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In April 2015, Governor Edmund G. Brown Jr announced the launch of the California Initiative to Advance Precision Medicine (CIAPM). The state initially provided $3 million and appropriated an additional $10 million in its FY 2016/17 budget. CIAPM is a partnership between the state, the University of California, and other public and private entities. Its aim is to help build infrastructure and assemble the resources necessary to support precision medicine efforts in the state. Hosted by UC Health and the University of California, San Francisco, the initiative supports patient-focused demonstration projects, and builds an inventory of California’s precision medicine assets, such as research projects and clinical studies, databases, and analysis platforms. As a centralized information base, the inventory will coordinate the use of precision medicine resources, and stimulate cross-sector collaborations among the state’s scientists, clinicians, entrepreneurs and patient participants, enabling them to turn available large data sets and technical innovation into better health outcomes.
As envisioned in the 2011 National Academy of Sciences’ (NAS) report, “Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease,” precision medicine aims to use advanced computing tools to aggregate, integrate and analyze vast amounts of data from research, clinical, personal, environmental and population health settings, to better understand diseases and develop and deliver more precise diagnostics, therapeutics, and prevention measures.
Why do people who have the same disease often respond differently to the same treatment?
Why do so many diseases, such as heart disease and cancer, affect racial and ethnic groups in different ways?
Why do some people with a healthy life style still get conditions such as diabetes or heart disease?
Precision medicine aims to answer questions like these, and in doing so, deliver more effective, predictive, and precise health care to all. Bringing together a person-centered approach with innovative analyses of large and diverse health-related data sets, precision medicine seeks to define well-being and improve health care—from prevention to diagnosis to treatment—for each individual, based on what is known about that person’s unique characteristics and circumstances.
For instance, when choosing treatment strategies for an asthma patient, a doctor may want to consider how well a particular medication works for people who share similar air quality, diet and exercise habits as well as genetic heritage and health history as the patient. With precision medicine, such treatment strategies will become more and more precise, as cross-disciplinary collaborations of clinicians, researchers, computer scientists and patient participants continually advance our understanding of factors that contribute to health and disease. Vast amounts of information are being gathered from the population at large, from electronic medical records and clinical studies, to genomic, environmental, socioeconomic, and mobile lifestyle data. These data will be integrated with the continuously expanding knowledge of biological processes discovered in basic science laboratories and analyzed to reveal patterns of health or disease that might otherwise be invisible, and to use this new information to achieve better health across our society, to diagnose earlier and more accurately, to treat with less waste and fewer adverse outcomes, and, consequently, to lower health care costs.
The vision for California’s Initiative to Advance Precision Medicine is to maximize the use of the State’s enormous resources and accelerate progress in precision medicine, improving human health in California and establishing California as a leader in this new approach to research, health and health care. To lay the groundwork for innovation, CIAPM is pursuing two main goals, (1) to assemble an extensive inventory of precision medicine assets in California, and (2) to support demonstration projects that have the potential for tangible benefit to patients within a short timeframe.
The sheer volume of data to be analyzed for precision medicine is enormous. In order to efficiently collect, access and analyze these data and validate findings so they can inform health decisions, effective partnerships and collaborations are essential. Such partnerships extend from fundamental biology to clinical investigation and care to computation and engineering, they span across academic, government, commercial and nonprofit sectors, and they engage patients and well people. To coordinate and facilitate collaborative use of the immense resources within California, CIAPM will create an extensive asset inventory.
To illustrate the power and application of precision medicine, CIAPM supports collaborative demonstration projects that leverage the state’s investment with private funds and in-kind support.
“Just as California has led the way with stem cell research,” Governor Brown said in his 2014 State of the State address, “so too can we pioneer the new field of precision medicine.”