Abstract
Wellness projects are large scale studies of healthy individuals through extensive laboratory and other testing. The “Hundred Person Wellness Study”, was one of the first to report results and lessons from its approach and these lessons can be applied to other wellness projects which are being undertaken by major companies and other organizations. In the “Hundred Person Wellness Study”, investigators from the Institute for Systems Biology (ISB) sequenced the genome, and analyzed the blood, saliva, urine and microbiome of 108 healthy participants every 3 months, for 9 months, to look for subtle changes signifying the transition to disease. We discuss some of the possible shortcomings of this approach; questioning the need to “improve” biomarker levels, excessive testing leading to over-diagnosis and over-treatment, expected results and improvements, selection of tests, problems with whole genome sequencing and speculations on therapeutic measures. We hope this discussion will lead to a continued evaluation of wellness interventions, leading to strategies that truly benefit patients within the constraint of limited health care resources.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Verily. Project Baseline. 2018. https://www.projectbaseline.com/. Accessed: 2 January 2019.Search in Google Scholar
2. National Institutes of Health. All of Us Research Program. https://allofus.nih.gov/. Accessed: 3 Jan 2019.Search in Google Scholar
3. Lake Nona Institute. About Lake Nona Life Project. 2018. http://www.liveworkparticipate.com/about-lnlp/. Accessed: 2 Jan 2019.Search in Google Scholar
4. Prince ND, Magis AT, Earls JC, Glusman G, Levy R, Lausted C, et al. A wellness study of 108 individuals using personal, dense, dynamic data clouds. Nat Biotechnol 2017;35:747–56.10.1038/nbt.3870Search in Google Scholar PubMed PubMed Central
5. Providence St Joseph’s Health. P4 medicine. http://future.psjhealth.org/scientific-wellness/p4-medicine. Accessed: 2 Jan 2019.Search in Google Scholar
6. Institute for Systems Biology. P4 medicine. https://systemsbiology.org/research/p4-medicine/. Accessed 2 Jan 2019.Search in Google Scholar
7. Barter PJ, Caulfield M, Eriksson M, Grundy SM, Kastelein JJ, Komajda M, et al. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med 2007;357:2109–22.10.1056/NEJMoa0706628Search in Google Scholar PubMed
8. Pezaro C, Woo HH, Davis ID. Prostate cancer: measuring PSA. Int Med J 2014;44:433–40.10.1111/imj.12407Search in Google Scholar PubMed
9. Jaffe AF. Troponin – past, present, and future. Curr Probl Cardiol 2012;37:209–28.10.1016/j.cpcardiol.2012.02.002Search in Google Scholar PubMed
10. Hood L, Lovejoy JC, Price ND. Integrating big data and actionable health coaching to optimize wellness. BMC Med 2015;13:4.10.1186/s12916-014-0238-7Search in Google Scholar PubMed PubMed Central
11. Hickner J, Thompson PJ, Wilkinson T, Epner P, Sheehan M, Pollock AM, et al. Primary care physicians’ challenges in ordering clinical laboratory tests and interpreting results. J Am Board Fam Med 2014;27:268–74.10.3122/jabfm.2014.02.130104Search in Google Scholar PubMed
12. Choosing Wisely. Society of General and Internal Medicine recommendation. 2013 September 12. http://www.choosingwisely.org/societies/society-of-general-internal-medicine/. Accessed: 2 Jan 2019.Search in Google Scholar
13. Ponka D. The periodic health examination in adults. Can Med Assoc J 2014;186:1245.10.1503/cmaj.141125Search in Google Scholar PubMed PubMed Central
14. Diamandis EP. The failure of protein cancer biomarkers to reach the clinic: why, and what can be done to address the problem? BMC Med 2012;10:87.10.1186/1741-7015-10-87Search in Google Scholar PubMed PubMed Central
15. Manson JE, Cook NR, Lee IM, Christen W, Bassuk SS, Mora S, et al. Vitamin D supplements and prevention of cancer and cardiovascular diseases. N Engl J Med 2019;380:33–44.10.1056/NEJMoa1809944Search in Google Scholar PubMed PubMed Central
16. Whitlock EP, Garlitz BA, Harris EL, Beil TL, Smith PR. Screening for hereditary hemochromatosis: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2006;145:209–23.10.7326/0003-4819-145-3-200608010-00009Search in Google Scholar PubMed
17. Choosing Wisely. American college of medical genetics and genomics recommendations. 10 July 2015. http://www.choosingwisely.org/societies/american-college-of-medical-genetics-and-genomics/. Accessed: 2 Jan 2, 2019.Search in Google Scholar
18. Lemke AA, Bick D, Dimmock D, Simpson P, Veith R. Perspectives of clinical genetics professionals toward genome sequencing and incidental findings: a survey study. Clin Genet 2013;84:230–6.10.1111/cge.12060Search in Google Scholar PubMed PubMed Central
19. Kalia SS, Adelman K, Bale SJ, Chung WK, Eng C, Evans JP, et al. Recommendations for reporting of secondary findings in clinical exome and genome sequencing, 2016 update (ACMG SF v2.0): a policy statement of the American College of Medical Genetics and Genomics. Genet Med 2017;19:249–55.10.1038/gim.2016.190Search in Google Scholar PubMed
20. MacArthur DG, Manolio TA, Dimmock DP, Rehm HL, Shendure J, Abecasis GR, et al. Guidelines for investigating causality of sequence variants in human disease. Nature 2014;508: 469–76.10.1038/nature13127Search in Google Scholar PubMed PubMed Central
21. The New York Times. Kolata G. The online gene test finds a dangerous mutation. It may well be wrong. 2 July 2018. https://www.nytimes.com/2018/07/02/health/gene-testing-disease-nyt.html. Accessed: 2 Jan 2019.Search in Google Scholar
22. Vos J, Menko FH, Oosterwijk JC, van Asperen CJ, Stiggelbout AM, Tibben A. Genetic counseling does not fulfill the counselees’ need for certainty in hereditary breast/ovarian cancer families: an explorative assessment. Psychooncology 2013;22:1167–76.10.1002/pon.3125Search in Google Scholar PubMed
23. Hirschberg AM, Chan-Smutko G, Pirl WF. Psychiatric implications of cancer genetic testing. Cancer 2015;121:341–60.10.1002/cncr.28879Search in Google Scholar PubMed
24. Houfek JF, Soltis-Vaughan BS, Atwood JR, Reiser GM, Schaefer GB. Adults’ perceptions of genetic counseling and genetic testing. Appl Nurs Res 2015;28:25–30.10.1016/j.apnr.2014.03.001Search in Google Scholar PubMed
25. Voorwinden JS, Jaspers JP. Prognostic factors for distress after genetic testing for hereditary cancer. J Genet Couns 2016;25:495–503.10.1007/s10897-015-9894-9Search in Google Scholar PubMed PubMed Central
26. Sido B, Hack V, Hochlehnert A, Lipps H, Herfath C, Droge W. Impairment of intestinal glutathione synthesis in patients with inflammatory bowel disease. Gut 1998;42:485–92.10.1136/gut.42.4.485Search in Google Scholar PubMed PubMed Central
27. Coupland C, Morris R, Moore M, Arthur A, Hippisley-Cox J.Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database. Br Med J 2016;352:i1350.10.1136/bmj.i1350Search in Google Scholar PubMed PubMed Central
28. Andermann A, Blancquaert I, Beauchamp S, Dery V. Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bull World Health Organ 2008;86:317–9.10.2471/BLT.07.050112Search in Google Scholar PubMed PubMed Central
©2019 Walter de Gruyter GmbH, Berlin/Boston
