Project Baseline Aims to Ward Off Illness Before We Get Sick

Given Google's ravenous appetite for data, do we trust that the biomedical information Verily gathers will stay safe, not be used for marketing, and remain the property of the individuals tested? The NIH approach, driven by our tax dollars funding basic science and kept in the public domain, seems like a better bargain for citizens. Google isn't driven to provide public benefit; they're in it for the eventual profit.

This sounds like a good idea. More information is always desirable. It does sound very time-consuming, though. For now, I'd rather just go with a yearly CT scan of the chest to keep tabs on any growing tumors but when I'm much older, maybe with not much else to do but fret about my health, I think this would be a great project to get in.

Was the illustration to this article inspired by April Greiman’s poster? The woman’s body is very similar.

Prevention doesn't make big pharma any money. There is no mention of diet in the study which would seem critical.

Protocols are needed to manage abnormal test results. Doctors pass them off as outliers, or say that different people have different normal values. Over time, the results get lost or worse, the doctor uses old results as a baseline to discount current abnormal results. Example: A patient has elevated liver enzymes. Doctor says "that may just be your normal". 20 years go by with intermittent abnormal results. Finally patient is diagnosed with fatty liver. Medical information processing is in the dark ages, even with computerized records. Why would we expect any different, since computerized records are designed for the benefit of insurance companies?

In my opinion we do not need more studies to find out that human experiences (mainly relational experiences) are the main reason for the development of ill health. But I understand that common Doctors needs to understand and learn more about how experiences gets imprinted in our organism. "Human experiences are not only absent from contemporary evidence-based medicine, but it is also in fact explicitly eliminated by the mathematical analyses performed during assembly of evidence. Doctors, therefore, lack theoretical understanding of how experiences associated with self-image, relations and values become «inscribed» in the body. During the past decade, empirical documentation has demonstrated that experience – the information that an individual acquires during a lifetime of sensing and acting – is of fundamental biological relevance. Unfortunately, such experience does not lend itself easily to standardized interpretation; it is always an experience of something for someone, in a unique context. Chronic metabolic disturbances related to experienced overload of the human organism appear to contribute, at least partly through epigenetic mechanisms, to the development of the major, complex diseases of our time – cardiovascular disease, overweight, diabetes, chronic obstructive pulmonary disease,unclear fatigue symptoms, other immunological and inflammation-driven diseases, vegetative dysfunction, and many more. Future medical science must be experience orientated.

I am a member of this study. I joined March 2018. I am not confident in what I read in the article about information sharing. The only info I have been able to obtain so far is the chest x-ray and the calcium score (which is ZERO!). Additionally, I had dry macular degeneration that they should have caught and I believe, should have told me about, but they did not, which was disappointing when I subsequently found out about it elsewhere. When I attended their 1st annual anniversary brouhaha back in August down at Stanford, they were still thinking about HOW to share other info with study participants. Personally, I am a quantified self person and would love to get ALL the info they collected from me. The article doesn't mention that they give you a smart watch to wear at least 10 hours a day. I don' t know exactly what info this watch is collecting/tracking but it does prompt you to take an ECG reading at least once per day. And the watch also tracks your steps and reports on them daily/weekly/monthly via a smartphone app. You also get an electronic device which goes under your mattress and tracks when you are in bed, presumably tracking when you sleep, but not entirely sure on this. Lastly, you are paid for your time to participate. The initial testing took 2 days of time and I was paid $420. I also receive $10 each quarter for filling out a survey documenting any changes to my life, health, eating habits, etc. You can sign up at www.projectbaseline.com

Be interesting if the study consistently identifies similar transitional markers in a pre-disease phase in a large sample.

I'm a bit surprised this study got approved by the IRBs of the researchers' institutions without much of a plan in place for how to share the information with the participants and explain it to them. I would have thought an institutional review board would have asked those questions, since potential psychological harm (anxiety) or physical repercussions (additional testing, etc.) would be part of what they would be charged with preventing.

