I
WOULD EXPECT NOT A WHOLE LOT OF
THE INFORMATION BE AVAILABLE FOR
INSTANCE IN THE ELECTRONIC
HEALTH RECORD.
BUT, I THINK THERE IS RELEVANT
QUESTIONS IN THE COVID SURVEY IT
THAT WERE LAUNCH THE. YOU WOULD
HAVE TO ACTUALLY QUERY THOSE
KINDS OF THINGS THROUGH THE DATA
BROWSER THAT I MENTIONED BEFORE.
AND SEE IF THOSE KINDS OF
CONTENT ARE AVAILABLE.
IT SOUNDS LIKE ANOTHER GOOD
SUGGESTION FOR SOMETHING TO
CONSIDER FOR ANOTHER FUTURE
SURVEY MODULE.
>>THANK YOU SO MUCH.
>>OKAY. HOLD ON, PLEASE.
>>SO, FIRST OF ALL, THANKS SO
MUCH, JOSH. IT WAS A GREAT,
GREAT PRESENTATION AND SO
INSPIRING. I JUST WANT TO
FOLLOW UP ON THAT QUESTION ABOUT
THE DIETARY SUPPLEMENTS.
I WAS REALLY CURIOUS ABOUT THAT
WHEN WE FIRST HEARD ABOUT THE
PRECISION NUTRITION STUDY THAT
THERE WILL BE A SORT OF FREE
LIVING RIGHT COHORT WHERE IS
THAT STILL -- THAT IS STILL IN
PLAY; RIGHT?
>>WHY HE.
>>A FREE LIVING COHORT WHERE
PEOPLE WILL JUST STUDY THESE
PEOPLE.
>>THAT IS RIGHT.
>>I WOULD IMAGINE THAT IN THOSE
PEOPLE THAT WE PROBABLY WILL
HAVE QUESTIONNAIRES REGARDING
DIETARY SUPPLEMENTS; RIGHT?
>>RIGHT.
>>WOULDN'T MAKE SENSE TO SEE
WHAT THEY EAT WITHOUT ASKING
WHAT SUPPLEMENTS THEY TAKE THAT
WILL BE PART OF THE PRECISION
NUTRITION EFFORT. CORRECT?
>>THAT IS A REALLY EXCELLENT
ADDITION THAT I TEND TO OFTEN
TOO MUCH ANSWER QUESTIONS FROM
THE PERSPECTIVE OF HIGHER
COHORTS NOT THE PERSPECTIVE WHAT
ACTUALLY ENDS UP BEING A VERY
LARGE NUTRITION STUDY THAT WILL
HAVE THAT DATA IN GREAT DEPTH.
IT THINGS LIKE I IMAGINE ALL
SORTS OF OTHER STUDIES AROUND
METABOLITES THAT WILL HELP YOU
TO THINK THROUGH ALL SORTS OF
EXPOSURES THAT MIGHT NOT BE
THERE EVEN DIRECTLY THAT THEY
YOU KNOW FOR WHATEVER REASON
THAT THEY DIDN'T RECORD IT THAT
THEY MAY BE TAKING THAT IS A
GREAT OBSERVATION. THANK YOU.
>>ONE OF THE MILLION DOLLAR
QUESTIONS FOR PEOPLE WHO TAKE
DIETARY SUPPLEMENTS DOES IT --
WHAT IS THE ELAITIONSHIP OF THE
EFFECT OF THE SUPPLEMENT WITH
WHICH YOU ARE ALREADY EATING;
RIGHT?
THAT IS HARD TO DO AND THERE IS
NOT A LOT OF STUDIES THAT DO
THAT AND SEEMS A STUDY WITH
PRECISION NUTRITION WOULD BE A
UNIQUE AND PROBABLE OPPORTUNITY
TO LOOK AT THAT. I DON'T KNOW
IF IT IS SPECIFICALLY BLAND OR
MAYBE THERE CAN BE CONVERSATIONS
ABOUT THAT.
>>YEAH. YOU KNOW, IT IS
IMPORTANT. THE OTHER IMPORTANT
NOTICE IS AS ANCILLARY STUDIES
BUILD OFF RESOURCE, ALL OF THE
STUDIES WILL COME BACK TO THE
SAME RESEARCHER WORK BENCH AND
WE HAVE INFRASTRUCTURE TO MAKE
DATA BROADLY AVAILABLE TO LOTS
OF RESEARCHERS.
THAT ONE, WILL YOU HAVE TO WAIT
SOME TIME FOR BUT WILL REALLY
PROVIDE SOME REALLY INCREDIBLE
INFORMATION ACROSS DIET,
SUPPLEMENTS, YOU KNOW, THEN
CONTROLLED FEEDING STUDIES THAT
HAVE EFFECT ON MICROBIOME AND
METABOLITE STUDIES AND THINGS
CHANGING BEFORE AND AFTER
FEEDING STUDIES WILL BE PART OF
IT TOO.
>>UH-HUH. GREAT. THANK YOU.
GUNNER, YOU HAVE YOUR HAND UP?
>>YUP. FIRST OF ALL, JOSH,
THIS IS AMAZING. IT IS ONE HECK
OF A DATABASE. AWESOME JOB WITH
THIS. THIS IS A SORT OF MUNDANE
AND THINK I SORT OF KNOW THE
ANSWER TO THIS BUT ONE OF THE
THINGS THAT WE REQUIRE IN OUR
MEDICAL SCHOOLS THAT STUDENTS
HAVE RESEARCH EXPERIENCE AND FOR
VAST MAJORITY OF MEDICAL
STUDENTS YOU WENT THROUGH THE
PROCESS TURNS OUT TO BE SMALL
CASE REPORTER OR SMALL STUDIES
AND RESEARCHERS HAVE A PRETTY
GOOD SKILLSET AND QUESTION WOULD
BE I'M EXCITED ABOUT THIS
FILLING OUT PAPERWORK BECOME
INSTITUTIONAL MEMBER WOULD THAT
ALLOW STUDENTS TO ALSO BE ABLE
TO PARTICIPATE? HOW DOES IT
WORK IF WE ARE AN INSTITUTIONAL
MEMBER AND CAN OUR STUDENTS THEN
PARTICIPATE WITH ONE OF OUR
FACULTY MEMBERS IN A MENTOR
PROJECT? CLEAR ABOUT THAT?
UNDERSTAND WHAT I'M SAYING?
>>YOU ARE. I LOVE THE
QUESTION. BRING THEM ON. ALL
YOUR MEDICAL STUDENTS, LET'S GO
FOR IT.
>>OKAY.
>>IF YOU SIGN THE MASTER
AGREEMENT AS INSTITUTION HOWEVER
YOU CHOOSE TO VALIDATE USUALLY
IS TRUE THROUGH VALIDATING AN
INSTITUTIONAL E-MAIL ADDRESS FOR
MOST PLACES AND THOSE PEOPLE
COULD COME RIGHT ON AND DO
STUFF. YOU KNOW, YOU CAN
FACILITATE COLLABORATION VERY
NICELY AND PUT RESEARCH MENTOR
AS WELL AS THE STUDENT ON THE
SAME WORKSPACE. THEY CAN LOOK
AT THE CODE AND COHORTS THEY
BUILD TOGETHER AND ALL THOSE
THINGS.
I'M VERY ENTHUSIASTIC ABOUT
TRAINEES USING RESOURCES LIKE
THIS.
>>THAT IS AWESOME. I COULDN'T
BE MORE ENTHUSIASTIC ABOUT IT
MYSELF. GREAT JOB. THANK YOU.
>>THANK YOU.
>>WELL --
>>I WANT TO MAKE SURE TO SEE IF
ALL COUNCIL MEMBERS HAD A
CHANCE. IF NO OTHER QUESTIONS,
I DON'T WANT TO LET THE SESSION
END WITHOUT ASKING THE WHOLE
PERSON HEALTH QUESTION.
SO, IT IS A CHALLENGE. YOU
KNOW, WE HAVE HAD CONVERSATIONS
ALREADY ABOUT SORT OF, YOU KNOW,
INTEGRATING A PRIMARILY
DISEASE-FOCUSED ANALYTIC
APPROACH TO A MORE
HEALTH-FOCUSED APPROACH.
DO YOU HAVE ACCESS TO HOW THAT
COULD HAPPEN? I MEAN, CLEARLY,
YOU KNOW, WHEN WE -- WHEN WE --
WHEN PATIENTS HAVE DIAGNOSIS;
RIGHT?
EITHER THEY HAVE DIAGNOSIS OR
THEY DON'T; RIGHT?
IT IS EITHER A YES ORE NO TYPE
OF A QUESTION. THERE IS THAT
GRAY AREA BEFORE THE DIAGNOSIS
IS ACTUALLY MADE WHERE THERE IS
ALMOST A PREDISEASE STATE AND
STATE BEFORE THAT WHERE YOU HAVE
MORE OF A BEHAVIORAL SITUATION
WHERE THERE IS NOT EVEN ANY
CHEMICAL ABNORMALITY AND YOU ARE
STARTING TO SEE SOME LIFESTYLE,
YOU KNOW, PREDISPOSITION.
HOW WOULD A STUDY LIKE ALL OF US
ADDRESS SOMETHING LIKE THAT? IS
THAT SOMETHING THAT IS DOABLE?
YOU PRESENTED YOUR STEP STUDY
THAT I THINK IS HEADING IN THAT
DIRECTION.
>>YEAH. I THINK THESE ARE ALSO
OTHER MILLION DOLLAR QUESTIONS
THAT I THINK ARE IN TERMS OF HOW
WE ASSESS THEM AND BUILD WHAT
MAYBE SOME [INDISCERNIBLE] ARE.
IN SOME CASES THAT IS PROBABLY
COLLECTING DIFFERENT READINGS
AND VARIABLES. YOU ARE THE
EXPERT HERE AND COLLECTIVELY
YOUR COUNCIL WOULD BE HOW YOU
WOULD GO ABOUT DOING SOMETHING
LIKE THAT. I LOVE YOUR QUESTION
AND IT THAT TRANSITION TO
THINKING -- THERE IS DISCUSSION
EARLY ON ABOUT PRECISION
MEDICINE AND THINKING ABOUT
PRECISION HEALTH AND BROADEN
DEFINITION A LITTLE BIT IN WHAT
WE ARE THINKING ABOUT AND
CERTAINLY TERMS FROM THE VERY
BEGINNING LIKE RESILIENCE AND
WELLNESS AND DIFFERENT
COMPONENTS THAT ARE PART OF
THIS. IT IS REALLY WHERE WE
WANT TO HEAD AND BE MORE
INCLUSIVE AND STARTS WITH
BROADER NOT JUST ONE DOMAIN OF
DISEASE AND THINK STARTING WITH
BEING MORE HOLISTIC FEN OHMWIDE
IN THAT COMPONENT AND WITH THAT
IS A FOUNDATION TO START TO
COLLECT COMPONENTS CREATIVELY
WITH YOU AND HOW TO DO WHAT SOME
ASSESSMENTS MIGHT BE AND SOME
MIGHT BEGIN AS AN ANCILLARY
STUDY AND WHAT I MENTIONED WITH
SOME COMPONENTS ON NPH AND SOME
ELEMENTS COULD BE SOME THAT
COULD BE ADOPTED. YOU KNOW, IN
A LARGER SCALE ACROSS THE
PROGRAM.
>>UH-HUH. WE WOULD LOVE TO
WORK WITH YOU ON THIS. IT IS A
LITTLE BIT OF A SHIFT IN -- NOT
SHIFT BUT A DIFFERENT I DON'T
WANT TO SAY PHILOSOPHY BUT
DIFFERENT WAY OF LOOKING AT
HEALTH THAT IS COMPLEMENTARY TO
PRECISION MEDICINE THAT IS VERY
TARGETED YOU KNOW WHICH IS ALSO
EXTREMELY IMPORTANT AND THIS IS
EXCITING THAT ALL OF US PLATFORM
COULD REALLY ALLOW US TO DO
BOTH. IT IS GREAT.
>>DEFINITELY.
>>POWERFUL.
>>THANK YOU.
>>SO, GREAT. WELL, YOU HAVE
BEEN -- YOU HAVE ENTERTAINED US
WITH A WONDERFUL PRESENTATION.
YOU HAVE ANSWERED ALL OF OUR
QUESTIONS AND WE REALLY THANK
YOU FOR TAKING THE TIME OUT OF
YOUR BUSY DAY. WE REALLY LOOK
FORWARD TO HEARING MORE AS -- AS
ALL OF US CONTINUES TO EVOLVE
AND TO, YOU KNOW, FIGURE OUT ALL
OF THE WAYS TO INTERACT AND
PARTICIPATE. THANK YOU.
>>THANK YOU VERY MUCH FOR THE
TIME. I APPRECIATE THE
OPPORTUNITY TO SPEAK WITH ALL OF
YOU.
>>GREAT.
>>THANK YOU.
>>OKAY. WE ARE RIGHT ON TIME.
QUITE IMPRESSIVE.
>>NICE.
>>ABSOLUTELY.
>>TO HEAR OUR NEXT SPEAKER.
>>UH-HUH.
>>YUP. WE HAVE DR. GILLMAN
HERE PROGRAM DIRECTOR FOR
ENVIRONMENTAL INFLUENCES OF
CHILD HEALTH OUTCOMES ECHO AND
HANDING IT TO DR. LANGEVIN TO
INTRODUCE OUR NEXT SPEAKER.
>>THANK YOU. GREAT PLEASURE
INTRODUCING NEXT SPEAKER DR.
MATTHEW GILLMAN DIRECTOR OF
ENVIRONMENTAL INFLUENCES ON
CHILD HEALTH OUTCOMES OR ECHO
PROGRAM. ECHO IS A 7-YEAR NIH
INITIATIVE TO USE LARGE EXISTING
STUDY COHORTS TO CONDUCT
RESEARCH ON HIGH IMPACT
PEDIATRIC OUTCOME AND DR.
