UPMC doctors lead charge in paradigm shift for approach to medicine
The doctors are building a database of health information from 150,000 central and Western Pennsylvanians in order to better diagnose, prevent and treat disease in the future.
Two local Jewish doctors are charged with implementing a task of multigenerational value. Steven Reis and Mylynda Massart, both of the University of Pittsburgh, are seeking to recruit nearly 150,000 central and western Pennsylvanians for participation in the PA Cares for Us research program.
Reis and Massart’s efforts coincide with similar undertakings occurring throughout the country, as National Institutes of Health-supported physicians and scientists are attempting to build a database of information from one million participants.
The national endeavor, which is titled All of Us, along with its regional counterpart, is to facilitate better understanding of disease, explained Reis, principal investigator, associate vice chancellor for clinical research, Health Sciences, professor of medicine and CTSI director at the University of Pittsburgh.
“The goal of All of US is to collect the largest dataset in the United States, so it’s one million people and their histories … and their genetics. And once you have a database of one million people,” explained Reis, “you have individuals in the database who have every disease essentially: rare diseases, common diseases. And then scientists can start making observations.”
Collectively, it’s about “individualizing care” for patients, echoed Reis.
PA Cares and its national counterpart are part of the Precision Medicine Initiative introduced by President Barack Obama in his 2015 State of the Union address.
“He recognized that this was really how we needed to advance medicine and take medicine to the next level,” said Massart. What Obama also realized was that “historically, research has been done on Caucasian men,” but when doctors are “trying to make medical decisions and they want to go to the research for the best evidence, then that evidence has to be applicable to the patient that they are considering at that moment.”
“For example, “if I’m in my office and the majority of my patients are African-American or Ashkenazi, if the research is done on some Caucasian male who is 70 years old, how am I going to interpret that data in terms of these patients? Obama recognized this and said not only do we need to advance medicine, but we need to broaden our research base to be the most diverse it’s ever been in the history of this country because we need doctors to interpret the data to the specific patient that they’re taking care of.”
Adopting a precision-medicine method is really about “treating people based on who they are, which is different from the way we approach medicine right now,” echoed Reis. “Right now, we use evidence-based medicine, which is based on the results of large-scale studies of cohorts of large numbers of people, not necessarily on individuals. There’s just a different frame of reference essentially. It’s a paradigm shift. It’s changing the way we as physicians will practice medicine, and for patients, the way they will be cared for in the future.”
To date, the University of Pittsburgh has received more than $7 million in NIH grants toward PA Cares.
“The university anticipates receiving $67 million in awards for the life of the study,” said William K. Young of the Clinical and Translational Science Institute at the University of Pittsburgh.
This is a “huge monumental groundbreaking research study that Pitt is taking the lead on. We should have a lot of community nachas that Dr. Reis has accomplished all of this,” said Massart.
“I think regionally we should take pride that we were selected to be one of only a few centers around the country to participate in this landmark study. There are many institutions that applied, and we are one of a handful, so I am very proud of that fact,” added Reis.
Massart, who has been largely responsible for individual engagement and education, explained that participating in PA Cares is a relatively simple process that requires volunteers to answer questions pertaining to their health, environment and lifestyle, as well as contribute urine, measurements and blood samples at an enrollment site.
For those fearful of releasing their electronic health records to a national database, she explained that all information is “de-identified. It doesn’t travel with your name, and researchers don’t have access to that.”
The two physicians, both of whom have already joined the study, are excited by the possibility of recruiting 150,000 participating Pennsylvanians.
“We already know from the advancements in Jewish genetics that there are unique things relevant to our community, population, subpopulation and our health that are really important, and there are probably many more that we have yet to discover, and this is the type of study that will help us to understand that,” said Massart.
Both PA Cares and precision medicine are “going to affect all of us now,” but they will also “have a very large impact on our children, grandchildren and future generations,” said Reis. “So I signed up for this study, and I did it because I believe in the science, and I really want to move medicine forward. But one of my main motivations was to support future generations, to make future generations healthier.”
Those interested in enrolling or learning more about PA Cares for Us can visit pacaresforusresearch.org/. PJC
Adam Reinherz can be reached at areinherz
@pittsburghjewishchronicle.org.
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