Sunday, 21 May 2017

ARTICLE: A healthy dose of mathematics

Toward Precision Healthcare: Context and Mathematical Challenges
C Colijn, N Jones, IG Johnston, S Yaliraki, M Barahona
Frontiers in Physiology 8 136 (2017)
  • The continuing explosion of available biomedical data will help us tailor and optimise therapies for individual patients; we are designing new maths and statistics to help this process and to include social and other data into an overarching "precision healthcare" approach.
Our research combines tools from maths and statistics with biological data to learn more about the biological world. An exciting, growing, and much-discussed branch of science -- precision medicine -- is a specific instance of this idea. The vision of precision medicine is to use the expanding volume of data that's emerging from medicine and biology to tailor and optimise medical therapies for individual patients, making the therapies as effective as possible. This idea isn't new -- we are well aware, for example, that an individual's blood type dictates which blood transfusions they can successfully receive. But precision medicine is a much bigger picture, potentially taking into account large amounts of genetic, environmental, dietary, and other features to identify the optimal treatment for a disease -- for example, tailoring chemotherapy treatments to match the genetic specifics of a particular cancer case.

Dealing with these large and diverse datasets will need new mathematical and statistical approaches, built with an ongoing link to clinical practice. At the same time, we're interested in expanding the idea of precision medicine to include the "big data" that's increasingly available about individuals' social and logistic contexts. Social networks can dictate how diseases spread -- and how knowledge and views about therapies, vaccines, and other medically pertinent ideas are transmitted and shaped from person to person. A person's home region determines the genetic structure of local people who may act as donors. We're looking at the idea of "precision healthcare" -- using new maths and statistics to optimise healthcare strategy, not just individual therapies, in the light of large-scale datasets.

One aspect of precision healthcare we'll be exploring is exploring how progressive diseases -- those that involve the accumulation of symptoms over time -- develop in patients, using transition networks like those above to model "disease spaces" and find pathways in those spaces.

We're excited to be part of a new initiative -- the Centre for the Mathematics of Precision Healthcare -- involving six parallel and related research projects that align with this goal. Some of our previous work -- for example, estimating social structures of big UK cities to explore the challenges that genetic diversity poses to gene therapies for mtDNA disease -- already has a precision healthcare feel. In a new review paper (available for free) we discuss this and other examples of past and future work that we hope will contribute to the precision healthcare goal, along with some key ideas and context for the initiative. Iain