GILLMAN BEGAN HIS ROLE WITH NIH
IN JULY 2016 AND HE CAME TO NIH
FROM BOSTON WHERE HE WAS A
PROFESSOR OF POPULATION MEDICINE
AT HARVARD MEDICAL SCHOOL AND
PROFESSOR OF NUTRITION AT
HARVARD SCHOOL OF PUBLIC HEALTH.
DR. GILLMAN IS RECOGNIZED IN
INTERNATIONAL LEADER IN COHORT
STUDIES THROUGHOUT THE LIFESPAN
SERVING AS PRINCIPLE OR
COINVESTIGATOR ON SEVERAL
STUDIES THE FRAMING HEART STUDY
AND NATIONAL CHILDREN STUDY AND
RECIPIENT OF PRESTIGIOUS NIH
METHOD RESEARCH EXTENT TIME ON
MERIT AWARD. I WANT TO SAY FROM
THE VERY BEGINNING DR. GILLMAN
IS ONE OF THE FIRST PEOPLE I MET
AT NIH WHEN I FIRST CAME.
FIRST THING TELLING ME ASKING
HIM WHAT IS ECHO PROGRAM ABOUT?
DESCRIBING PROGRAM TO ME AND
VERY IMPRESSED FIRST TIME I
HEARD AND NOT TOO MANY SINCE
THEN HEARD A PROGRAM EXPLICITLY
FOCUSING ON POSITIVE HEALTH
OUTCOMES THAT I FELT VERY
INTERESTING AND TITLE OF THE
TALK TODAY IS ENVIRONMENTAL
INFLUENCES ON CHILDHOOD OUTCOMES
AND SHARED INTEREST WITH NCCIH.
WELCOME.
>>THANK YOU. IT IS A PLEASURE
TO BE HERE AND THANK YOU FOR THE
NICE INTRODUCTION AND NICE TO
MEET YOU ALL. I HEARD THE TAIL
END OF YOUR DISCUSSION WITH JOSH
DENNY AND YOU WILL SEE A GOOD
OVERLAP WITH WHAT I WILL TELL
YOU ABOUT IN THE ECHO PROGRAM.
I WILL FIRST STOP MY VIDEO AND
DO THE SHARE SCREEN THING.
THAT IS THE WRONG ONE. LET'S
TRY THIS ONE.
WE WILL TRY TO GET IT INTO
PRESENTER MODE.
OKAY. EVERYONE SEEING THAT NOW?
MARTINA, DOES IT LOOK GOOD?
>>WE SEE YOUR PRESENTER VIEW.
NOT SLIDES BUT YOUR PRESENTER
VIEW.
>>DISPLAY SETTINGS AT THE TOP.
GO THERE. TO THE RIGHT OF THAT.
>>YES. DISPLAY SETTINGS. NOW.
>>I CAN'T SEE IT ON MY SCREEN.
THAT IS SO INTERESTING. YEAH.
>>UH-HUH.
>>HUH. USUALLY I CAN SEE
DISPLAY SETTINGS ALL I CAN SEE.
>>MOVING TO THE RIGHT A LITTLE
BIT.
>>THAT IS MY MUTE BUTTON ON
MINE.
>>YEAH.
>>TELL ME WHERE TO MOVE THE
MOUSE.
>>TO THE RIGHT A LITTLE BIT.
GO TO THE RIGHT.
>>I'M NOT GETTING IT.
>>OKAY. GETTING IT THAT BAR.
>>VERY WEIRD.
>>I THINK YOU HAVE TO SHARE THE
OTHER SCREEN. YOU ARE SHARING
THE WRONG SCREEN, ACTUALLY.
>>LET'S TRY IT A DIFFERENT WAY.
>>UH-HUH.
>>NOPE.
>>WOULD YOU LIKE ME TO SHARE
SLIDES?
>>ONE MORE CHANCE.
>>UH-HUH.
>>YES. NOW. NOW WE ARE.
>>EXCELLENT.
>>PERFECT.
>>OKAY. THANK YOU.
WE WILL SEE IF WE CAN ADVANCE
THE SLIDES.
GREAT. OKAY. SO, TODAY, I
WOULD LIKE TO TELL YOU A LITTLE
ABOUT THE ECHO PROGRAM TO
DESCRIBE HOW WE APPROACH
POSITIVE HEALTH IN ECHO AND GIVE
YOU THREE EXAMPLES OF
COLLABORATIVE ECHO RESEARCH
RELATED TO NCCIH THEMES AND HAVE
PLENTY OF TIME FOR QUESTIONS AND
DISCUSSION.
FIRST, ABOUT ECHO. ECHO'S
MISSION IS ENHANCING HEALTH OF
CHILDREN FOR GENERATIONS TO
COME.
WE DO OUR WORK UNDER THE NOTION
THAT A GOOD START TO LIFE CAN
LAST A LIFETIME AND OVER
GENERATIONS.
WE UNDERSTAND TO ENSURE A GOOD
START WE HAVE TO KNOW SOMETHING
ABOUT POTENTIAL RISKS AND
RESILIENCIES WHETHER CONDITIONS
OR THINGS WE FIND ON OUR SHELVES
OR UNHEALTHFUL OR UNHEALTHFUL
HEAVENS AND HELPFUL TO KNOW WHEN
AND TO WHOM THESE APPLY TO
UNDERTAKE PRECISION PREVENTION.
IN GENERAL, WE WOULD LIKE TO
INFORM PROGRAMS POLICIES AND
PRACTICES AN APPROACH THAT WE
CALL SOLUTION-ORIENTED RESEARCH.
WE DO OUR WORK THROUGH BOTH
OBSERVATIONAL AND INTERVENTION
RESEARCH THAT IS ON THE RIGHT
AND IDEA STATES PEDIATRIC
CLINICAL TRIALS NETWORK AND ECHO
COHORTS ON THE LEFT THAT IS
OBSERVATIONAL WORK AND TOGETHER
THEY COVER 44 STATES DC AND
POIRTO ROOEKO AND TODAY WILL
FOCUS ON OBSERVATIONAL SIDE OF
ECHO. OVERALL GOAL OF ECHO
COHORTS IS ANSWERING SOLUTION
ORIENTED QUESTIONS ABOUT EFFECTS
OF BROAD RANGE OF EARLY
ENVIRONMENTAL EXPOSURES ON CHILD
HEALTH AND DEVELOPMENT. BY THIS
BROAD RANGE OF EARLY
ENVIRONMENTAL EXPOSURES
INVESTIGATORS COVER MANY FACETS
FROM SOCIETY TO BIOLOGY
INCLUDING PHYSICAL AND CHEMICAL
ENVIRONMENT SOCIETAL MEDICAL
PSYCHOSOCIAL BEHAVIORAL AND
BIOLOGICAL AND BECAUSE PERIOD
FROM CONCEPTION TO AGE 5 IS MOST
DEVELOPMENTALLY PLASTIC PERIOD.
WE FOCUS ON THAT AS A TIME WHERE
PERTUBATIONS OR [INDISCERNIBLE]
OR EVENTS MIGHT HAVE LIFETIME
CONSEQUENCES.
THEN WE FOCUS ON 5 KEY PEDIATRIC
OUTCOMES WITH HIGH IMPACT ON
CHILD HEALTH FROM BIRTH THROUGH
ADOLESCENCE INCLUDING PREPERIAND
POST NATAL UPPER AIRWAY AND AS
WE WILL TALK ABOUT MOSTLY TODAY
POSITIVE HEALTH OR WELLBEING.
WE HAVE CONSTRUCTED OVER THE
FIRST 6 PLUS YEARS OF ECHO WHAT
WE CALL ECHOWIDE CO-HORT WEAVING
TOGETHER DATA FROM 69
PRE-EXISTING AND ONGOING
MATERNAL CHILD AND COHORT
STUDIES CREATING DATA PLATFORM
FROM DATA FROM 69 COHORT STUDIES
FROM 103,000 PARTICIPANTS WITH
NOW MORE THAN 60 -- ABOUT 65,000
CHILDREN MORE THAN HALF OF WHOM
ARE ACTIVE FOLLOW UP AND NOW
MORE THAN 90 THOUSAND
BIOSPECIMENS AND IDEA TO
HARMONIZE EXISTING MEASURES
COHORTS CAME IN WITH. IT THAT
IS A BIG JOB. STANDARDIZING NEW
MEASURES AS COHORTS COLLECT NEW
DATA THROUGH COMMON DATA
COLLECTION PROTOCOL.
WE WOUND UP WITH A COHORT
DIVERSE IN TERMS OF GEOGRAPHY
SEX AGE SOCIOECONOMIC STATUS AND
YOU SEE ON THIS SLIDE RACE AND
ETHNICITY.
WE HAVE RECORRECTLY CREATED A
FIRST RELEASE OF A PUBLIC USED
DATABASE THAT IS UNDERPINNING A
NATIONWIDE RESEARCH RESOURCE.
WE WANT ECHO DATA TO BE AS
WIDELY AVAILABLE TO THE
SKUNTIVIC COMMUNITY AS POSSIBLE.
DATA ANALYSIS CENTER DEPOSITS
DEIDENTIFIED DATA ON REGULAR
INTERVALS ON NICH DATA SPECIMEN
HUB KNOWN AS DASH AND FIRST
PUBLIC RELEASE WAS ABOUT 5
MONTHS AGO AND RELEASES WILL BE
AT LEAST EVERY YEAR AND DEPOSIT
BIOSPECIMENS LATER ON THAT IS
WIDELY AVAILABLE TO THE
SCIENTIFIC COMMUNITY THROUGH
NICHD DASH ADMINISTRATIVE
REVIEW.
BEFORE I GO ON, I WANTED TO SAY
ALONG WITH CCIH WE BENEFITED
WITH COLLABORATIONS WITH MANY
INSTITUTES CENTERS AND OFFICES
ACROSS THE NIH. YOU CAN SEE
SOME OF THE THINGS WE WORKED ON
WITH OTHER INSTITUTES HERE IN
THIS LIST.
AND I JUST WANTED TO POINT YOUR
ATTENTION TO THE LAST BULLET.
OUR NEXT CYCLE FOR ECHO COHORTS
STARTS IN SEPTEMBER OF THIS YEAR
AND MEANT TO LAST ANOTHER 7
YEARS AND ONCE WE GET UP AND
RUNNING, WE WILL BE ATTENDING TO
POSSIBILITIES FOR CO-FUNDING FOR
NEW SCIENCE WITH OTHER
INSTITUTES AND CENTERS.
JUST AS A REMINDER, THE ECHO
PROGRAM IS IN THE OFFICE OF THE
DIRECTOR.
OKAY. SO, WHAT ARE WE TALKING
ABOUT WHEN WE MEET OR SAY
POSITIVE HEALTH IN THE ECHO
PROGRAM?
SO, WE THINK ABOUT HEALTH IN
SORT OF THESE TWO WAYS.
ON THE TOP, THE USUAL APPROACH,
WHICH YOU MIGHT CALL A NEGATIVE
APPROACH. WHICH EMPHASIZES
SUFFERING AND DISEASE.
YOU COULD SAY IN, YOU KNOW, LAY
LANGUAGE THAT STUDY IS WHAT GOES
WRONG. WE CAN ALSO STUDY WHAT
GOES RIGHT.
AND THERE IS TWO SORT OF MAIN
WAYS THAT WE THINK ABOUT THIS
AND A POSITIVE APPROACH. ONE IS
YOU CAN DEFINE POSITIVE HEALTH
AS ABSENCE OF DISEASE.
CERTAINLY SOME DISEASE SPECIFIC
ENTITIES HAVE DONE THAT LIKE THE
LIFE SIMPLE 7 FOR CARDIOVASCULAR
HEALTH AND WE THINK THERE IS A
MORE GENERIC MEANING OF POSITIVE
HEALTH THAT INCORPORATES
PHYSICAL, MENTAL, AND SOCIAL
WELLBEING. IN ADDITION TO
THINKING ABOUT A POSITIVE HEALTH
OUTCOME, WE CAN ALSO THINK ABOUT
A POSITIVE HEALTH OR ASSET-BASED
APPROACH THAT WE THINK ABOUT
STRENGTHS OR ASSETS AND BODY AND
BRAIN ASSETS AND ENVIRONMENTAL
RESOURCES. OVERTIME THEY
INTERACT WITH EACH OTHER TO
PRODUCE MORE HEALTHY FUNCTIONING
THAT IS AN ASSET BASED APPROACH
THAT ON THE RIGHT YOU SEE
VARIOUS DEFINITIONS OF POSITIVE
HEALTH OUTCOME WHETHER IT BE
PHYSICAL OR PSYCHOLOGICAL AND
MOST THAT WE LOOKED AT IS
PSYCHOLOGICAL HEALTH AND GLOBAL
HEALTH DOMAIN AND SOME PHYSICAL
AS WELL. SO, WHAT ARE STRENGTHS
AND ASSETS THAT WE MIGHT LOOK
AT?
THE WELL-BEING AND REDUCED
DISEASE RISK AND PROMOTE HEALTH
THAT COULD BE WE ARE TALKING
ABOUT PERSONAL ASSETS THAT MIGHT
BE PHYSICAL OR PSYCHOLOGICAL.
ONE THAT I WILL COME BACK TO IN
A EXAMPLE IS SLEEP HEALTH ON
RIGHT COULD BE ENVIRONMENTAL
RESOURCES ON BIOSPHERE AND BUILT
IN ENVIRONMENT AND SOCIAL AND
ORGANIZATIONAL ENVIRONMENT AND
MIDDLE OF THE INTEGRATED
FUNCTIONS COULD BE PHYSICAL OR
PSYCHOLOGICAL.
