If you offer 100 people $50 today or $60 in two months, some will choose the smaller reward now, others will choose the larger reward later. The way people evaluate current versus future rewards is partially genetic and has broad implications for a variety of health outcomes. We have already published on this paradigm (https://www.nature.com/articles/s41593-017-0032-x) but much more data is needed, ideally in subject... more »

The burden of sudden cardiac death remains high, accounting for over 350,000 deaths in the US annually. The implantable defibrillator remains the major primary prevention modality. However, in order for this important measure to stay sustainable from a health costs perspective, the criteria for selecting candidates most likely to benefit need to be improved significantly. It will be important to identify all use cases... more »

This project would examine contextual factors that may influence the health outcomes of individuals. Contextual factors include social environment factors (such as social cohesion, crime) and built environment factors (green space, mixed land use, access to healthy food and clinical services). These factors can help or hinder individuals from achieving or maintaining health. Outcomes of interest include obesity, diabetes,... more »

Obesity and poor diet are threats to population health. The food environment and related policies may be major contributors. Longitudinal measures of food purchasing, diet, and health can be linked to environmental/policy data (eg community gardens, changes in convenience store offerings, fast food moratoriums, menu labeling, food taxes/subsidies), and used to identify health effects. Results can help prioritize multilevel... more »

An annual blood test with analysis of methylation sites from key epigenetic aging clocks (e.g. Horvath). Epigenetic aging clocks have already been shown to reliably predict age, time-to-death, all cause mortality, cog. function, immune function, CV disease, cancer, and more. They may also become a key tool to demonstrate the reversibility of disease risk through dietary and therapeutic regimens, as epigenetic states are... more »

1) Collect the genetics of drug metabolizing enzymes from the genetic samples in the All Of Us study.
2) Describe the population genetics of these specific genes. How many people are normal (extensive metabolizers, EMs)? How many have other profiles? How many genes is the "average person" abnormal for?
3) By collecting data for "allergies" (some of which are intolerances, not true allergies) and medication reactions requiring... more »

Mood disorder in pregnant and postpartum women is common, often severe, but frequently undiagnosed and untreated, and largely understudied. I propose to augment the AllofUs protocol for research into PPMD by adding collection of biospecimens for OMIC measurements at fixed times relative to pregnancy, and also when triggered by alerts of critical clinical mood state shifts as informed by wearable technology or computerized... more »

Breast cancer represents a major public health problem. In 2017, >250,000 women received a first diagnosis of invasive and >60,000 of non-invasive breast cancer in the US. This is a heterogeneous disease with respect to morphologic, molecular and genomic features, defining subtypes with distinct etiology and clinical behavior. Understanding the causes of different subtypes is needed to improve risk assessment and inform... more »

Genetics can be the earlier risk predictor of common, heritable traits such as atherosclerotic cardiovascular disease (ASCVD). Longitudinal environmental exposures and behavioral practices subsequently modify risk. Uniform dense ascertainment of environmental exposures and behavior is feasible through wearable sensors. We and others are beginning to look at the comprehensive set of exposures that influence ASCVD risk.... more »

Obesity and breast cancer are leading cause of morbidity and mortality. Evidence strongly suggests that certain periods of life, including those during fetal development and pregnancy, influence risk of breast cancer later in life. Environmental chemicals may increase breast cancer risk-especially during pregnancy-by mimicking estrogen and other hormones. Epigenomic signatures present in the placenta uniquely capture... more »

Breast cancer is the most common cancer in US women. Breast density, usually measured from mammograms, is a strong risk factor for breast cancer and is correlated with many other risk factors, but it is unknown whether changes in breast density reflect changes in breast cancer risk. Importantly, breast density provides a measure of breast cancer risk during menopause when endogenous hormone levels are changing and breast... more »

Urinary stone disease is burdensome and costly, and frequently recurs. Via the EHR and qualitative/quantitative methods, we will identify person and intervention characteristics associated with urinary stone recurrence. Factors associated with recurrence may provide potential treatment targets for preventing stone recurrence.

Transient ischemic attack (TIA) is a frequent precursor to stroke. Studies of modern treatments (e.g., carotid endarterectomy and carotid artery stenting) do not consider TIA as an indicator for treatment, nor which treatments may be more effective following a TIA. All of Us provides a unique opportunity to not only examine the interaction between TIA and treatment to prevent subsequent strokes, but also to suggest... more »

This case study focuses on symptoms not identifiable as a "disease" or indication, and based on the risk factors captured in that subset's data, identify what can be done with tailored prevention and primary care prevent the symptoms from becoming syndromes. A participant subset with similar complaints, race/ethn, geographical factors, genetic, and SDH factors might sort out syndromes and treatment that are undiagnosed... more »

Autoimmune diseases afflict nearly 1 in 12 Americans and many more have autoantibodies but no evidence of clinical disease. Recent work has identified biomarkers or clinical symptoms which associate with subsequent developing development of systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) and NIH-funded prevention trials are underway. AoU provides a unique opportunity to identify at risk individuals through... more »