This session focused on the transformative impact of genomic and molecular research on the field of medicine. Personalized medicine has emerged as a result of advancements in our understanding of the human genome and molecular markers of disease, particularly in the context of prevention. New technologies and data have paved the way for preventing disease, monitoring its progression, and developing strategies to improve outcomes. Importantly, these technologies hold the potential to enhance health equity throughout the state of Wisconsin. The panel discussion featured experts who shared insights into the intersection of prevention and equity through personalized medicine.
Lisa Cadmus-Bertram discussed the All of Us Research Program, emphasizing its mission to accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all participants. The program’s goal is to nurture relationships with at least a million participants reflecting the diversity of the U.S., deliver a rich biomedical dataset, and create an ecosystem of communities, researchers, and funders. In Wisconsin, more than 27,860 people have joined this initiative, contributing to over 717,000 adults nationwide. The program’s potential for groundbreaking health discoveries is significant, as reflected in its vast scientific publications and ongoing research projects.
Amy Kind’s presentation focused on the power of the exposome in forwarding precision health across populations. She highlighted that precision medicine goes beyond individual genetics and includes environmental exposures, as most diseases cannot be attributed to genetics alone. Kind introduced the concept of the exposome, which encompasses factors external to the biological individual, such as the microbiome, structural inequities, ecosystems, lifestyles, and social, physical, and chemical factors. The presentation discussed the quantification of exposures and linking them to biology, emphasizing the research’s potential to drive action.
The Center for Health Disparities Research (CHDR) at UW-Madison is a national leader in quantifying social exposome through the Neighborhood Atlas Area Deprivation Index (ADI). This index has been used in numerous studies and even influenced U.S. federal policy. Examples include its utilization in the Milwaukee Water Works’ prioritization plan for mitigating lead exposure in children.
Honey Reddi explored the concept of personalized medicine and polygenic risk scores (PRS). Precision medicine involves the prevention, treatment, and management of diseases based on molecular diagnostics, while personalized medicine considers genetics, lifestyle, and environmental exposure. Genetic variation can have neutral, harmful, or beneficial effects, leading to monogenic, oligogenic, and polygenic inheritance patterns.
The laboratory considerations for PRS-based genetic tests were discussed, including the measurement of PRS and clinical utility. The presentation emphasized the importance of community partnerships in decision-making and context-specific clinical utility. It also underscored the necessity of personalized risk communication and transparent reporting of PRS limitations and uncertainties.
Future considerations in PRS implementation were highlighted, including the promotion of health equity, epigenomic risk modeling, and assisted reproductive technology.
The Morning Panel 2 offered a deep dive into the role of personalized medicine, the exposome, and polygenic risk scores in the pursuit of preventative care and health equity. These discussions are crucial in shaping the future of healthcare and improving outcomes for all individuals.