NOW, WHAT ABOUT POSITIVE HEALTH
OUTCOME IN THE ECHOWIDE COMMON
HEALTH PROTOCOL ASSESSING CHILD
ADOLESCENCE AND HEALTH AND
PERSONAL WELLBEING AND INCLUDES
THREE DOMAINS GENERAL HEALTH
LIFE SATISFACTION GENERAL
MEANING AND PURPOSE. EACH IS
MEASURED WITH PROMISE INSTRUMENT
YOU SEE IN 5 TO 7 YEARS GLOBAL
HEALTH ALONE BY PARENT PROXY AND
ONCE KIDS TURN 8 THEY REPORT
THEMSELVES BOTH GLOBAL AND
HEALTH AND LIFE SATISFACTION FOR
8 TO 11 YEARS AND IN 12 TO 7
TAENWE ADD MEANING AND PURPOSE.
THIS IS A PILOT STUDY WE DID
AMONG JUST OVER 1,000 PEOPLE.
IT IS WITH MEASURES OF GLOBAL
HEALTH AND DIE COT MIEZING
GLOBAL HEALTH INTO HIGHER LOW
AND LOOK AT IT IN DEMOGRAPHIC
AND CLINICAL CHARACTERISTICS AND
BLUE LINES ON TOP SHOW OLDER AGE
ASSOCIATED WITH LOWER GLOBAL
HEALTH AND GREEN LINES SHOW A
HIGHER FAMILY INCOME WAS
ASSOCIATED WITH HIGHER GLOBAL
HEALTH AND THE ORANGE LINE SHOWS
PRESENCE OF CHRONIC DISEASE WAS
ASSOCIATED WITH LOWER GLOBAL
HEALTH WITH NO REAL DIFFERENCES
BY SEX, RACE, OR ETHNICITY.
I WILL COME BACK TO THE CHRONIC
DISEASE IN ONE OF MY EXAMPLES.
LOOKING AT YOUR STRATEGIC PLAN
SEEMS IT THAT OUR APPROACH DOES
REALLY OVERLAP -- FOSTERING
RESEARCH -- TALKING ABOUT --
LOOKING AT INDIVIDUAL FAMILY AND
COMMUNITY POPULATION LEVELS THAT
IS A CONTINUUM BETWEEN HEALTH
AND DISEASE.
WE DEFINE IT AS WELL BEING
MEASURED GLOBAL HEALTH AND
MEANING AND PURPOSE AND MEASURES
AGES 5 TO 17 AND PERSON REPORTED
OUTCOME SCORE IS WORKING ON
MEASURES FOR YOUNGER KIDS THAT
THIS APPROACH ALLOWS SPECIFICITY
OF OUTCOME FACILITATING
COMMUNICATION FOSTERING
CONSISTENCY OVER ANALYSIS.
WE THINK ABOUT POSITIVE HEALTH
APPROACH KNOWN AS ASSET BASED
APPROACH MANNED ASSETS
ASSOCIATED NOT ONLY WITH
POSITIVE HEALTH AND FOUR OTHER
HEALTH OUTCOMES TOO IN THE ECHO
PROGRAM AND PREVIOUS SLIDE THESE
ARE CONSISTENT WITH WHOLE PERSON
CENTERED FRAMEWORK. I WILL SHOW
A FEW EXAMPLES OF COLLABORATIVE
ECHO RESEARCH RELATED TO NCCIH
THEMES.
ONE EXAMPLE HOW DOES COVID-19
RELATED STRESS EFFECT CHILD
WELLBEING AND CHRONIC PHYSICAL
AND MENTAL HEALTH CONDITIONS
EFFECT WELLBEING AND SLEEP
QUALITY CORRELATES WITH WELL
BEING AND FIRST TOOK ADVANTAGE
OF PIVOT WITH COVID-19 PANDEMIC
GETTING COVID-19 SPECIFIC
MEASURES IN COHORTS -- SWEEPING
DECISIONS TO ENVIRONMENTS THAT
CHILDREN GROW AND PLAY AND LEARN
AND TIME OF UNIVERSAL DISTRESS
TO IDENTIFY PROMOTING FACTORS
FOR POSITIVE PSYCHOLOGICAL WELL
BEING AND CONCEPTUAL MODEL
BEHIND STUDY IS RECOGNIZING
PANDEMIC ENGENDERED SOCIAL
ISOLATION POLICIES.
SOME OF WHICH COULD BE RELATED
TO PSYCHOLOGICAL STRESS HAVING
IMPACT ON LIFE SATISFACTION AND
WERE QUESTIONS IN THEMSELVES AND
ADDITIONAL QUESTIONS SOURCES OF
RESILIENCE FAMILY RELATIONSHIPS
-- PARTICIPANTS CAME FROM 11
COHORTS ACROSS 27 STATES AND
THEIR MAIN AGE IS 8 AND
COLLECTED DATA IN CAREGIVER
SURVEYS INCLUDING FAMILY
HARDSHIPS AND ENCOMPASS 24 OF
THEM AND FOR EXAMPLE
UNEMPLOYMENT AND ACCESS TO
HEALTH CARE FOOD SECURITY
CONCERNS ABOUT THE CHILD AND
ACUTE STRESS RELATED TO COVID-19
AND SCALE THAT PSYCHOLOGISTS
DEVELOPED ALIGNING WITH DSM
CRITERIA FOR ACUTE STRESS AND
SOCIAL CONNECTEDNESS AND HERE IS
ONE OF THE QUESTIONS THAT YOU
CAN SEE RESPONSE CATEGORIES
EXAMPLES IF IN THE QUESTIONNAIRE
AND FIRST PART OF THE ANALYSIS
THESE HARDSHIPS RELATED TO
SALIENT STRESSORS IN CHILDREN
ACCESS TO MEDICAL CARE AND
HEALTH CONCERNS RELATIONAL
IMPACT ON CHILD AND FAMILY AND
SOCIAL DISTANCING AND ECONOMIC
STRESSORS AND CONCERNS AND
ACCESS TO SUPPLIES AND RANGE IN
CHILDCARE AND LOOKING AT
LEFT-HAND SIDE OF THIS NOW
RESULTS ORIENTED CONCEPTUAL
MODEL WE CAN ASK QUESTIONS TO
WHAT EXTENT IS COVID RELATED
FAMILY HARDSHIPS CONTRIBUTING TO
CAREGIVER STRESS AND COVID-19
FAMILY HARDSHIPS RELATED TO
COVID-19 RELATED STRESS AND
PARTIALLY DIRECTLY AND MOSTLY
THROUGH PATHWAY OF THE CAREGIVER
ACUTE STRESS.
THESE METRICS ARE STANDARD
DEVIATION SCORES WITH STANDARD
ERROR IN PARENTHESIS.
IN TURN, CHILD COVID-19 RELATED
STRESS AT INVERSE IMPACT AS YOU
MIGHT EXPECT ON CHILD LIFESTYLE
SATISFACTION THAT IS NEGATIVE
3.7. SO, THE TRANSLATION OF
THESE RESULTS ARE YES HARDSHIPS
CONTRIBUTE TODAY CAREGIVER AND
CHILD STRESS THAT IN TURN HAVE
INVERSE IMPACT ON CHILD-LIFE
SATISFACTION AND PRACTICAL
CONSIDERATION IS FEDERAL STATE
AGENCIES TO [INDISCERNIBLE] TO
TARGET HARDSHIPS AS WE SAW
DURING FIRST COUPLE YEARS OF THE
COVID-19 PANDEMIC.
IT IS POSSIBLE TO DEVELOP
INTERVENTIONS TARGETING STRESS
AND LIFE SATISFACTION MEASURES
OF PSYCHOLOGICAL FUNCTIONING FOR
EXAMPLE THROUGH MINDFULNESS
INTERVENTIONS AND HAS BEEN ONE
CONCEPT PUT FORWARD IN IDEA
STATES CLINICAL TRIAL NETWORK TO
DO MIENTDFULNESS INTERVENTIONS.
SECOND PART OF THIS PROMOTING
AND PROTECTING IN THE STUDY YOU
CAN SEE HERE, SOCIAL CONNECTION
AND FAMILY ENGAGEMENT ARE BOTH
POSITIVELY RELATED TO CHILD
SATISFACTION THAT IS A PROMOTING
EFFECT. IN ADDITION, FAMILY
ENGAGEMENT HAS A PROTECTIVE
EFFECT AGAINST RELATIONSHIP
BETWEEN STRESS AND CHILD-LIFE
SATISFACTION THAT IS A MODIFIER
OF THAT EFFECT.
SO, SOCIAL CONNECTION AND FAMILY
ENGAGEMENT CAN PROMOTE
CHILDREN'S LIFE SATISFACTION
ADMITTING STRESS DUE TO PANDEMIC
AND HARDSHIP THAT ENTAILS. WHAT
ARE POSSIBLE PRACTICAL
CONSIDERATIONS HERE?
ONE IS SOCIAL PRESCRIBING AND
HEALTH PROFESSIONALS LEVERAGING
LOCAL ASSETS AND COMMUNITY
ACTIVITIES TO CONNECT -- FOSTER
FAMILY ENGAGEMENT STRATEGIES.
FOSTERING WORKING TOGETHER AS A
FAMILY TO SOLVE PROBLEMS AND
IDENTIFYING STRENGTH AND STAY
HOPEFUL. EVIDENCE-BASED WELL
VISIT PLANNER PRIMARY CARE
PRACTITIONERS USE TO ENGAGE
FAMILIES AND INDIVIDUALIZE
STRATEGIES.
OKAY. SECOND EXAMPLES THERE IS
MENTAL HEALTH AND CHILD
WELL-BEING. THIS IS PUBLISHED A
FEW MONTHS AGO TO EXAMINE
SELF-REPORTED GLOBAL HEALTH AND
LESS SATISFACTION FOR CHILDREN
ADOLESCENCE WITH AND WITHOUT
CHRONIC CONDITIONS. HERE COMES
NOT ONLY LIFE SATISFACTION AND
SATISFYING LIFE IS AND GLOBAL
HEALTH MEASURE COVERING PHYSICAL
AND SOCIAL AND MENTAL HEALTH.
SO, THERE HAS BEEN A PREVIOUS
PILOT STUDY IN ECHO INVOLVING
THREE COHORTS AGE 5 TO 9 YEAR
OLDS AND IN THIS STUDY THEY ARE
ABLE TO ONLY DIE COT MIEZ
PRESENCE AND ABSENCE OF CHRONIC
ILLNESS AND FOUND IN GENERAL
SMALL DIFFERENCES IN GLOBAL
HEALTH AND SIMILAR LIFE
SATISFACTION SUGGESTING WITH
CHRONIC ILLNESS KIDS COULD BE
SATISFIED WITH THEIR LIVES.
WELL, THIS STUDY FILLED
ADDITIONAL GAPS.
IT HAD AN OLDER AGE GROUP AND
WIDER AGE RANGE 8 TO 7 TAENAND
SAMPLE OF 13 ECHO COHORTS AND
EXAMINE SPECIFIC CONDITIONS
PHYSICAL CONDITIONS AS MOTOR
PROBLEMS COGNITIVE LIKE
DEVELOPMENTAL DELAY AND
EFFECTIVE LIKE ANXIETY AND
DEPRESSION AND COULD COMPARE
WITH NATIONAL NORMS FROM
NATIONAL SURVEY OF CHILDREN'S
HEALTH THAT DEVELOPED
PERCENTILES FROM PROMISED
MEASURES.
AND I MENTIONED PROMISE MEASURES
DEVELOPED AS PART OF NIH PATIENT
REPORTED OUTCOMES MEASURE
INFORMATION SYSTEM DEVELOPED IN
SCORE WITH A NONRESPONSE THEORY
AND DATA ANALYSIS IN THIS STUDY
PROMISING T SCORES REGREYSED ON
SOCIO DEMOGRAPHIC AND HEALTH
CONDITIONS AND AUTHORS
CONSIDERED CHANGE IN SCORE OF
MORE THAN A 3 THAT IS 1/3 OF
STANDARD DEVIATION AS A
SUBSTANTIVE CHANGE. STUDIES YOU
WILL SEE ON THE LEFT THAT HAD 1
THOUSAND 7 HUNDRED 64 CHILDREN.
18% PHYSICAL CONDITION ONLY AND
9% COGNITIVE ONLY. 4% EFFECTIVE
ONLY. 23% WITH MULTIPLE TYPES
AND IN COMPARE COMBRISON IN
NATIONAL SURVEY OF CHILDREN'S
HEALTH AND 65% HAD NO HEALTH
CONDITIONS AND SOME OF ECHO'S
COHORTS WERE RECRUITED ON BASIS
OF HAD HEALTH CONDITIONS THERE
ARE MORE HEALTH CONDITIONS HERE
THAN IN THE NATIONAL SAMPLE THAT
YOU CAN SEE ON THE RIGHT-HAND
SIDE THAT 8% ARE HISPANIC AND
24% BLACK AND 2/3 ANNUAL
HOUSEHOLD INCOME OF 50,000.
79% OF PARENTS HAD SOME COLLEGE
EDUCATION.
TURNING TO RESULTS WE MAINLY SEE
DEPRESSION AND SO ON THE BOTTOM
PANEL, YOU CAN SEE MENTAL HEALTH
DIAGNOSIS DEPRESSION ASSOCIATED
WITH [INDISCERNIBLE] THESE
PROMISED MEASURES ARE NORMED TO
MEDIAN OF 50 -- MEAN OF 50 AND
STANDARD DEVIATION OF 10. THIS
IS 2/3 OF A STANDARD DEVIATION
AND TOP PANEL YOU SEE CHRONIC
PAIN IS ASSOCIATED WITH
DECREMENT OF 3.5 IN GLOBAL
HEALTH.
MOSTLY LOOKING AT TABLE YOU WILL
SEE ESTIMATES FOR GLOBAL HEALTH
ON THE BOTTOM THAT THEY ARE A
LITTLE HIGHER THAN LIFE
SATISFACTION. THEY ARE MOSTLY
NOT MUCH DIFFERENT FROM 0.
