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Catching up with Baseline

| Written by:
Robert M. Califf

Robert M. Califf

Head of Clinical Policy and Strategy for Verily and Google Health

A bit over a decade ago, Andy Conrad and I were lamenting a problem I think of as the "blind men and the elephant" challenge in human research. In essence, because any given technology was capable of assessing only a part of the whole human being, researchers were fundamentally limited in their understanding of health and disease. However, we could clearly see that dramatic advances in measurement, computation and analysis were on the horizon.

Although we weren't then in a position to take full advantage of these changes, we nevertheless started to lay what we hoped would be the conceptual groundwork for a new approach to research in a North Carolina town called Kannapolis (Greek for "city of looms") that had been devastated by the offshoring of the textile industry. Thanks to significant investment by philanthropist David Murdock and the joint efforts of Duke University and the University of North Carolina system, with Andy's guidance we were able to develop a biotechnology and research campus on land that once housed a shuttered textile mill. The first major effort initiated through this center, the MURDOCK Study, is a large-scale longitudinal population cohort study with the ambitious goal of enrolling the entire population of Kannapolis and surrounding Cabarrus County. Despite challenges created by the 2008 economic downturn, MURDOCK is going strong and, with the help of the people of Kannapolis, we've learned a tremendous amount about chronic diseases in real-world settings.

When Andy moved to Google, we and a number of our colleagues started to plan a study that would extend this work by "riding the wave" of coming changes in scientific measurement and analysis. Our idea was to characterize states of health and the transition to states of disease in as many dimensions as possible—something that would move us much closer to seeing the "whole elephant." With support from Duke, Stanford and Andy's growing team that evolved into Verily, our team began the tremendous undertaking of developing the construct for what came to be known as the Project Baseline study, but in the midst of planning, I departed to serve at the FDA.

Upon returning to Duke and joining the Verily team, I found that an astonishing amount of work had been accomplished, enabling Baseline to "ride the technology wave" by combining Verily's technological and analytical insight with the scientific and clinical expertise at Duke and Stanford. I was particularly thrilled to learn that the study protocol had been finalized, numerous pilot programs were completed, and participants had been enrolled. Last month, as noted in a blog post, both Stanford and Duke, through its Kannapolis site, have enrolled their first participants.

I also met with the Verily Baseline project team to review the study's progress. The systems in place for biological measurement, laboratory management and information capture, integration, and analysis represent an amazing display of the deep technological, analytical, and organizational expertise available within the Alphabet/Google family. Just as importantly, the respectful engagement with and attention to the needs and preferences of study participants was inspiring, and the team's good spirits and camaraderie made my day. I wish I could name all the people at Verily, Stanford and Duke who have done the work, but I'll start by recognizing the leadership of Sam Gambhir at Stanford and Jess Mega and Scarlet Shore at Verily.

Project Baseline is an exciting study for multiple reasons. Because of my involvement with all institutions, I won't have direct decision-making input in this effort, but I will be its most fervent cheerleader and advocate. The integrative science made possible by combining so many cutting-edge capabilities in a thoughtful way has the potential to enable new understandings of human biology and the subtle interactions of clinical events, individual behavior, and states of health and disease. It will also illuminate new pathways for engaging diverse individuals and communities as active participants in research, and may improve health outcomes, both now and for future generations. In future blogs, I plan to reflect on some of the specifics that make this effort the nidus of a new era of human research.

Next story: Science Spotlight: Microbiome with Vanessa Ridaura

We sat down with Vanessa Ridaura, a genomics scientist at Verily (center), to learn about her role on Project Baseline.