Early symptoms get diagnosed as “psychosomatic”, “conversion disorder”, or just “anxiety”.

This project probably will fail because most of the scientists are so preoccupied with conventional mainstream theories; cancer is caused by gene mutations, or heart attack/stroke are caused by cholesterol. These mainstream theories have been loosing luster day by day. For example, no scientists have ever succeeded in making a new cancer cell by transplanting nucleus that carry mutated cancer genes to a healthy cell, according to prof. Thomas Seyfried of Boston College. He says that cancer is a mitochondrial metabolic disease, not a gene mutation disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941741/ Today's NY Times article by Carl Zimmer explains surprising story that healthy cells carry a surprising number of cancer-linked mutations, but they don't turn into tumors., with a title " Researchers explore a cancer paradox". This is an additional evidence to support prof. Seyfried's theory, or Otto Warburg's theory. Otto Warburg received a Nobel prize for his theory.

I'm glad to hear that there remain medical experts who are willing to buck the "stick your head in the sand" trend that is driven by the current sentiments regarding "over testing" and rising healthcare costs. Some cancers might spread quickly even when detected early, some might grow slowly and be treatable, even when detected late, some might never evolve at all - but WE WON'T KNOW unless we take the time to do the studies and gain a better understanding.

How about including seniors (those over 65) in these types of studies who do not have cancer - but are not in optimal health either - to study them longitudinally to see if they (the doctors) can determine when/IF they (the seniors) develop cancer (because many in older age brackets seem to develop cancers more than young people).

There is a problem with lead-time bias, and I am not sure four years and 10,000 patients will clarify the effectiveness of this screening program.

One obvious issue that will arise due to the almost continuous screening for sleep disorders--will the study tell people that they likely have a sleep disorder and get them treatment and them monitor the treatment? Or, will they simply study the effects of untreated sleep apnea. Keep in mind that about 5-10% of American adults over 40 have sleep apnea, at any one time 80% do not know that they have sleep apnea, and that untreated sleep apnea has been estimated to increase a person's health care costs--and therefore, illness burden by 100% or more. If the researchers will get the patients treatment, then the population may be unusually healthy and outcomes for the diseases such as heart disease and cancer may not reflect those of the general population. In this case, the study needs to have a control group that does not get nightly sleep monitoring to see which if any diseases are lower in the study group. If the patients will not be told about their sleep problems, this raises an ethical issue.

For sure, security is a big issue. I’d consider being notified only in the case of something very clearly dangerous if not addressed. Another Q; since I have twice-a -year lab test due to high BP and and family history of cancers , , IBD, plus yearly colonoscopies, wouldn’t those lab tests already give me and my doc early warnings? Lastly, adding to the public base of knowledge is admirable. But again- privacy, security, still big issues.

This sounds like a great idea. How can you sign up ?

If you want to talk about anxiety provoking, just think of what will happen when an insurance company gets hold of this information and decides that you are uninsurable. Insurers have been trying to get hold of people’s genetic information even though we still don’t know why certain genes are expressed. The existence of those genes in your body could be used (was used) to deny coverage. This research makes it clear that age is a risk factor. Unsurprisingly, prior to obamacare, insurers managed to find “pre-existing conditions” to exclude many/most over 40 from coverage. Mitch McConnell has made it clear that post midterms he will support pre-existing condition exclusions (of course, he does not have to deal with the problem, we are paying for his insurance). Be sure to contact your local representative and or vote in a responsible representative to make sure that you will be able to get coverage in the future.

From the Nixon era to the present, billions have been poured into the war on cancer, into research, new treatment techniques and drugs. But relatively little, a pittance compared to other aspects, into prevention. Government funding agencies are involved in these imbalances, as well as the medical profession, non-profit fund-raising organizations and the media, which thrives on reporting about new technological advances and new research projects. In my opinion, one of the best steps that can be taken in the war on cancer is to focus greater attention on measures that individuals can take to reduce their risks, to increase funding for prevention, to increase coverage in the media of preventative measures, and for all players to be less intimidated by the lobbyists in the food and beverage industry and the drug industry, and by antagonists to revealing how pollution works against good health. This suggestion is not meant to be a substitute for medical research, or for new medicines. It is a plea to elevate preventative measures to their rightful place in the fight against cancer.