EVEN THESE KIDS FOR THE MOST
PART WITH CHRONIC CONDITIONS
DIDN'T HAVE A LARGE DECKREMENT
IN GLOBAL HEALTH OR LIFE
SATISFACTION.
FINDING ON DEPRESSION BEARS
LOOKING AT PREVALENCE OF
DEPRESSION IN THESE KIDS IT THAT
WAS LESS THAN 1% IN CHILDREN
WITHOUT ANY OTHER CHRONIC
CONDITIONS AND 12% IN CHILDREN
WITH PHYSICAL HEALTH CONDITIONS
AND 14% WERE IN CHILDREN WITH
COGNITIVE OR DEVELOPMENTAL
CONDITIONS AND LARGE 41% IN
CHILDREN WITH ANXIETY.
THE AUTHORS LOOKED ALSO AT HOW
THESE RESULTS COMPARED WITH
NATIONAL NORMS.
SO, GLOBAL HEALTH AND LIFE
SATISFACTION AND WITH DEPRESSION
AND WITH CHRONIC PAIN AND WITH
NO DEPRESSION AND WITH OTHER
CHRONIC CONDITION WITH NO
DEPRESSION OR CHRONIC CONDITION
AND KIDS WITH DEPRESSION ARE IN
THE FAIR OR 25TH PERCENTILE FOR
GLOBAL HEALTH AND LIFE
SATISFACTION AND KIDS WITH
CHRONIC PAIN HAD DECREMENT OF
CHRONIC GLOBAL HEALTH IN THE
FAIR RANGE.
I'M SORRY. IN THE GOOD RANGE.
BUT, STILL LESS THAN 50TH
PERCENTILE WHEREAS NOT SO MUCH
IN THE LIFESTYLE SATISFACTION
AND OTHER TWO GROUPS WERE CLOSE
TO THE NATIONAL MEANS IN BOTH
MEASURES OF POSITIVE HEALTH.
KEY TAKEAWAYS FROM THE STUDY IS
MOST CHILDREN WITH CHRONIC
CONDITIONS HAVE LEVELS OF
POSITIVE HEALTH SIMILAR TO PARTS
WITH CHRONIC HEALTH CONDITIONS
AND DEPRESSION ASSOCIATED WITH
POSITIVE HEALTH AND -- AMONG
CHILDREN WITH CHRONIC HEALTH
CONDITIONS. TRANSLATION IS TO
EXAMINE POTENTIAL BENEFITS AND
HARMS OF FACILITATING SCREENING
OR TREATMENT FOR DEPRESSION
AMONG CHILDREN WITH PHYSICAL
MENTAL HEALTH CONDITIONS AND
THIRD I WANTED TO TELL YOU ABOUT
SLEEP AND CHILD WELLBEING AND
SLEEP IS ONE THING I HAVE BEEN
INTERESTED IN A LONG TIME AND
POTENTIAL FOR INTERVENING SLEEP
DURATION AND SLEEP QUALITY AND
ESPECIALLY EARLY IN THE LIFE
COURSE AND SOMETHING THAT ALL
PARENTS WANT KIDS TO SLEEP
BETTER AND IS GOOD FOR
FUNCTIONING OF PARENTS AS WELL
AS KIDS.
AND WE KNOW THAT SLEEP QUALITY
IS IMPORTANT TO A NUMBER OF
CHILDREN'S HEALTH OUTCOMES.
PREVIOUS STUDIES FOCUSED ON POOR
SLEEP AND DURATION OF QUALITY
AND DISEASE OUTCOMES AND IS ONE
OF THE FIRST TO LOOK AT SLEEP
QUALITY AND POSITIVE HEALTH.
THIS PARTICULAR STUDY WAS
CROSS-SECTIONAL.
SO, THIS IS IMBEDDED IN POSITIVE
HEALTH PILOT STUDY WITH THREE
ECHO COHORTS AND ANALYSIS
INCLUDES 1,259 -- GENERAL HEALTH
PSYCHOLOGICAL STRESS AND LIFE
SATISFACTION AND GENERAL HEALTH
IS SAME AS GLOBAL HEALTH I WAS
TALKING ABOUT BEFORE. PROMISE
MEASURES ARE NORM THE TO GENERAL
POPULATION AND STUDY PERIOD
MARCH TO DECEMBER OF 2017.
THESE ARE MAIN RESULTS.
SO, POORER SLEEP QUALITY YOU SEE
ON THE LEFT IS ASSOCIATED WITH
LOWER LIFE SATISFACTION VIA ONE
ON THE TOP PSYCHOLOGICAL STRESS
YOU CAN SEE THAT PATH AS A
POSITIVE COEFFICIENT AND
COEFFICIENT FROM PSYCHOLOGICAL
STRESS TO LIFE SATISFACTION IS A
NEGATIVE COEFFICIENT.
SECONDLY TO A LESSER EXTENT
THROUGH GENERAL OR GLOBAL
HEALTH. YOU SEE POOR SLEEP
QUALITY IS NEGATIVE WILL I
ASSOCIATED WITH GENERAL HEALTH
IN TURN IS POSITIVELY ASSOCIATED
WITH LIFE SATISFACTION.
ADDITIONALLY THERE IS A LINK
THAT IS BETWEEN PSYCHOLOGICAL
STRESS AND GLOBAL HEALTH AND
NEGATIVE DIRECTION AS YOU WOULD
EXPECT.
ONCE MEDIATED PATHWAYS TAKEN
INTO ACCOUNT NO DIRECT EFFECT OF
POOR SLEEP QUALITY IN LIFE
SATISFACTION PAST F YOU CAN SEE
HERE. TAKEAWAY IS CHILDREN WHO
SLEEP BETTER HAVE NOR SATISFIED
LIVES THAT GIVES US ANOTHER
ELEMENT TAKING INTO
CONSIDERATION MOUNTING
INTERVENTION STUDIES TO IMPROVE
SLEEP DIMENSIONS IN CHILDREN.
AGAIN, IT IS AN AREA THAT IDEA
STATES NETWORK IS INTERESTED IN.
SO, OVERALL SUMMARY ECHO IS
MAJOR INVESTMENT UNDERSTANDING
ENVIRONMENTAL INFLUENCES ON
CHILD HEALTH RELATING TO 5 KEY
PEDIATRIC OUTCOMES INCLUDING
POSITIVE HEALTH.
ECHOWIDE COHORT FILLING EVIDENCE
GAPS ON LONG-TERM INFLUENCES
PRENATAL CHILDHOOD FACTORS
INCLUDING POSITIVE HEALTH AND WE
TRY TO TYPICALLY IDENTIFY GAPS
THROUGH ENGAGEMENT WITH
STAKEHOLDERS SO WE KNOW TO
EXTENT POSSIBLE WE ARE INFORMING
PRACTICES POLICIES AND PROGRAMS
AND ECHO COHORT TAKES ADVANTAGE
OF LARGE SAMPLE SIZE DIVERSITY
AND GENERALIZABLE THE AND
BECOMING NATIONWIDE RESOURCE
RESEARCH. I DIDN'T TALK ABOUT
UNITED STATES NETWORK BUT IDEA
THERE IS ALLOWING ACCESS TO
STATE OF THE ART CLINICAL TRIALS
AMONG KIDS FROM RURAL AND
UNDERSERVED POPULATIONS.
SO, THANK YOU VERY MUCH. I
REALLY APPRECIATE BEING HERE AND
I WILL STOP SHARING SO I CAN SEE
PEOPLE'S FACES.
THEN HAPPY TO ANSWER QUESTIONS
OR TO GET INTO ANY OTHER
DISCUSSION.
>>OKAY. THANK YOU SO MUCH.
THIS WAS REALLY INTERESTING.
FOR THOSE THAT I HAVE THE
ADVANTAGE OF SEEING THE SLIDES
BEFOREHAND.
I WAS NO -- I DIDN'T KNOW WHAT
TO EXPECT. I WAS LOOKING
FORWARD TO THIS.
LET'S OPEN IT UP FOR QUESTIONS.
LET'S SEE.
WE HAVE -- YOU HAVE TIME FOR
THIS DISCUSSION.
SO, YEAH.
DR. LOR ET CETERA KI, PLEASE GO
AHEAD.
>>AMAZING SET OF DATA. I'M A
GERIATRIC PSYCHIATRIST WORKING
WITH OLDER ADULTS. DO YOU EVER
WORK ON INTERVENTIONS
CONSIDERING INTERGENERATIONAL
INTERVENTIONS?
>>SO, IT THAT IS AN INTEREST OF
MINE IN PARTICULAR AND MANY
PEOPLE ON THE STAFF. IDEA
STATES NETWORK WE FOCUSED TO
DATE ON PEDIATRICS.
REASON IS THIS IS A NEW NETWORK.
IT IS MADE UP OF PEOPLE WHO
HAVEN'T DONE LOTS OF CLINICAL
TRIALS BEFORE. PIS ARE ALL
PEDIATRICIANS AND WE NEEDED A
PLACE TO START. THERE IS NOW
DISCUSSION OF DOING
INTERGENERATIONAL INTERVENTIONS
BY STARTING BEFORE BIRTH.
ON THE OTHER HAND, COHORT
STUDIES ALL DO INTERGENERATIONAL
RESEARCH.
NEXT CYCLE WILL ADD NOT ONLY
PRENATAL BUT PRECONCEPTION UNDER
PRECONCEPTION PILOT STUDY.
>>IT THAT IS WAY TO GO FOR
GLOBAL PREVENTION OF EVERYTHING.
THANK YOU.
>>YOU'RE WELCOME.
>>OKAY. DR. ZABINGA.
>>YES. THANKS SO MUCH. THAT
WAS WONDERFUL. AS A
PEDIATRICIAN AND SOMEBODY
TALKING TO ALL AGES OF CHILDREN
DIRECTLY TO TRY TO GET THEIR
SENSE OF WHAT IS GOING ON AND
HOW THEY ARE DOING, I WONDER HOW
MUCH WORK YOU LOOK AT TO LOOK AT
INTERRELATOR RELIABILITY BETWEEN
-- BETWEEN CAREGIVER REPORTING
AND TRIAL REPORTING. IT IS A
REALLY FASCINATING SET OF
STUDIES AND CERTAINLY INTENTION.
I THINK IT WILL BE POTENTIALLY
ENHANCED BY BETTER UNDERSTANDING
THE INFORMATION THAT WE GET FROM
CHILDREN DIRECTLY IN RELATION TO
THE INFORMATION FROM THE PEOPLE
AROUND THEM.
>>THANK YOU. THANK YOU FOR
THAT QUESTION. I THINK THERE IS
TWO WAYS TO ANSWER THAT.
ONE IS THE QUESTION FROM WHICH
RESPONDENT ARE WE GETTING THE
RIGHT ANSWER IS ONE KIND OF
QUESTION. OTHER QUESTION IS OH,
THESE TWO PEOPLE HAVE DIFFERENT
PERSPECTIVES.
LET'S TAKE THEM BOTH INTO
ACCOUNT.
SO, FOR THE FIRST KIND OF
QUESTION, WE HAVE EXAMPLES SAY
OF PUPITIAL CLIMBING AND HOW
GOOD QUESTIONS ARE DID CAREGIVER
ANSWER OR KID ANSWER?
WE HAVE OVERLAP THERE WE ARE
TRYING TO LOOK AT THAT. THAT IS
ONE KIND OF CAREGIVER PLUS CHILD
REPORT AND OTHER IS I THINK
REALLY INTERESTING IN
PERSON-REPORTED OUTCOMES IN
WHICH ARE MORE SENSITIVE TO
EXPOSURES OR ACTUALLY PREDICT
OUTCOMES BETTER. WE HAVE
EXAMPLES OF IT THAT ESPECIALLY
IN EARLY ADOLESCENCE. THANKS
FOR THE QUESTION.
PERSON-REPORTED OUTCOMES, CORE,
IT IS DOING SOME WORK ON
RELIABILITY.
MOSTLY ON MEASURES THEMSELVES.
IF WE THINK THAT THEY ARE TWO
DIFFERENT BOTH RELIABLE REPORTS,
THAT IS ALSO INFORMATIVE.
>>TOTALLY AGREE. IT THAT IS
WONDERFUL. WONDERFUL WORK,
THANK YOU.
>>THANKS.
>>OKAY. DR. HARRIS, PLEASE.
>>THANK YOU FOR THAT WONDERFUL
TALK, MATT. IT IS VERY
ENGAGING.
I WAS CURIOUS ABOUT THE
RELATIONSHIP OF BOTH PAIN AND
SLEEP. YOU ARE INTERESTED IN
SLEEP VERY MUCH.
AND WE KNOW THAT IN ADULTS THERE
IS A VERY TIGHT RELATIONSHIP
BETWEEN SAY A POOR NIGHT'S SLEEP
AND SOMEONE'S NEXT-DAY PAIN AND
VICE VERSA SOMEONE'S PAIN ON ONE
DAY AND CAN EFFECT SLEEP AND
PAIN AND SLEEP ARE CONNECTED.
IN KIDS AND ECHO STUDY DO YOU
ALSO SEE TIGHT RELATIONSHIPS
BETWEEN SLEEP AND PAIN AND A
CHILD'S WELLBEING?
>>THAT IS A QUESTION THAT IS
WONTDERFUL.
I DON'T THINK THAT WE HAVE
ADDRESSED THAT YET.
WE WILL TAKE THAT BACK. I MEAN,
I SHOWED YOU SOME THINGS THAT
ARE ABOUT CHRONIC PAIN AND
POSITIVE HEALTH AND ABOUT SLEEP
AND POSITIVE HEALTH BUT NOT
ABOUT THE TWO. I REALLY
APPRECIATE THE QUESTION. WE
WILL TAKE IT BACK.
