Project Baseline: Understanding and Mapping Human Health

June 29 marked 1 year since the Duke University School of Medicine enrolled its first participant in the Project Baseline study in Kannapolis, North Carolina, and started the journey toward mapping human health. The study, launched a year ago in April, was brought to life by Duke, Verily, Stanford Medicine, and Google to better understand the transition from health to disease and shift healthcare in the United States from reactive to proactive.

“We know a lot about human disease, we know how to diagnose disease, and we have treatments for many diseases,” explained Svati H. Shah, MD, MHS, a Duke cardiologist and the Project Baseline study principal investigator for the Duke site, in an interview with The American Journal of Managed Care^®. “But, taking a step back, what do we know about human health? What defines human health, and what defines healthy? If we don’t know how to define health, then we can’t tell a patient whether they’re healthy or not.”

The study is enrolling 10,000 people of different ages, backgrounds, and medical histories and following them for at least 4 years. Throughout the period, participants will attend yearly appointments to undergo standardarized health assessments, update their medical history, give blood and saliva, and answer lifestyle questions.

In order to get a complete picture of a person’s health, the project also focuses on collecting information on lifestyle factors, such as sleep and exercise patterns, as well as social determinants of health, such as how far a participant lives from a grocery store or how much pollution there is where the participant resides.

“We’re taking people who enroll and using an agnostic approach, meaning: I don’t know if you’re healthy, and I don’t know if you have a disease, and the only way I can try to understand is by looking almost everywhere possible,” said Shah.

The study is looking at things that may not typically be discussed during a doctor’s appointment, often because the provider didn’t ask or there wasn’t enough time during the visit, she explained. Sometimes, patients may not even realize how lifestyle factors might be important to their health. “The general population has an underrecognition of what things like sleep quality do to your health,” she added.

Even if the right questions are asked, “How much will your provider learn about you in 10 minutes?” Shah pointed out. Instead of 1 time point a year, there needs to be a continuous, longitudinal range of data points in order to get the full picture.

Understanding that health doesn’t only evolve year to year, but also day to day, Project Baseline study participants wear the Study Watch, an investigational device developed by Verily, to collect data such as heart rate and activity level, and they place a sensor under their mattress to collect data related to sleep habits. The project also relies on self-reported data, such as a mood and sleep diary. Every 3 months, participants fill out a set of online surveys related to well-being, diet, and exercise habits. Changes in health, such as new prescriptions or recent hospitalizations, will also be recorded.

By studying these habits, the researchers may be able to pinpoint when a person transitioned from a healthy state to a disease state and learn from that data to better identify changes in health before a disease occurs or progresses in the future.

Notably, participants are at the forefront of the study, Shah explained. Throughout the journey, the study will return results to participants, such as imaging, digital health data, and genetic information, in order to help them understand their health and adjust their lifestyle, if needed.

Shah also has hopes that the project will lead to new ways to diagnose and treat disease based on the data and information collected from participants. The Project Baseline study will contribute to the growing prevalence of precision medicine in the healthcare system as the researchers help providers shift from one-size-fits-all medicine to interventions based on the individual.