Predictive Health: The Imminent Revolution in Health Care

Abstract

Increasing social, economic, and political pressures to reform the American approach to medical care makes change likely. A fundamental premise of predictive health is that it should be cheaper (at least per person life year), more efficient, and have a greater return on the investment of keeping people healthy as opposed to waiting for disease to intervene. The Emory Predictive Health and Society Strategic Initiative and its Center for Health Discovery and Well Being have embarked on a program to define health to the extent that modern science permits in the context of the entire human experience, to identify measurable variables that describe and predict a healthy state, and to use that knowledge to design health-focused interventions that are affordable and effective. Initial results from a study of a randomly selected “essentially healthy” cohort, utilizing extensive assessments and a health partner, are promising. Studies of healthy aging over the entire life spectrum promise valuable normative data for age-specific assessments of health and the setting of realistic health goals.

High-performance metabolic profiling with dual chromatography-Fourier-transform mass spectrometry (DC-FTMS) for study of the exposome

“…Unfortunately, a large extent of the metabolome is still unidentified, especially many of the chemicals in the diet, as well as persistent organic pollutants and chemicals derived from commercial products, household products and health behaviors. Links between such exposures and human diseases have already been identified (Howell and Mangum 2010; Peng et al 2010; Lewis et al 2007; Ziech et al 2010; Gilmour et al 2006), and systematic collection of information on these exposures by improved metabolic profiling could be instrumental to characterization of the summation of these exposures, termed the “exposome” (Wild 2005) and use in personalized medicine and predictive health (Loscalzo et al 2007; Brigham 2010; Voit 2009). Therefore, the aim of this study was to increase overall metabolic detection in order to capture a larger extent of the exposome.…”

Multilevel Simulations of Health Delivery Systems: A Prospective Tool for Policy, Strategy, Planning, and Management

“…A goal of the center is to define, predict, and maintain health throughout the human life span. The studies done in the center complement other ongoing longitudinal studies on aging (Brigham 2010, Rask et al 2011.…”

“…Inclusion criteria were male or female employees aged 18 and older and absence of hospitalization in the previous year except for accidents. Participants understand that the center is not a medical care facility and that this program complements, but does not substitute for, appropriate medical care (Brigham 2010).…”

Insomnia Symptoms Are Associated With Abnormal Endothelial Function

“…The methodology has been reported previously. 13,14 In brief, the cohort was recruited largely (~ 90%) from a random sample of university and healthcare employees and lesser (~ 10%) from self or healthcare provider referral. 13 Participants were eligible for enrollment if they were: ≥ 18 years of age without a previous 12 month history of non-accident related hospitalization, Axis 1 psychosocial disorder, medication adjustment for treatment of a chronic condition (except for changes to antihypertensives or antiglycemics), substance or alcohol abuse, current malignant neoplasm, uncontrolled or poorly controlled chronic condition, acute illness within 2 weeks of the baseline visit, inability to participate in study assessments or inability to give informed consent.…”

“…13 Participants were eligible for enrollment if they were: ≥ 18 years of age without a previous 12 month history of non-accident related hospitalization, Axis 1 psychosocial disorder, medication adjustment for treatment of a chronic condition (except for changes to antihypertensives or antiglycemics), substance or alcohol abuse, current malignant neoplasm, uncontrolled or poorly controlled chronic condition, acute illness within 2 weeks of the baseline visit, inability to participate in study assessments or inability to give informed consent. 13,14 The study involved two baseline assessments (2-4 weeks apart), a 6 month assessment and 4 annual assessments. At each time point multiple psychosocial, physical and biomarker assessments were completed as previously described.…”