>>EXCELLENT.
>>>>OKAY. YEAH. DR.
LANGEVIN, PLEASE.
>>WHY DON'T YOU GO. I WANT TO
GIVE COUNCIL MEMBERS A CHANCE TO
GO FIRST.
>>YEAH. I THINK -- YOU KNOW, I
THINK THAT IT IS REALLY THE
EMPHASIS THAT THE ECHO STUDY IS
GIVING ON HEALTHY DEVELOPMENT IS
SO IMPORTANT BECAUSE IN A WAY
WHAT IS PROTECTING PEOPLE FROM
THE -- YOU KNOW, BEING ABLE TO
DEFINE WHAT IS PROTECTING PEOPLE
FROM GOING INTO SOME SORT OF
DISEASE STATE IS REALLY
IMPORTANT. I THINK THAT YOU
TAKE THE EXAMPLE OF A BROKEN ARM
FOR EXAMPLE. MANY PEOPLE BREAK
LIMBS BUT NOT EVERYBODY GETS
COMPLEX REGIONAL PAIN SYNDROME
FOLLOWING A BROKEN LIMB AND
PROTECTING PEOPLE WITH THE SAME
TYPE OF INJURY FROM GOING AND
DEVELOPING A CHRONIC PAIN
SYNDROME AND HEARD HIM COMMENT.
THAT STUDY OF NORMAL HEALTH IS
EXTREMELY IMPORTANT.
>>THANK YOU FOR THE COMMENT. I
REALLY APPRECIATE IT. SOME OF
THIS REMINDS ME OF STUDIES SOME
INVESTIGATORS ARE DOING CALLED
POSITIVE OUTLIERS AND WHO IS
VERY RESILIENT IN THE FACE OF
STRESSORS AND IN ADDITION WE
TAKE THE VIEW THAT ALMOST ALL
BABIES ARE BORN HEALTHY AND HOW
DO WE KEEP THEM THAT WAY AS THEY
GROW AND DEVELOP?
I WANTED TO ASK ABOUT YOUR
PROMISE INSTRUMENT AND WE ARE
INTERESTED IN THIS AND CONTEXT
AT NICCH WE ARE INTERESTED IN
WHOLE PERSON HEALTH. THIS IS
COMPLEX. WE -- AS YOU -- THERE
WERE NICELY SHOWING IN THE
DIAGRAM THAT -- THAT, YOU KNOW,
REALLY KIND OF ABOUT DIFFERENT
LEVELS SHOWING RELATIONSHIPS
BETWEEN NCCIH'S APPROACH AND
ECHO AND APPRECIATE YOU SHOWED
THAT AND PHILOSOPHIES ARE WELL
ALIGNED AND I'M CURIOUS AS TO
WHETHER WE COULD ALIGN OUR
MEASUREMENTS AS WELL.
AND SO ONE OF THE THINGS WE ARE
WORKING ON RIGHT NOW IS TO TRY
TO DEVELOP A SET OF MEASURES
THAT WOULD TRULY CAPTURE THE
WHOLE -- THE HEALTH OF THE WHOLE
PERSON INCLUDING ALL THOSE, YOU
KNOW, DIMENSIONS.
SO, BIOLOGICAL BEHAVIORAL SOCIAL
AND ENVIRONMENTAL AND ALSO WOULD
CAPTURE CROSS SYSTEMS
INTEGRATION THAT WOULD GIVE YOU
AN UNDERSTANDING HOW THAT PERSON
IS FUNCTIONING IN VARIOUS
DIFFERENT PHYSIOLOGICAL DOMAINS.
YOU CAN SEE THIS BECOMES SO
COMPLEX. IT IS VERY CHALLENGING
TO DEVELOP A SET OF MEASURES TO
TRULY CAPTURE ALL THAT WITHOUT
BEING UNMANAGEMENTUNMANAGEABLE.
THAT COMES BACK IS MEASUREMENTS
OF WELLBEING AND SOME PEOPLE ARE
ON THIS COUNCIL WHO HAVE BEEN
REALLY VERY ALSO VERY INTERESTED
IN THIS.
THE FACT YOU HAVE ALREADY AT
LEAST YOUR MEASUREMENTS OF
POSITIVE OUTCOME THAT IS CORRECT
AND PROMISE OF GENERAL HEALTH
SATISFACTION MEANING AND
PURPOSE, WOULD YOU CONSIDER
THAT, THAT WOULD INCLUDE AN
ASSESSMENT OF WELLBEING?
IS THAT -- DO YOU THINK THAT IS
IN THERE SOMEWHERE?
>>I THINK OF THOSE THREE AS
ENCOMPASSING WHAT WE MEAN BY
WELLBEING.
>>UH-HUH.
>>WHEN I THINK ABOUT THE STATE
OF WELLBEING, THEY ARE THREE
DOMAINS THAT CONSTITUTE IT.
MAYBE THEY ARE NOT ALL OF IT,
BUT THEY ARE COMPONENTS OF IT.
>>UH-HUH. VERY INTERESTING.
SO, YOU KNOW, IT IS -- WELLBEING
IS CERTAINLY WE HAVE -- WE HAVE
WORKSHOPS ON THIS AND IT IS VERY
DIFFICULT TO -- TO DEFINE
RELATIONSHIPS FROM WELLBEING TO
HEALTH AND IS WELLBEING PART OF
HEALTH OR HEALTH PART OF
WELLBEING? YOU ARE PUTTING
WELLBEING ON THE OUTSIDE OF THE
ENVELOPE IF I'M CORRECT.
>>THE WAY WE OPERATIONALIZE
THIS AND ECHO THAT I UNDERSTAND
COULD BE UP FOR CONVERSATION IS
THAT POSITIVE HEALTH, WE ARE
MEASURING POSITIVE HEALTH AS
WELLBEING AND CONCEPTUALIZING
POSITIVE HEALTH AS WELLBEING AND
MEASURING IT BY GLOBAL HEALTH
LIFE SATISFACTION MEANING AND
PURPOSE.
>>AND SO.
>>UH-HUH.
>>WE THINK ES SPLESHL --
ESPECIALLY FOR CHILDREN THAT IN
MY BRAIN THIS IS A KEY OUTCOME
CONCEPT. IT IS DISEASE
DIAGNOSTIC.
MOST KIDS DON'T HAVE DISEASE?
WELL, YOU KNOW, WE DID SAY 50%
OF KIDS AND ECHO HAVE CHRONIC
CONDITIONS.
THIS IS A CHILD CENTRIC OUTCOME
AS WELL. IN OTHER WORDS, WE
OFTEN THINK ABOUT CHILDREN'S
HEALTH AND DISEASE AS A
PRECURSOR TO ADULT SOMETHING OR
OTHER WHETHER HEALTH FUNCTION
RING ECONOMICS OR JOBS OR
WHATEVER AND FORGET THAT KIDS
HAVE HEALTH STATUS IN AND OF
THEMSELVES WHICH IS IMPORTANT
FOR THE CHILD NOT JUST FOR
GROWING ADULTS OR PERSON GROWING
INTO AN ADULT.
I THINK OF POSITIVE HEALTH AS A
GOOD WAY TO CAPTURE THAT. IT IS
SOMETHING THAT IS MEANINGFUL TO
THE CHILD AND NOT JUST WHAT WE
AS ADULTS SAY WHEN WE MEASURE
BLOOD PRESSURE IN THE KID I DID
MY FELLOWSHIP ON AND 20 YEARS OF
RESEARCH ON. WE ARE THINKING
ABOUT THAT. YOU KNOW, .01
PERCENT OF THE KIDS HAVE
DISEASE.
WHAT IS SAVING THE CHILD HIM OR
HERSELF.
>>WHAT MATTERS TO THE CHILD.
>>WHAT MATTERS TO THE CHILD,
YEAH.
>>THIS IS SIMILAR TO THE WAY OR
MIGHT BE FAMILIAR WITH THE WHOLE
HEALTH PROGRAM AT THE VA.
>>UH-HUH.
>>PRIMARY AND THIS IS AN AREA
THAT WE ARE WORKING WITH PEOPLE
TO DEVELOP MEASURES OF THAT WHAT
MATTERS TO PATIENT OPPOSED TO
WHAT MATTERS WITH THE PATIENT.
>>YEAH.
>>I LOVE THAT.
>>IT SOUNDS LIKE YOU ARE
ALIGNED WITH THIS.
>>WE SHOULD TRY TO LINE UP OUR
MEASUREMENTS SINCE GOALS ARE --
I'M REALLY CURIOUS WHAT DR. SAYS
ABOUT THIS. ANYWAY, HELEN HAS
HER HAND UP FIRST.
>>I HAVE BEEN WORKING IN THIS
AREA FOR A WHILE STRUGGLING WITH
MEASUREMENTS ONE MEASURE DATA
POINTS OUT TO EXTREME RESILIENCE
IN CHILDREN AND TAKES HAVING
DEPRESSION ONLY COMPARED TO
EVERY OTHER CHRONIC CONDITION TO
GET THEM BACK.
IT WOULD BE IMPORTANT TO
UNDERSTAND WHAT FEATURES
REPRESENT THIS RESILIENCE BESIDE
WLZ OR NOT THEY HAVE DEPRESSION
THERE IS NOT GOOD PROMISE
MEASURE OF RESILIENCE AND
ADAPTIVE MEASURE AND I USE
DIFFERENT RESILIENCE MEASURES
UNDERSTANDING NEUROBIOLOGICAL
FACTORS THAT ARE CONTRIBUTING TO
RESILIENCE.
>>I APPRECIATE THAT QUESTION
AND TO DATE PEOPLE IN CONSORTIUM
UP TO DATE THINKING OF
RESILIENCE NOT AS A DEMAIN IN
AND OF ITSELF BUT AMALGAM OF
ASSETS I SHOWED AND I WOULD BE
INTERESTED IN HEARING ABOUT
THAT?
>>I WOULD LIKE TO TALK YOU TO
ABOUT THIS IF I CAN.
>>THANK YOU.
>>IF YOU CAN REACH OUT.
>>IF YOU WOULD LIKE TO RESPOND
DR. CLAYTON.
>>I HAVE A QUESTION. THANK YOU
FOR THAT. IT WAS INTERESTING I
DIDN'T KNOW A PROMISE AND
MEANING AND PURPOSE SCALE
SEEMING LIKE A GOOD STEP IN THE
RIGHT DIRECTION LET ALONE FOR
CHILDREN FOR YOUR AWARENESS
WORKING ON CONCEPT DEFINING AND
MEASURING WHOLE PERSON WELLBEING
OR HEALTH IN THE VA AND IS SO
CHALLENGING SO MANY DIMENSIONS
OBVIOUSLY AND DECIDING WHICH TO
FOCUS ON.
ANOTHER THING HAPPENING I DON'T
KNOW HOW IT CONNECTS WITH
TRANS-NIH WORK BUT THERE IS AN
INTERAGENCY OR FEDERAL
INTERAGENCY GROUP CALLED ELTRR A
FEDERAL PLAN FOR EVALUATING
LONG-TERM RESILIENCE AND
RECOVERY THAT WAS STARTED UP
DURING COVID.
THEY ARE WORKING ON BRINGING UP
TOGETHER MULTIPLE FEDERAL
AGENCIES AND HOW EACH ONE IS
DEFINING AND SUPPORTING
RESILIENCE THAT IS VERY WIDE
SCOPE RANGING ALL THE WAY FROM
RESILIENCE TO CLIMATE DISASTERS
TO RESILIENCE TO SOCIAL
PRESSURES TO DOMESTIC VIOLENCE
OR WHATEVER IT MIGHT BE.
THEY ARE TRYING TO COME UP WITH
A COLLECTIVE DEFINITION OF
RESILIENCE THAT THEY ARE GETTING
CLOSE TO. FROM THERE AND GOING
TO UNDERSTANDING UNIVERSE OF
MEASURES ACROSS FEDERAL
GOVERNMENT BY THE WAY AND
ESTABLISHING A REPOSITORY OR
PLATFORM PEOPLE DID LOOK WHAT IS
MEASURED IN WHAT SETTINGS AND TO
WHAT DEGREE WORK IS MEASURED
INTO THAT. NOT SURE BRAVO FOR
DOING IT THAT IN KIDS AND
APPROACHING IT IN KIDS. THANK
YOU.
>>THANK YOU FOR GREAT
INFORMATION.
>>WELL, I WANTED TO SAY A QUICK
WORD ABOUT RESILIENCE.
I AGREE WITH WHAT YOU WERE
SAYING MATT. RESILIENCE IS MORE
COMPLICATED. THERE IS A TREND
IN NIH WORKING GROUP ON
RESILIENCE WE ARE STRUGGLING
WITH DEFINITION OF RESILIENCE
AND WORKING ON IT OVER A YEAR
AND CLTRR GROUP STRUGGLING WITH
THAT AND IN NIH WE ARE HAVING
TROUBLE AND TO FOCUS ON
SOMETHING IMMEDIATE THAT IS
WELL-BEING I LIKE THAT
EDISTILLIENCE HAS LAYERS TO IT
AND STRESSOR FOR EXAMPLE AND
RESPONSE TO STRESSOR THAT
EFFECTS RESPONSE TO STRESSOR AND
WELLBEING IS JUST WHAT IS THE
PERSON THAT IS SUBJECTIVE
ASSESSMENT WHAT OR HOW THEY F
FEEL.
YOU CAN ASK THEM.
I THINK MY INSTINCT IS FOCUSING
FIRST OF ALL PINNING DOWN WELL
BEING IS THE FIRST TAVK.
>>THERE IS PLENTY MORE TO
LEARN. WE ARE HAPPY TO BE IN
THESE CONVERSATIONS. SOUNDS
LIKE MEASUREMENT INSTRUMENT IS
NOT BURDENSOME BUT REASONABLY
SIMPLE.
