|Personalized Medicine in Mental Health and Performance
|Human Factors and Medicine|
Biomarkers, Biosensors, Mental Health, Military, Omics, Personalized Medicine, Personalized Performance, Precision Medicine, Precision Performance
The medical field is committed to delivering evidence-based care, but the evidence used is often from population-wide studies that does not always allow for tailored approaches reflective of an individual patient’s biological makeup, history, and responses to environmental factors. This may contribute to less than optimal prevention strategies, diagnostics, and responses to treatments. However, there have been great advances in some areas of medicine such as oncology that use Precision Medicine to customize treatment approaches based on an individual patient’s profile in the context of evidence-based care. The use of Precision Medicine will ultimately have a positive impact on military readiness and performance.
For the purposes of this Research Task Group (RTG), the focus is on Precision Health and Performance as an approach that takes into account and when possible exploits/leverages people’s individual variations in biological makeup, history, environment and lifestyle for disease prevention, diagnosis and treatment as well as optimization of military performance. Precision Health and Performance is the result of a convergence of transformative technological advancements that are all reaching a sufficient level of technical maturation such as biomarkers, wearable technologies, and big data analytics.
The Exploratory Team (ET) concluded that the breadth, required expertise, and amount of material to be covered in Precision Health and Performance would be too large in scope for one RTG. As a result, based on the expertise resident among the ET members, the pervasiveness of Mental Health issues across military members, and the potential impact of Precision Medicine on Mental Health issues, it is proposed that the initial RTG is focused on the impact of Precision Health and Performance on Mental Health and the relationship of Mental Health to Military performance. The ET further recognizes that additional RTG(s) focused on other aspects of Precision Health and Performance may be of particular importance to the HFM Panel.
This RTG will address the 2016 NATO S&T Priority “Advanced Human Performance and Health” in the following areas: Human Resiliency, Medical Solutions for Health Optimization, and Enhanced Cognitive Performance. In addition, this RTG will address other NATO S&T Areas to include Big Data & Long Data Processing and Analysis, and Sensor Integration & Networks. This RTG will also coordinate with relevant on-going activities: ET-137 Leveraging Technologies in Psychiatry, ET-150 Reducing Musculo-skeletal Injuries, and HFM-RTG-260 Wearable Sensors.
The outcome of this RTG will be identification of cutting-edge precision medicine techniques that will lead to improvements in how NATO member nations provide Mental Health problem prevention, diagnoses, and treatment as well as improvements in Mental Health aspects (e.g., focused concentration, mental endurance) related to Military-relevant mission performance. The end result will be improved military readiness and performance during the full spectrum of military operations.
The main objective is to harness and encourage new advances in personalized approaches to optimize: 1) mental health, including ensuring medical readiness, prevention/diagnosis/treatment of disorders, and return to duty; and 2) mental health aspects related to military-relevant mission performance.
1) Early exploitation of:
a) Individual genetic reactions to pharmacological interventions (pharmacogenomics) - review and evaluate existing evidence for potential immediate application (ex: genetic markers that predict the efficacy and tolerance of psychotropic and analgesic medications)
b) Databases (e.g., follow oncology example) – deeper analysis of existing databases would allow for predictive models to be created on issues such as response to treatments, withdrawal from treatment, etc.
2) Use a Systems Biology approach for prevention, diagnosis, treatment of psychological injury/illness. For example, use biomarkers (e.g., omics, data analysis, imaging, sample banking, phenotypical data, contextual/environmental data) as tools for 1) targeted prevention/intervention strategies based on personalized stratified risk, 2) objective diagnosis, 3) targeted treatment choices. Explore whether Systems Biology approaches may be able to identify mental and cognitive fitness characteristics within individuals.
3) Develop and exploit the predictive ability of emerging technologies, science, data, and models (e.g., machine learning) in order to identify the risk for adverse mental health outcomes and the opportunities to optimize mental health aspects of performance.
4) Maximize the convergence of sciences to capitalize on multiple disciplines in the life sciences, physical sciences and engineering to prevent psychological injury/illness and optimize performance by leveraging perspectives from clinicians, researchers, and engineers.
5) Assess the feasibility of utilizing real-time and continuous physiological and psychological status monitoring and feedback in military settings (coordinated with HFM-260 Wearable Biosensors).
6) Recommend approaches to develop databases/registries that would guide precise interventions. Encourage nations to share data to allow for analyses that are important for each nation.