Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
Clin Chem Lab Med. 2019 Sep 25;57(10):1494-1500. doi: 10.1515/cclm-2019-0122.
Wellness projects are large scale studies of healthy individuals through extensive laboratory and other testing. The "Hundred Person Wellness Study", was one of the first to report results and lessons from its approach and these lessons can be applied to other wellness projects which are being undertaken by major companies and other organizations. In the "Hundred Person Wellness Study", investigators from the Institute for Systems Biology (ISB) sequenced the genome, and analyzed the blood, saliva, urine and microbiome of 108 healthy participants every 3 months, for 9 months, to look for subtle changes signifying the transition to disease. We discuss some of the possible shortcomings of this approach; questioning the need to "improve" biomarker levels, excessive testing leading to over-diagnosis and over-treatment, expected results and improvements, selection of tests, problems with whole genome sequencing and speculations on therapeutic measures. We hope this discussion will lead to a continued evaluation of wellness interventions, leading to strategies that truly benefit patients within the constraint of limited health care resources.
健康计划是通过广泛的实验室和其他测试对健康个体进行的大规模研究。“百人健康研究”是首批报告其方法的结果和经验教训的研究之一，这些经验教训可以应用于其他正在由大公司和其他组织开展的健康计划。在“百人健康研究”中，来自系统生物学研究所（ISB）的研究人员对 108 名健康参与者的基因组进行了测序，并分析了他们的血液、唾液、尿液和微生物组，每 3 个月进行一次，共进行了 9 个月，以寻找表明疾病发生转变的细微变化。我们讨论了这种方法的一些可能的缺点；质疑是否需要“改善”生物标志物水平，过度检测导致过度诊断和过度治疗，预期的结果和改善，测试的选择，全基因组测序的问题以及治疗措施的猜测。我们希望这次讨论将导致对健康干预措施的持续评估，从而制定出在有限的医疗保健资源限制下真正使患者受益的策略。