>>YES AND MAXIMUM OF 8 + 8 + 7
QUESTIONS AND RESPONSE THEORY SO
YOU DON'T NECESSARILY ANSWER ALL
OF THEM.
>>I WILL HAVE TO HEAR MORE
ABOUT THAT.
>>GREAT.
>>YEAH.
YOU DIDN'T FIND SALIENT
DIFFERENT IN TERMS OF OVERALL
WELLBEING THAT VAIRY WHEN YOU
LOOKED AT VARIATIONS BY RACE AND
ETHNICITY YOU FOUND DIFFERENCES
BASED ON WEALTH AND COULDN'T
REMEMBER OTHER VARIABLES
SIGNIFICANT DIFFERENCES CURIOUS
IF YOU WOULD.
>>THAT IS CORRECT
CROSS-SECTIONAL STUDY AND
BIVARIED ANALYSIS NO ASSOCIATION
WITH GLOBAL HEALTH AND RACE AND
ETHNICITY BUT WAS WITH INCOME.
>>OKAY.
>>THAT IS VERY INTERESTING TO
SEE CLEARLY.
>>YEAH.
>>ANOTHER IMPORTANT OTHER IS
CHRONIC ILLNESS IF I RECALL?
>>YES.
>>DEGREE.
>>THERE WAS NOT MUCH EFFECTS ON
LIFE SATISFACTION BUT MAYBE ON
GLOBAL HEALTH BUT NOT MUCH WHICH
IS INTERESTING.
>>YEAH. GREAT SALIENCE TO
ACCESS TO RESOURCES WHICH WE
KNOW THAT MATTERS A LOT.
>>ABSOLUTELY.
>>YES. THANK YOU.
>> DISENTANGLING SOCIOECONOMIC
FACTORS FROM RACE AND ETHNICITY
IS ALSO VERY IMPORTANT.
>>YEAH. THANKS SO MUCH.
>>ABSOLUTELY.
>>APPRECIATED THIS PRESENT
PRESENTATION.
>>DO WE HAVE MORE QUESTIONS?
>>I HAVE ONE MORE IF THERE IS
NO OTHERS.
IN YOUR PRESENTATION, MATT, YOU
SAID YOU ARE ENTERING A 7-YEAR
CYCLE. THIS WOULD BE NEXT YEAR?
BEGINNING?
>>YEAH. SLATED TO BEGIN
SEPTEMBER 1ST OF THIS YEAR. IT
WILL INVOLVE FOLLOWING UP ALL OF
THE CHILDREN WHO ARE ACTIVELY
AND FOLLOW UP NOW AS LONG AS THE
APPLICATIONS ARE AWARDED.
AS WELL AS CREATING A NEW COHORT
OF 20,000 PREGNANCIES AND
CONCEIVING PARTNERS.
AND FOR THOSE WHO ARE AT HIGH OR
MODERATE PROBABILITY FOR HAVING
A SECOND PREGNANCY DURING THE
FUNDING PERIOD WILL FORM A
PRECONCEPTION COHORT AND WILL GO
ON AND FOLLOW SECOND PREGNANCIES
AND THEIR CHILDREN.
>>THERE IS STILL OPPORTUNITIES
AND I PRESUME YOU MUST HAVE
FUNDING ANNOUNCEMENTS OUT
ALREADY FOR THIS?
>>YES. THEY CLOSED IN
NOVEMBER. ALL OF THE
APPLICATIONS ARE IN.
>>ALL APPLICATIONS ARE IN.
>>YES.
>>OKAY. WILL THERE BE MORE
OPPORTUNITIES IN THE FUTURE FOR
ADDITIONAL ANCILLARY STUDIES OR
SOMETHING LIKE THAT?
>>YES. THERE WILL BE
OPPORTUNITIES. WE HAVE
ANCILLARY STUDY PROCESSES NOW,
PRINCIPLES AND PROCESS.
AND AS LONG AS OUTSIDE
INVESTIGATORS COLLABORATE WITH
ECHO INVESTIGATOR THEY CAN
SUBMIT ANCILLARY STUDY AND
PUBLIC USE DATA SET, ANYBODY
WITH A BON AFIED POSITION
SOMEWHERE CAN USE THOSE DATA BUT
TEND TO BE A LITTLE FURTHER
BEHIND DATA OR THE ENCLAVE
PLATFORM WITH PII.
>>GREAT.
>>WELL, THIS IS ALL VERY
IMPORTANT AND I'M SURE IT WON'T
FALL ON DEAF EARS.
>>THANK YOU VERY MUCH TO
COUNCIL MEMBERS AND TO NCCIH.
AND ALLANA AND YOUR STAFF FOR
HAVING ME AND TO FOLLOW UP ON
CONVERSATIONS.
>>GREAT HAVING YOU AND THANK
YOU FOR TAKING TIME TO COME
SPEAK WITH US AND WE LOOK
FORWARD TO FOLLOWING UP ON MANY
POINTS WE DISCUSSED.
>>EXCELLENT. THANKS SO MUCH.
>>THANK YOU, MATT.
>>THANK YOU.
>>BYE.
>>OKAY. WITH THIS, WE WILL
MOVE TO THE NEXT ITEM ON THE
AGENDA. IT IS A CONCEPT
CLEARANCE BY DR. PETER MURRAY A
PROGRAM OFFICER IN OUR CLINICAL
RESEARCH BRANCH.
>>ARE YOU SEEING MY SLIDES?
>>YES, WE ARE. THANK YOU,
PETE.
>>OKAY. SO, FIRST, WHAT A
COUPLE GREAT TALKS THAT ARE
TOUGH TO FOLLOW IN THOSE
FOOTSTEPS. I WILL TRY TO MAKE
MY CONCEPT PROPOSAL SIMILARLY
RIVETING.
CONCEPT THAT I'M PUTTING FORWARD
FOR YOUR CONSIDERATION IS TO
ESTABLISH A RESEARCH RESOURCE
FOR SYSTEMATIC REVIEW OF
COMPLEMENTARY AND INTEGRATIVE
HEALTH.
WE FUND CLINICAL RESEARCH
GENERATING DATA ON SAFETY AND
EFFICACY INTERVENTIONS ACROSS
RANGE OF HEALTH CONDITIONS TO
INFORM CLINICAL PRACTICE AND
HEALTH POLICY AND TO ALSO GUIDE
TRAJECTORY OF RESEARCH PROGRAMS
THAT THERE IS A CHALLENGE
AGGREGATING STUDY RESULTS
PROVIDED BY DISTINCT GROUP OF
RESEARCHER WHEN METHODS AND
OUTCOMES DIFFER ACROSS STUDIES
AS THEY VERY OFTEN DO.
SYSTEMATIC REVIEWS PROVIDE A
METHODOLOGICAL TOOL TO SUMMARIZE
STUDY RESULTS FROM RANDOMIZED
CLINICAL CONTROLLED TRIALS IN AN
UNBIASED MANNER AND PROVIDE A
WAY TO ASSESS LITERATURE FOR
RISK OF PUBLICATION BIAS AND
PROVIDE FORMAT FOR HEALTH CARE
PRACTITIONERS FOR MASHENTS AND
POLICYMAKERS AND CLINICAL
PRACTICE GUIDELINE DEVELOPMENT
AND SYSTEMATIC REVIEWS MAY ALSO
CONCLUDE MAKING A RECOMMENDATION
FOR A GIVEN INTERVENTION.
IN ONE WAY THAT NCCIH USES THESE
SORTS OF CONCLUSIONS IS
INFORMING RESEARCH GAPS AND
SHAPING PORTFOLIO DEVELOPMENT.
JUST A LITTLE BACKGROUND ABOUT
NCCIH FUNDING IN THIS AREA.
NCCIH HAS FUNDED SEVERAL GROUPS
CONDUCTING SYSTEMATIC REVIEWS
FOR COMPLEMENTARY INTEGRATIVE
HEALTH APPROACHES MAINLY
ACUPUNCTURE SYSTEMATIC REVIEWS
AND HEALTH RESEARCH AND QUALITY
AND HEALTH CARE RESEARCH AND
QUALITY AND EVIDENCE-BASED
REVIEWS AND NOTABLY COCKRAN CAM
FIELD AND PROJECTS RESULTED IN
HIGH IMPACT PUBLICATIONS OF
SYSTEMATIC REVIEWS ABOUT
COMPLEMENTARY AND INTEGRATIVE
HEALTH APPROACHES AND THIS FIELD
ITSELF HAS BEEN CONTINUALLY
FUNDED BY NCCIH THAN NCAM SINCE
2003. THEY HAVE ESTABLISHED A
REGISTER OF CLINICAL TRIALS.
IT IS ON COMPLEMENTARY AND
INTEGRATIVE HEALTH INTERVENTIONS
AND CURRENTLY INCLUDING OVER
100,000 OF THESE CONTROLLED
TRIALS IN THE REGISTER. ALSO,
THEY HAVE PUBLISHED OR PUBLISHED
THEMSELVES OR SUPPORTED
PUBLICATION BY VARIOUS GROUPS
AROUND THE WORLD OF NEARLY 1,000
SYSTEMATIC REVIEWS FOCUSED ON
COMPLEMENTARY AND INTEGRATIVE
HEALTH APPROACHES AND WE HAVE
LINKS TO SEVERAL RESOURCES
INCLUDING COCHRAN REVIEWS ON THE
WEBSITE AND PURPOSE OF THIS
INITIATIVE IS TO ESTABLISH
SUPPORT FOR RESEARCH RESOURCE
FOR CONTINUATION OF A DATABASE
OF CONTROLLED TRIALS OF
COMPLEMENTARY AND INTEGRATIVE
HEALTH INTERVENTIONS AND
RESEARCH TEAM NEEDS TO SDLOOIB
DESCRIBE HOW TO ESTABLISH A
DATABASE OR CONVERT EXISTING
DATABASE AS WELL AS HOW TO
MAINTAIN AND KEEP CURRENT
INCREASE OUTREACH AND ACCESS AND
AVAILABLE THE OF THE DATABASE TO
BROADER SCIENTIFIC COMMUNITY
PUBLIC AND POLICY MAKERS AND TO
CONDUCT AND OR UPDATE SERIES OF
HIGH QUALITY SYSTEMATIC REVIEWS
AND METAANALYSIS EACH YEAR
INTEGRATIVE COMPLEMENTARY
ANALYSIS ALIGN WITH PLAN AND
PARTICULAR INTEREST AND TOPICS
RELATED TO WHOLE PERSON HEALTH.
SO, THE OBJECTIVES ARE TO
MAINTAIN AND KEEP CURRENT
RESEARCH RESOURCE CONSISTING OF
A DATABASE OF PRIMARY REPORTS OF
CONTROLLED TRIALS OF SPECTRUM
COMPLEMENTARY INTEGRATIVE HEALTH
CONVENTIONS UTILIZATION OF
RESOURCE TO CONDUCT AND UPDATE
REVIEWS AND INTEGRATIVE
APPROACHES AND WHEN POSSIBLE
METAANALYSIS AND INCREASING
VISIBLE THE OF RESOURCE AND
PRODUCTS OUTREACH SCIENTIFIC
COMMUNITY PUBLIC POLICY
STAKEHOLDERS AND WORKING WITH
BROADER SCIENTIFIC COMMUNITY
FURTHER DEVELOPING AND ENHANCING
METHODS OF SYSTEMATIC REVIEW AND
METAANALYSIS FOR NONFARM LOGIC
INTERVENTIONS. WITH THAT, I
WILL TAKE ANY QUESTIONS.
THANK YOU.
>>>>PETE, I HAVE A QUESTION.
THIS IS BEN. SO, I'M SORRY IF
THIS IS AN OBVIOUS QUESTION.
HOW DOES THIS RELATE TO THE
SUPPORT OF THE COCHRAN
COLLABORATIVE? I MEAN, THE
THINGS THAT YOU ARE DELINEATING,
AREN'T THEY THINGS THAT COCHRAN
DOES? SORRY. OBVIOUS QUESTION.
>>VERY FAIR QUESTION.
YES. WE HAVE A HISTORY OF
CONSISTENTLY FUNDING COCHRAN WHO
HAS BEEN SUCH A GREAT RESOURCE
FOR US. THAT AWARD IS COMING TO
AN END. WE ARE JUST THINKING
ABOUT, YOU KNOW, HOW TO MAINTAIN
THE -- A KIND OF RESOURCE THAT
PROVIDES THINGS THAT ARE SIMILAR
TO WHAT COCHRAN HAS PROVIDED TO
US IN THE PAST.
>>AND, AGAIN, I'M SORRY IF I'M
BELABORING. DOES THIS MEAN
COCHRAN IS NO LONGER ABLE TO DO
THAT OR ARE THEY ONE OF THE
ENTITIES THAT MIGHT APPLY FOR
THIS?
>>I DON'T THINK WE WILL --
>>I'M SORRY. MAYBE WE DON'T
TALK ABOUT THAT HERE.
>>ABOUT THE SPECIFICS.
>>YEAH.
>>THIS IS KIND OF THE OVERALL
GOAL.
>>OKAY. OKAY. I APOLOGIZE.
THANK YOU.
>>I'M SORRY. I'M A TINY BIT
CONFUSED AND THINK IT IS THE END
OF THE DAY. BUT, SO, YOU ARE
GOING TO OFFER THIS UP. PEOPLE
WILL APPLY TO DO THIS?
>>WELL, AGAIN, I THINK AT THIS
LEVEL, THIS IS JUST SORT OF A
CONCEPT THAT WE ARE PUTTING
FORWARD. WE ARE HAVING WORKED
OUT STRATEGIES I DON'T THINK
THIS IS THE PLACE TO DISCUSS
SPECIFICS ABOUT THAT STRATEGY TO
ACCOMPLISH THE GOALS LAID OUT IN
THE CONCEPT.