Any expert thoughts on this comment? A physician told me that everyone over 40 has cancer cells somewhere in the body. The immune system is designed to get rid of them and the diagnosis of cancer is only done when the immune system is not working well and not preventing the growth of the cells. Shouldn't there be more emphasis on building up our immune systems and finding out why those of cancer patients are not functioning properly? Eradicating poor nutrition, stress, chemicals and other factors in weakening the immune system seem more important than extensive testing.

It is much easier to make measurements than to know exactly what you’re measuring. -JWN Sullivan, physicist, c. 1925 After 30 years in family medicine I am convinced the body sends itself and therefore ourselves, signals when something is amiss. Usually, if able, the body takes care of what is amiss before it becomes a life threatening issue. When it can’t, disease often progresses. At some point in their development before they manifest as disease we are able to listen in on these signals. Call it intuition or self awareness or what have you. Ability to sense and interpret these signals is not part of current medical or general societal practice these days. Perhaps this will change in the future but it would sure be nice to see an arm in these studies that explored this aspect of early detection.

it's an interesting idea and one of the few ways that Google et al could contribute to healthcare. of course when you test normal subjects looking for abnormalities that are uncommon, the vast majority of positive results will be false positives, which could lead to more people invasive and therefore riskier tests and ultimately damage rather than improve health.

The idea of monitoring health trajectories for earliest signs of transition to disease is fundamentally flawed –an even worse: most “experts” don’t even know their ignorance. The human body is an open, complex, non-linear stochastic system. This implies: (1) Future external influences are not considered, such as exposure to unknown noxious agents; (2) Even the intrinsic dynamics is unpredictable: accidental random cell/tissue ticking bombs may amplify into clinical relevance, such as thrombo-emboli, -OR stay calm for decades.. (3) Even longitudinal monitoring of health variables may be meaningless because they may fluctuates around an unknown “tipping point”, crossing it to cause a disease by chance or depending of non-observable parameters. But even if we can detect early stages of a disease, what can we do? In the case of tumors the non-linearity is particular dramatic: treating an early, slowly growing tumor may actually ACCELERATE the disease – awaking a sleeping giant. The entire Big Data driven health is strictly speaking large-scale academic charlatanism. There is no serious science behind it. The field is driven by clinicians, epidemiologists, data scientists who, as sadly only few laypeople know, are clueless about the science needed to comprehend complex systems, such as the human body. Unlearned and unread in such sciences, they view the human body as black boxes and make up arguments that sound scientific but actually is pseudo-science.

Something as simple and seemingly mundane as getting an annual physical can also save lives. I'm amazed at the number of people who have a free annual physical included in their health insurance plans and don't go. After an annual routine physical, my white blood cell count looked really off, and I was then diagnosed with a rare type of leukemia. I was immediately prescribed an oral chemo medication - that was five years ago. A routine physical (and a smart doctor) basically saved my life, feeling great and very fortunate!

I see a lot of emphasis on the emotional aspect...anxiety, frightened. Yes, that matters. How about the time, money, discomfort, health risks, scars, complications, and generally putting one’s life on hold that are involved when one goes down the overtesting rabbit hole? Those matter more.

Thanks Anahad! My sister has Stage 4 Breast cancer- and they caught it at stage four, and it's been interesting watching her deal with this with a small child. So I'm grateful for the study, and it hits home. I'd like to email you a related idea and see what you think.

Interesting but I'd be concerned about over-diagnosis and unnecessary anxiety when "unusual" findings pop up in individuals. Earlier detection does not always translate into better outcomes.