Chinese, American experts explore precision health, big data at symposium

More than 300 health researchers from China and the United States convened at Stanford to share their knowledge of precision health, mobile health devices, population health, genomics and cancer.

From left, Jieming Qu, Euan Ashley, Guoyuan Yang and Taha Kass-Hout participate in a panel discussion on precision health Oct. 15 at the Sino-U.S. Symposium on Medicine in the 21st Century. The event was held on the Stanford campus at the Li Ka Shing Center for Learning and Knowledge.
Norbert von der Groeben

In a recent cartoon in The New Yorker, a bureaucrat across a desk remarks to a man in a chair, “You can’t list your iPhone as your primary-care physician.” But maybe someday our smartphones will in fact be the guardians of our health, said Euan Ashley, MD, in a wide-ranging discussion of precision health and mobile health devices Oct. 15.

Ashley, an associate professor of cardiovascular medicine and of genetics at Stanford,  spoke at the ninth Sino-U.S. Symposium on Medicine in the 21st Century, which was held at the Li Ka Shing Center for Learning and Knowledge. The two-day event brought together 335 health researchers from China and the United States to foster collaboration and friendship, and to share their knowledge of precision health, mobile health devices, population health, genomics and cancer.

“Health care is the opportunity of our time,” Lloyd Minor, MD, dean of the School of Medicine, said in opening remarks at the symposium. “We have the opportunity to harness the power of genomic data and electronic medical records, and to deliver better care, more personalized care for acute illness and, perhaps even more importantly, to predict and prevent disease before it even occurs — thereby moving the focus of medicine from sick care firmly toward health care.”

Ashley showed The New Yorker cartoon as he concluded his talk, remarking, “We’re almost but not quite at the point where you can list your iPhone as your primary care physician. I think lots of my patients would like to do that because of the convenience, and I think we can use the phone in their pocket to do a lot more than just be a portal to the Internet.”

Many people already carry one or more devices that track their activity, sleep and heart rate, Ashley noted. “With the next generation of wearable sensors, we can detect heart arrhythmias,” he said. “Imagine if we could pick up atrial fibrillation before someone had a stroke. Imagine if they had a wearable sensor on, and we could get to them with a blood thinner before they actually have the stroke.”

A future with cloud-based monitoring?

Alan Yeung, MD, the Li Ka Shing Professor in Cardiology and professor of cardiovascular medicine at Stanford, described a similar vision. In China, clinics are so crowded that people line up in the morning to get a lottery number to be seen, he said. Yet, 1.3 billion people there own a smartphone that can potentially help monitor health. Globally, he said, 4.8 billion people own a cellphone.

“We could score someone’s risk of a heart attack and, depending on their risk factors, give them medications that would lower their risk,” said Yeung. “The idea at the end of the day is instead of one patient coming to a clinic, health-care providers come to a small clean room to monitor tens of thousands of patients and see who is in trouble.”

Cloud computing that monitors people’s heart rate, heart rhythm, blood pressure and glucose levels, for example, could alert health-care providers when heart attack risk factors started to shoot up for a particular person. “We could schedule a quick call and find out what’s up,” said Yeung, “and then change whatever the problem is before they become entrenched in their habits.”

Jerry Yang, co-founder of Yahoo, board member for the Chinese Internet portal Alibaba and technology investor through AME Cloud Ventures, spoke about some of the many ways to collect personal data. He described sensors that can monitor an individual’s sleep patterns, temperature, blood pressure and heart rate; home devices that can do a full urine or blood test; wearable sensors that monitor not just activity, but also posture, how much you stand or sit, core movements and even gait.

“As we see more sensors in our environment, we should think about what the implications of all those sensors are,” Yang said.

Some of those implications are about privacy and security. Others have to do with standardizing devices to make sure they are generating accurate data.

Gap between collecting, effectively using data

Data scientist Yixue Li, director of the Shanghai Center for Bioinformation Technology, said another challenge is the gap between our ability to collect data and our ability to deploy it in a way that helps physicians and patients. Li distinguished between the kind of data generated by Alibaba or Google and that which comes from living entities, such as human beings. He said biological data is far more heterogeneous than data from the Internet and contains intricate causal relationships that makes analysis challenging.

Yeung also pointed out that while the Internet is rife with gamelike apps that promise to motivate people to eat better, walk more and become healthier, none are scientifically validated. And there’s very little accurate data on how much physical activity helps. Most data comes from what people remember, or think they remember, he said. “Everyone thinks they did a lot of exercise last Monday, but in reality you were sitting in front of your computer answering email,” he said. Wearable sensors could tell us more precisely just how much exercise actually helps whom.

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