Mobile application software plays an increasing role in research, health, and wellness
TGen Distinguished Professor Dr. Nicholas Schork has no intention of practicing New Age medicine. He doesn’t even meditate. But as Deputy Director for Quantitative Sciences, he knows good data when he sees it.
Dr. Schork has looked at many of the hundreds of self-help apps that have recently hit the market, aiming to turn individuals’ smart phones into health tools.
The big question Dr. Schork seeks an answer for is how to bring these technologies into the care stream expeditiously and in a manner that ensures their reliability and safety.
“We are putting a research protocol together to evaluate the utility of multiple emerging technologies, one of which involves digital devices and digital therapeutics,” said Dr. Schork.
Dr. Schork’s TGen collaborator, Dr. Laura Goetz, Director of TGen’s Cancer Prevention and Early Detection Program, believes that combining new digital technologies with the genomic analysis tools developed in recent years by TGen will help researchers and clinicians detect cancers earlier, when they are easier treat, and even help prevent cancer from developing.
“This is an experimental approach to prevention, taking advantage of all that TGen has to offer with regard to genomics, the microbiome, metabolomics, proteomics. We’re hoping to actually gain new insights into early phases of carcinogenesis (the origins of cancer), not only obtaining better risk prediction models, but also identifying new areas for intervention and prevention.”
Current prevention programs rely on two main approaches: public health screening, such as mammograms and colorectal tests, and screening for genetic syndromes, such as identifying individuals with genes associated with the development of cancer, such as the BRCA gene, which is linked to types of breast and other cancers.
However, Dr. Goetz said that these currently available ways of screening for cancer are simply not predictive for the majority of people who actually get cancer.
“Working with TGen’s many abilities to probe and analyze the human genome, we want to use all these new technologies to understand why people get cancer,” she said. “The goal is getting to a better understanding of the majority of people who are going to get cancer.”
INTEGRATING DIGITAL TECHNOLOGIES INTO LIFE
An initiative by the U.S. Food and Drug Administration (FDA) aims to review internet-based devices and therapies, giving them an official government seal of approval to show they actually have a medically valid use.
Dr. Schork believes a mental health app called Stop, Breathe & Think is an example of one new digital technology worthy of FDA approval. In fact, he was the senior author of a scientific paper published in May in the Journal of Medical Internet Research (JMIR), which provides peer-reviewed research about cyber-medicine and electronic health.
“Our results suggested that the long-term use resulted in an improvement in mood,” said Dr. Schork, who examined data from more than 1 million users of the app.
When the app is engaged, users record their mood at the beginning of each session. Then, they are given a menu of meditations to choose. They are asked to close their eyes and think about what is being described, such as a bubbling brook coursing through a forest. Then they record their mood at the end of the session.
“The app is one that can combat stress and promote mindfulness,” said Dr. Schork. “I’m not a meditator, but there’s a lot of data out there that suggests that practicing mindfulness and meditation could relieve stress.”
SEEING THE BIG PICTURE FOR EACH PATIENT
And stress can lead to a weakened immune system, which in turn can increase the possibilities of developing cancer, said Dr. Goetz.
“I really want to be on the front lines of bringing -omic technologies into the clinic to prevent cancer,” Dr. Goetz said. “We want to use new technologies; to find ways to quantify them so we can actually make a better assessment of someone’s health risks.”
These new apps are part of a growing body of digital therapeutics and health-data gathering devices that will play key roles in evaluating and improving patient health in the future. The challenge will be how to integrate these with other new and existing technologies into unique comprehensive care plans for each patient.
In early 2020, TGen’s parent organization in southern California, City of Hope, will open its first clinical location in Newport, California.
“This site in Orange County will have a focus on integrated preventive care. Prevention is much broader than treating a particular disease,” explained Dr. Schork, who also is Director of TGen’s Quantitative Medicine and Systems Biology Division.
“We’d like the clinic to be focused on a healthy environment, wellness, and having it really well-grounded in science. It wouldn’t be a ‘New Age spa.’ It would be a bona fide medical clinic, designed in a way that is consistent with promoting health,” he said.
This clinical location will focus on each patient’s health risks, reducing risks, early detection of disease, and how to make healthcare more cost-effective and efficient, while at the
same time making it more beneficial for the patient.