>>WOULD IT BE SIMILAR TO
COCHRAN OR OFFER SOME OTHER
FEATURES LIKE COMPARISON OF
PRODUCTS?
YOU KNOW, CONSUMER REPORTS ON
PRODUCTS?
>>WELL, I -- YOU KNOW, I THINK
THAT IF IT IS PRETTY CLEAR THAT
FROM THE OBJECTIVES THAT THEY
ARE VERY HIGHLY ALIGNED WITH
WHAT COCHRAN IS ALREADY DOING.
SO, YOU KNOW, I THINK WE ARE
JUST REALLY TRYING TO ESTABLISH
AN EVIDENCE-BASED ON THE
LITERATURE AND MAINTENANCE OF
FORMATION OR MAINTENANCE OF
CLINICAL TRIALS REGISTER.
YOU KNOW, I THINK THAT PEOPLE
CAN PROPOSE DIFFERENT STRATEGIES
OF BEST HOW TO DO THAT.
>>I WANT TO SAY I APOLOGIZE IF
I CREATED AN AWKWARD SITUATION
THERE FOR YOU, PETE. I'M HAPPY
TO SUGGEST TO COUNCIL WE NOT
TALK ABOUT POTENTIAL SPECIFIC
APPLICANTS AT THIS MOMENT. YOU
ARE TALKING ABOUT CONCEPT
CLEARANCE AND THINK I WENT OUT
OF BOUNDS A LITTLE BIT WITH MY
QUESTION. I APOLOGIZE.
>>NO PROBLEM, DAN.
MAYBE WE -- ALSO, WE HAVE NEW
COUNCIL MEMBERS AND MAYBE WE
COULD SORT OF REVIEW A LITTLE
BIT WHAT PURPOSE OF CONCEPT
THEORY IS. MAYBE THAT WOULD BE
HELPFUL. THE PURPOSE OF THIS IS
JUST TO SORT OF GET AN IDEA OF A
GENERAL CONCEPT AND HOPE THAT
THE GENERAL -- YOU KNOW, THE
COMMUNITY BECOMES -- I WILL GIVE
THEM SORT OF A SNEAK PREVIEW AND
ADVANCED NOTICE OF THIS KIND OF
THING WE ARE THINKING ABOUT.
ALSO, TO GET FEEDBACK FROM ALL
OF YOU FROM COUNCIL TO SEE IF
YOU THINK THIS IS A GOOD IDEA.
YOU KNOW?
IF YOU HAVE ANY FEEDBACK ABOUT
THAT OR GENERAL CONCEPT WE ARE
NOT TALKING ABOUT ANY SPECIFIC
FUNDING OPPORTUNITIES AT THIS
MOMENT AND BASICALLY JUST
TALKING ABOUT A CONCEPT AND
WHETHER THIS IS SOMETHING THAT
WOULD BE NEEDED AT THE PRESENT
TIME, IT IS A GOOD THING TO DO.
>>JUST QUICKLY TO FOLLOW UP.
DO WE ALREADY HAVE IT IN PLACE?
WE WILL REUP IT OR NO?
>>I -- I WILL COMMENT. I THINK
THAT WHAT HE WAS DOING IS GIVING
A BACKGROUND OF A LONG-STANDING
SUPPORT FOR THE COCHRAN THAT HAS
BEEN VERY USEFUL AND THIS IS
COMING TO AN END. WE ARE ASKING
COUNCIL IF THIS CONCEPT OF DOING
SYSTEMATIC REVIEWS IS STILL OF
INTEREST TO THE COMMUNITY AND TO
THE COUNCIL. WOULD YOU BE
WILLING TO SUPPORT IT IN A WAY
THAT IS MAYBE IN THE PAST BUT
ALSO THINKING ABOUT OTHER
POSSIBILITIES OF FUNDING
SYSTEMATIC REVIEWS AND COULD BE
CONTINUE WHAT WE ARE DOG OR
COULD BE SOMETHING DIFFERENT AND
IDEA FROM OUR PERSPECTIVE WE ARE
ASKING COUNCIL IF YOU FIND THIS
CONCEPT IMPORTANT AND SOMETHING
WE SHOULD AS AN INSTITUTE THAT
WE SHOULD CONTINUE TO INVEST IN
THIS IDEA OF SUPPORTING
SYSTEMATIC REVIEWS WHETHER AN
EXISTING PROGRAM OR SOMETHING
LIKE IT IN THE FUTURE IS WHERE
WE ARE REALLY ASKING THE COUNCIL
AND WE HAVE DONE THIS A LONG
TIME AND THINK THERE IS VALUE.
WE NEED A PANEL OF EXPERTS SUCH
AS YOURSELVES TO HELP US TO
FURTHER DECIDE ON MOVING FORWARD
WITH THIS PARTICULAR TYPE OF
APPROACH IN INTERROGATING
COMPLEMENTARY APPROACHES USING
THIS TYPE OF SYSTEMATIC REVIEWS
IS THE QUESTION WE ARE ASKING IF
YOU FIND VALUE IN THIS AND
THINGS WE SHOULD THINK ABOUT IN
MOVING FORWARD IN THE FUTURE
FIFING HISTORY AND ISSUES AND
TOPICS TO THINK ABOUT APPROACHES
AND ONE WE HAVE USED FOR SEVERAL
YEARS BUT THIS IS AN OPPORTUNITY
FOR FURTHER DISCUSSION TO GET
INPUT FROM COUNCIL WHERE WE
COULD GO NOW THAT THE PROGRAM IS
AT AN INFLECTION POINT WITH
RENEWAL AND REUPING ON THIS
IDEA. HOPE THAT HELPS IF IT
MAKES SENSE.
>>WE HAVE A COUPLE HANDS UP.
>>YES. DR. MCGEE?
>>YEAH.
>>HI.
>>YEAH.
>>RHONDA HERE. I GUESS I'M
JUST CURIOUS IF I COULD HEAR A
LITTLE MORE ABOUT THE GOAL OR
OBJECTIVE THAT IS AROUND SHARING
OR DISSEMINATING.
IN OTHER WORDS I'M NOT AS
FAMILIAR WITH THE COCHRAN OR ANY
OTHER DATABASE LIKE THIS.
OTHERS I MIGHT BE FAMILIAR WITH
DATABASES WITH REGARD FOR
EXAMPLE MINDFULNESS RESEARCH AND
THIS AND THAT. I KNOW THAT IF
I'M CURIOUS IF YOU COULD SAY A
LITTLE MORE ABOUT GOALS AND
OBJECTIVES THAT ARE AROUND
MAKING THIS INFORMATION MORE
AVAILABLE TO NONRESEARCH
COMMUN
COMMUNITY.
AS A PERSON APPLYING RESEARCH
MORE THAN BEING A PRIMARY
RESEARCHER, ONE THING I'M OFTEN
FRUSTRATED BY IS THE FACT THAT,
YOU KNOW, WE HAVE MEDIA OUTLETS
TALKING ABOUT THIS AND THAT AND
ALMOST DEVOID OF
SCIENTIFIC-BACKED INFORMATION.
IT FEELS LIKE PR AND NEED TO
DISSEMINATE IS SO STRONG.
I WONDER IF THAT IS SOMETHING WE
ARE REALLY THINKING WELL ABOUT
AT THE FRONT END AND THINKING
ABOUT THIS CONCEPT AND HOW IS
SORT OF STRATEGY THAT IS AROUND
SHARING IT AND DISSEMINATING
THIS INFORMATION AND BEING
IMBEDDED IN CONCEPTUALIZATION OF
THIS IDEA OF THESE SORTS OF
DATABASES.
I HOPE THAT IS CLEAR.
>>YEAH. I CAN TRY TO TALK
ABOUT IT.
THIS IS REALLY A CHANCE TO GIVE
AN OBJECTIVE OF EVIDENCE-BASED
FOR EXTENT DATA AND WHAT DATA IS
SHOWING US ACROSS VARIOUS
ELEMENTS OF COMPLEMENTARY AND
INTEGRATIVE HEALTH.
THE TYPE OF CONCEPT THAT YOU ARE
SPEAKING TO I THINK RHONDA IS
SOMETHING THAT IS RELATED TO
KNOW THE SIGNS PROGRAM AND
COMMUNICATIONS OFFICE THAT
OFFERS TRAINING EXAMPLES AND
INFORMATION TO THE PUBLIC ON HOW
TO CRITICALLY EVALUATE
INFORMATION COMING FROM
SCIENTIFIC JOURNALS AND PRESS
AND MEDIA IN GENERAL THAT IS AN
EXTENSIVE TRAINING THAT IS ON
OUR WEBSITE THAT ALLOWS PEOPLE
TO THINK ABOUT HOW TO EVALUATE
INFORMATION CRITICALLY.
IN THAT SPACE AND ALLOWING
PEOPLE TO EVALUATE COCHRAN
REVIEWS MEDIA INFORMATION IN A
CRITICAL WAY.
>>I KNOW SCIENCE PART SOUNDS
CRITICAL. I'M ALSO THINKING
ABOUT A PRELIMINARY ISSUE IT
FEELS SCIENCE IS SO HIDDEN WE
DON'T HEAR ABOUT SCIENCE LET
ALONE HAVING A NEXT STEP DO
PEOPLE UNDERSTAND THE SCIENCE.
I GUESS I'M -- YEAH. WE CAN
HAVE ANOTHER CONVERSATION ABOUT
WHETHER OR NOT WE THINK THE
DISSEMINATION OR RELEASING OF
THE INFORMATION THAT IS DONE
ROBUSTLY ENOUGH OR IF THERE
COULD BE GREATER INVESTMENT IN
JUST RELEASING THE INFORMATION
LET ALONE HOW PEOPLE UNDERSTAND
IT.
>>YEAH. DISSEMINATION OF
ACCURATE INFORMATION OR
ACCESSIBLE INFORMATION OF THE
PUBLIC IS PART OF THE MISSION OF
NCCIH. I WILL SAY THERE HAVE
BEEN ACTIVITIES IN THE PAST LIKE
BLOGS THAT REALLY SUCCINCTLY
SUMMARIZE FINDINGS OF REVIEWS
AND SO FORTH. COCHRAN HAS FOR
EXAMPLE BEEN ENGAGED IN AND
DIFFERENT WAYS TO ENGAGE IN
DIFFERENT MEDIA. YOU KNOW,
EFFORTS TO REACH THE GENERAL
PUBLIC NOT JUST THE RESEARCH
COMMUNITY.
>>OKAY. AMANDA?
>>YES. THANKS. NO. GREAT
DISCUSSION. THIS IS A REALLY
USEFUL INITIATIVE THAT NEEDS TO
DEFINITELY CONTINUE. CERTAINLY
JUST IF I CAN TALK ABOUT
BOTANICALS. I WILL ADD THAT
BOTH COLLECTION OF DATA AND COME
PILATION OF IT AND DISSEMINATION
IS ALL IMPORTANT AND
COMPLEMENTARY IS VERY DIFFERENT
TO CONVENTIONAL. THERE IS SO
MUCH NUANCE IN THAT WHEN YOU SAY
ACUPUNCTURE PICKING A BLAR
BOTANICAL THERE IS VARIABILITY
IN THE TYPE OF PRODUCT USED AND
SO ON AND IS HARD TO CONVEY ALL
NUANCES AND MEANS THAT REVIEWS
HAVE TO BE DONE IN A WAY THAT
COVERS ALL OF THAT. I GUESS IT
IS A LONG-WINDED WAY OF SAYING
IT WOULD BE GREAT TO HAVE A WAY
IN WHICH THOSE PEOPLE WHO HAVE
EXPERTISE IN THOSE AREAS COULD
BE SUPPORTED TO PRODUCE REVIEWS
AND WHEN WE WORK WITH BOTANICALS
WE CERTAINLY TEND TO DO REVIEWS
ANYWAY FOR OUR KNOWLEDGE AND
COLLECT AND GATHER INFORMATION
THAT COULD BE EXTREMELY TIME
CONSUMING. YOU HAVE TO DO IN
ADDITION TO RESEARCH AND SO ON
THAT YOU PROPOSED AND THIS MIGHT
BE A BIT PREMATURE. IF THERE IS
A WAY THAT YOU KNOW IS
GENERATING FUNDING FOR
RESEARCHERS TO DO THAT AND MAYBE
THROUGH ADMINISTRATIVE
SUPPLEMENTS OR SOMETHING THAT
WOULD SUPPORT THIS INITIATIVE.
I SUGGEST TO BRING IT UP AS A
SUGGESTION FOR CONSIDERATION
THANK YOU.
>>OKAY. DR. PROLINSON?
>>THANK YOU, PETE. YOU KNOW, A
VERY INTERESTING AND SORT OF
CONFUSING PROJECT. YOU KNOW,
THIS IS REALLY COMPLICATED
STUFF. I THINK PROBABLY AS LOTS
OF PEOPLE ON THE CALL KNOW BUT
MAYBE NOT PRODUCING A COCHRAN
DATABASE FOR GREAT EVIDENCE IN
WHAT YOU ARE DOING IN CLINICAL
PRACTICE AND YOUR PATIENCE AND
UNDERLYING PHILOSOPHY THERE IS
IMPORTANT FOR COMPLEMENTARY
INTEGRATIVE MEDICINE AS WELL.
IT IS A REALLY I THINK A TOUGH
THING TO GET AT TO REALLY BE
ABLE TO DISSEMINATE TO NOT ONLY
TO THE PUBLIC BUT ALSO TO
PRACTITIONERS SO WHEN
PRACTITIONERS ARE RECOMMENDING
VARIOUS OTHER TYPES OF
APPROACHES THERE COULD BE GOOD
EVIDENCE FOR WHAT YOU ARE TRYING
TO DO. ALL THAT BEING SAID, I
THINK ONE OF THE BIG PROBLEMS IS
THAT DESPITE COCHRAN DATABASE
BEING AROUND FOR A LONG PERIOD
OF TIME MOST OF WHAT WE DO IN
PRACTICE OF MEDICINE IS REALLY
NOT VERY EVIDENCE-BASED. WE ARE
POTENTIALLY BASED ON POORLY
DESIGNED OR FLAWED STUDIES THAT
GETS TO BE REALLY COMPLICATED
AND THANK YOU FOR GETTING THIS
OUT IN FRONT OF US FOR
DISCUSSION. IT IS A VERY
IMPORTANT TOPIC.
>>OKAY. THANKS, DR. DICKERSON.
>>YES, PETER. THANK YOU SO
MUCH FOR THE INTRODUCTION TO THE
CONCEPT AND BEING NEW TO THE
COUNCIL I'M NOT SURE. I HAVE
OPEN GENERAL THOUGHTS.
I DON'T KNOW HOW MUCH THEY CAN
APPLY. MAYBE IF AN ANNOUNCEMENT
WAS MADE TO HAVE INCLUDING
SPECIFICS AND FOR EXAMPLE TO
UNDERSTAND PAIN OR, YOU KNOW,
USE OF CAN -- YOU KNOW, CANNABIS
TO APPROACH WHOLE-PERSON HEALTH
OR ETHNIC DISPARITIES AND
UTILIZATION. THAT MIGHT HELP
WITH WHATEVER FOCUS THAT WE ARE
-- WHATEVER -- YOU KNOW, WE ARE
REALLY WANTING TO GET OUT OF
REVIEWS AS A COUNCIL AND AS AN
INSTITUTE. YOU KNOW, THAT MIGHT
MAKE IT REALLY OF VALUE TO
OVERALL MISSION OF THIS COUNCIL.
I THINK WE HAVE NOT REALLY
TALKED A LOT ABOUT
IMPLEMENTATION AND TRANSLATION
OF FINDINGS.
I DON'T KNOW IF THAT WOULD ALSO
BE SOMETHING THAT WOULD BE TO
LOOK FURTHER INTO. I'M FUNDED
UNDER THE HEAL I DON'T KNOW HOW
MUCH I CAN TALK ABOUT THIS.
UNDER THE HEAL AND FUNDED UNDER
HEAL AND MEMBER OF
IMPLEMENTATION SCIENCE
WORKGROUPS THAT IS A BIG PART OF
THE HEAL PROGRAM IS TRANSLATING
AND PUTTING ALL KNOWLEDGE
TOGETHER FOR TACKLING THE OPIOID
EPIDEMIC TRYING TO GET
INTERVENTIONS OUT THERE TO HELP
PEOPLE. I DON'T BEING NEW TO
THE COUNCIL, I'M NOT SURE HOW
MUCH EMPHASIS HAS BEEN PLACED ON
THAT.
OR, YOU KNOW, HOW THE OPIOID
EPIDEMIC IS A WHOLE DIFFERENT
PUBLIC HEALTH ISSUE.
YEAH. THOSE ARE JUST GENERAL
THOUGHTS.
>>OKAY. DR. ZABINGA.
MAYBE -- LOOKS LIKE --
>>YEAH.
>>EMILY, YOU ARE MUTED.
>>I JUST WANTED TO RESPOND TO
THE COMMENT BY DR. DICKERSON.
JUST TO LET YOU KNOW THAT ALMOST
TWO YEARS AGO NCCIH ACTUALLY
PUBLISHED A POSITION PAPER IT
THAT IS DETAILING OUR INTERESTS
AND PROGRESS TOWARDS
DISSEMINATION AND IMPLEMENTATION
SCIENCE.
WE HAVE HAD A NUMBER OF FUNDING
OPPORTUNITY ANNOUNCEMENTS
ALREADY IN THAT SPACE. WE HAVE
EXPANDED OUR FRAMEWORK OF DOING
CLINICAL RESEARCH BY ADDING
COMPONENTS OF DISSEMINATION AND
IMPLEMENTATION. WE ARE VERY
MUCH IN LINE WITH THE COMMENT
THAT YOU MADE.
>>THANK YOU.
>>ADDING TO THAT WE HAVE HAD
ACTUALLY THROUGH THE WORK OF OUR
STAFF AND FOR THOSE WHO ARE PART
OF THE HEAL INITIATIVE THAT I
THINK WE CAN SAFELY SAY THAT
NCCIH HAS HAD AN IMPACT.
>>YES.
>>ON THE IMPLEMENTATION AND ON
PROMOTING PRAGMATIC AND
IMPLEMENTATION HEALS WITH HEAL
AND WE HAVE BEEN AT THE
FOREFRONT OF THAT ONE.
>>THANKS.
>>DR. ZABINGA?
>>YEAH. I WANTED TO ECHO
ENTHUSIASM FOR CONCEPT OF
SYSTEMATIC REVIEWS AND
METAANALYSIS THAT IS AN
IMPORTANT METHODOLOGICAL TOOL TO
ADDRESS SPECIFIC CLINICAL TOOLS
FOR WHICH THERE WOULDN'T BE A
SINGLE STUDY TO HELP US ANSWER
THE CLINICAL QUESTIONS AND
HAVING BEEN INVOLVED IN AN AHRQ
METAANALYSIS ON MEDITATION THAT
WAS BOTH FASCINATING AND ALSO
EXTRAORDINARILY LABORIOUS AND
TIME CONSUMING AND REALLY
IMPORTANT PROCESS WHERE THERE
ARE LOTS OF -- OF IMPORTANT
DECISION POINTS TO BE TAKEN
SERIOUSLY DURING THE ANALYTIC
PHASES.
I THINK THAT THE IMPORTANCE OF
PROVIDING EXPLICIT SUPPORT FOR
THAT TIME AND EFFORT AND THOUGHT
IS REALLY LANDING RIGHT IN
NCCIH'S LAP.
OTHERWISE, IT GETS DONE AS
SOMEBODY ELSE SAID. IT GETS
DONE AS PART OF SOMETHING ELSE
OR TUCKED IN OR IN WAYS THAT
DON'T NECESSARILY REFLECT
COMPLEXITY OF THE ANLYTIC
APPROACH ESPECIALLY AT LEAST IN
MY EXPERIENCE WITH COMPLEMENTARY
AND INTEGRATIVE APPROACHES WHERE
YOU NEED TO HAVE A SOPHISTICATED
UNDERSTANDING OF THE
INTERVENTION SO THAT YOU CAN
INTERPRET THE ABILITY TO COMBINE
OR NOT THE DIFFERENT STUDIES AND
DATA. I'M IN FULL SUPPORT OF
THIS CONCEPT.
>>OKAY. AMANDA, YOU HAD YOUR
HAND UP QUICKLY OR SHORTLY?
>>I HAD MY THUMBS UP.
>>THUMBS UP. GOOD. IT IS
GETTING LATE IN THE DAY AND I
DON'T RECOGNIZE IT ANYMORE.
>>YEAH. DR. ZABINGA EXPRESSED
IT VERY NICELY MY POINT.
>>UH-HUH.
>>YEAH.
>>OKAY. ANY MORE COMMENTS OR
DISCUSSION? OKAY. IF NOT, DO
WE HAVE A MOTION FOR CONCURRENCE
WITH A CONCEPT? OKAY. GOOD.
DO WE HAVE A SECOND?
YEAH. GOOD. OKAY. IF THERE IS
NO FURTHER DISCUSSION FROM, CAN
WE PLEASE PUT UP THE VOTING
SCREEN?
OKAY. I CAN SAFELY SAY THAT THE
CONCEPT HAS BEEN ANONYMOUSLY
APPROVED. PERFECT.
OKAY.
SO, WITH THIS WE ARE GETTING
CLOSER TO THE END AND LAST THING
ON AGENDA IS PUBLIC COMMENTS.
WE HAVE A LITTLE TIME. IS THERE
ANYTHING OR ANY QUESTIONS OR YOU
KNOW THAT COUNCIL MEMBERS WOULD
LIKE TO RAISE OR HELENE OR DAVID
ANY ADDITIONAL COMMENTS OR
QUESTIONS YOU WOULD LIKE TO MAKE
BEFORE WE MONTH OF TO THE LAST
PART OF THE AGENDA?
NO? EVERYBODY IS GOOD?
IT WAS A LONG DAY?
>>WELL, I CAN JUST BASICALLY
SAY VERY QUICKLY THAT I REALLY
APPRECIATE EVERYBODY'S TIME AND
ATTENTION THROUGHOUT THIS DAY.
YOU KNOW, I -- YOU KNOW, I
REALLY FELT THAT THROUGHOUT THE
WHOLE DAY THAT THE WHOLE GROUP
WAS VERY ENGAGED AND INVOLVED
AND SOME GREAT QUESTIONS AND
GREAT DISCUSSIONS.
THAT IS WHAT WE LIKE TO SEE.
YOU KNOW, WE ARE STILL OBVIOUSLY
VIRTUAL AND WE STILL HOLD ON TO
THE HOPE THAT, YOU KNOW, SOME
DAY THAT WE MIGHT BE ABLE TO,
YOU KNOW, GATHER IN PERSON.
STAY TUNED ON THAT. AND WE WILL
LET YOU KNOW. IN THE MEANTIME
WE REALLY APPRECIATE THAT EACH
THOUGH SOMETIMES IN THIS VIRTUAL
ENVIRONMENT THAT IT IS HARD TO
KEEP YOUR ATTENTION, YOU KNOW,
ON A SCREEN ALL DAY. WE HAD A
LITTLE CONVERSATION ABOUT THAT
AT LUNCH AND WE REALLY FELT THAT
YOU WERE ALL THERE WITH US
TODAY. THANK YOU.
>>GOOD.
LAST ITEM WE HAVE IS PUBLIC
COMMENTS.
FOR OUR AUDIENCE, I WOULD LIKE
TO REMIND YOU THAT YOU DO HAVE
THE OPPORTUNITY TO SUBMIT PUBLIC
COMMENTS. THIS MEETING IS
VIRTUAL AND PLEASE SUBMIT YOUR
COMMENTS TO ME IN A WRITTEN
FORMAT WITHIN 15 DAYS AFTER
TODAY'S MEETING. PLEASE LIMIT
COMMENTS TO 750 WORDS AND YOU
HAVE WRITTEN COMMENTS ADDED TO
MEETING MINUTES THAT WILL BE
POSTED ON NCCIH WEBSITE WITHIN
THE NEXT 90 DAYS.
YEAH.
WITH THIS, AS I SAID, WE ARE
GETTING CLOSE NOW TO THE END OF
THIS JANUARY 2023 COUNCIL
MEETING. I REALLY WOULD LIKE TO
THANK ALL OUR COUNCIL MEMBERS
ATTENDING THE MEETING AND NCCIH
WOULD NOT BE ABLE TO FULFILL ITS
MISSION WITHOUT YOUR EXPERTISE
AND YOUR FEEDBACK.
THANK YOU SO MUCH FOR JOINING
TODAY AND OFFERING YOUR ADVICE.
YOU KNOW THIS IS EVEN MORE
TRUTHFUL. I KNOW THAT SOME OF
YOU REALLY WENT OUT OF YOUR WAY
TO BE HERE TODAY.
QUITE FRANKLY I KNOW THAT YOU
DIDN'T FEEL LIKE BEING HERE
TODAY.
YOU WERE SIMPLY SO WE COULD
ACTUALLY HAVE THIS MEETING.
I REALLY, REALLY APPRECIATE IT.
I ALSO WOULD LIKE TO EXPRESS MY
SINCEREST THANK YOU TO ALL OF
NCCIH STAFF AND TO ACTUALLY MAKE
THIS MEETING HAPPEN TODAY.
YOU KNOW, I HAVE BEEN ORGANIZING
REVIEW MEETINGS FOR A LARGE PART
OF MY LIFE. SEEING WHAT GOES
ALL INTO A COUNCIL MEETING WAS
QUITE IMPRESSIVE. THIS RANGES
ALL THE WAY FROM OUR IT STAFF
AND OFFICE OF COMMUNICATION AND
ADMINISTRATIVE STAFF THAT IS
WORKING BEHIND THE SCENES TO
MAKE THIS HAPPEN. IT ALSO GOES
TO THE FOREFRONT WHERE WE HAVE
PROGRAM REVIEW AND GRANTS
MANAGEMENT STAFF, YOU KNOW, WHO
MAKE -- DO ALL THEIR MAGIC AND
LET ME EVEN HAVE A MEETING. I
HAVE TO SAY THAT THIS IS QUITE
IMPRESSIVE. I AM REALLY
GRATEFUL. ESPECIALLY FOR ALL
HELP THAT I HAD TO GET THROUGH
THIS MEETING TODAY.
SO, WITH THIS --
>>I WAS GOING TO SAY THAT WE
WANT TO THANK YOU, MARTINA.
>>YEAH.
>>AS YOUR FIRST COUNCIL
MEETING, I THINK IT WENT ALL
SPLENDIDLY AND THANK YOU TO THE
ENTIRE STAFF FOR ALL THE SUPPORT
THAT WOULD NOT HAPPEN WITH ALL
OF THE PEOPLE WHO ARE BEHIND THE
SCENES TO MAKE ALL THIS WORK
FLAWLILESS.
IT IS GREAT TO HAVE YOU AT THE
HELM, MARTINA. I THINK WE CAN
SAY WELL DONE.
>>THANK YOU. APPRECIATE IT.
OKAY. WITH THIS, IF THERE ARE
NO ADDITIONAL COMMENTS, I WOULD
LIKE TO ADJOURN THIS 8 THIRD
MEETING OF NATIONAL ADVISORY
COMMITTEE FOR COMPLEMENTARY
INTEGRATIVE HEALTH AND POINTED
OUT BEFORE THAT NEXT MEETING
WILL BE MAY 12TH. THANK YOU.
OKAY. BYE.
>>BYE.