LiPuma: 1938, described in pancreas, failure to thrive in infants, death w/in first year, a GI disease. '43 Farber resp tract #AMP2016
9:13am November 11th 2016 via Twitter Web Client
LiPuma:1:30 carrier freq of CF. 60K in US/EU. CFTR very large ion channel; CF multiple manifestations across organs #AMP2016
9:11am November 11th 2016 via Twitter Web Client
John LiPuma (Univ Michigan MI) The microbiome of Cystic Fibrosis #AMP2016
9:06am November 11th 2016 via Twitter Web Client
MT @DNARNADan: #amp2016 #amplifier Very sensible Natl Acad Med recs being presented by Leonard, Pratt, Nussbaum https://t.co/1XZayci7qz
9:05am November 11th 2016 via Hootsuite
RT @iontorrent: Presenting #AMP2016 Poster I36 from 2:30-3:30 Methods for detection of somatic mutations at 0.05% frequency from cfDNA
9:00am November 11th 2016 via Hootsuite
Mysorekar: Part 2 on Zika, reviews history and spread across US. New Nature ref https://t.co/AiFYwVtfG8 of mAb mouse vaccine #AMP2016
8:55am November 11th 2016 via Twitter Web Client
Mysorekar: Shows distribution across regions from this '16 ref https://t.co/Eg8QuMHBcI (Note - high level of unk in some areas) #AMP2016
8:43am November 11th 2016 via Twitter Web Client
Mysorekar: Two routes of where microbe may come from: vagina via cervix, or from diet; but are distinct when compared to HMP data #AMP2016
8:39am November 11th 2016 via Twitter Web Client
Mysorekar: Fetal Membrane (FM) lowest variability of 3 areas. Validated quantitation via qPCR to find copy number #AMP2016
8:35am November 11th 2016 via Twitter Web Client
Mysorekar: Did 16S rRNA sequencing, analysed with QIIME and Greengenes. Shows Shannon diversity score by location #AMP2016
8:34am November 11th 2016 via Twitter Web Client
Mysorekar: Fetal-derived epthelial cells called EVTs also carry microbes '14 ref https://t.co/6GRRkPQbXt #AMP2016
8:33am November 11th 2016 via Twitter Web Client
Mysorekar: Bacterial stains show spirochetes, rods, etc. Shows close-ups from '12 ref #AMP2016
8:31am November 11th 2016 via Twitter Web Client
Mysorekar: Placentas collected, FFPE, three different portions (basal plate BP, placental villous PV, fetal membrane FM) #AMP2016
8:30am November 11th 2016 via Twitter Web Client
Mysorekar: Microbiome in placenta took time to be accepted; first work in 2012. https://t.co/onRzjMv0qU #AMP2016
8:29am November 11th 2016 via Twitter Web Client
Mysorekar: What makes us what we are? Genome, epigenome, and microbiome ('that can be changed'). 100T cells, co-evolved w/genome #AMP2016
8:25am November 11th 2016 via Twitter Web Client
Mysorekar: Not surprising that disorders are manifold - from infertility, preeclampsia, miscarriage, preterm birth #AMP2016
8:23am November 11th 2016 via Twitter Web Client
Mysorekar: First 9 mos have enormous impact on the rest of a life: placenta serves as a lung, CV, immune system, energy storage #AMP2016
8:21am November 11th 2016 via Twitter Web Client
Indira Mysorekar (Univ Washington MO) Microbes in the placenta: friends and foes #AMP2016
8:20am November 11th 2016 via Twitter Web Client
RT @GenomicPath: Summary slide of genomic medicine history from @eric_lander 's plenary at #AMP2016. #AMPlifier https://t.co/fupMlCopQD
7:49am November 11th 2016 via Twitter Web Client
Comment from CAP person: a 1.5y pilot project in CA, going from Intuitive EHR to CA Cancer Registry to look for trends. #AMP2016
Nussbaum: New methods for consent - no longer legal-ese, new mechanisms to help address these concerns #AMP2016
7:47am November 11th 2016 via Twitter Web Client
Leonard: They did have patient representation; often decisions made too conservatively. Today crowdsourcing etc. many willing #AMP2016
7:46am November 11th 2016 via Twitter Web Client
Nussbaum: con't it will take some thinking, it isn't straightforward, an important reminder about processes and ethics #AMP2016
Comment: Person from NCI, w/so much pt data, how to navigate ethical boundaries bet research and care? Nussbaum: It does blur #AMP2016
7:45am November 11th 2016 via Twitter Web Client
Leonard: Outcomes data cannot currently be captured from LIS, EHR, thus the emph on data structure #AMP2016
7:43am November 11th 2016 via Twitter Web Client
Leonard: The points 7-8: the need for structured data; physicians were 'aghast' that they would have to give up notes. #AMP2016
7:42am November 11th 2016 via Twitter Web Client
Comment: Guardian network is already starting down this path. EHR is a jungle of data w/in a hospital. To advance: focus on data #AMP2016
7:41am November 11th 2016 via Twitter Web Client
Leonard: In cancer their EHR is starting to change, needs to be broadly applied. #AMP2016
7:37am November 11th 2016 via Twitter Web Client
Q:How to get the investment into this living, breathing system? How to get info updated? Leonard: "EHRs are basically billing" #AMP2016
7:36am November 11th 2016 via Twitter Web Client
Nussbaum: We need to be all involved in this rapid learning process, in order to move this forward #AMP2016
7:34am November 11th 2016 via Twitter Web Client
Nussbaum: (Full report and summary here via IOM: https://t.co/5Qwt51fwJa ) #AMP2016
7:32am November 11th 2016 via Twitter Web Client
Nussbaum: From an artificial clinical trial environment to an integrated care system. Deliver care, ongoing assessment, modify #AMP2016
7:31am November 11th 2016 via Twitter Web Client
Nussbaum: So pts and physicians can benefit. A rapid learning system - a system for data accumulation and evaluation #AMP2016
7:30am November 11th 2016 via Twitter Web Client
Nussbaum: Rec 10: Expand interdisciplinary collaboration for integrated guidelines on appropriate use for tests for Rx #AMP2016
7:29am November 11th 2016 via Twitter Web Client
Nussbaum: Of particular relevance to #AMP2016 audience. A Nat'l Quality Forum to dev quality measure to assess unneeded repeat collection
7:28am November 11th 2016 via Twitter Web Client
Nussbaum: Rec 9: Enh specimen handling, documentation to ensure pt safety, accuracy of test results #AMP2016
7:27am November 11th 2016 via Twitter Web Client
Nussbaum: Fund dev or eval of biomarkers to ID and overcome these barriers. Perform demo projects w/ variety of incentives #AMP2016
7:26am November 11th 2016 via Twitter Web Client
Nussbaum: Rec 8:Promote equity in access to biomarker tests; expertise for effective use. Social, economic, geographic obstacles #AMP2016
7:25am November 11th 2016 via Twitter Web Client
Nussbaum: Need description of test, results, interpretation, Rx decisions, outcomes, longitudinal data, pt-reported outcomes #AMP2016
7:23am November 11th 2016 via Twitter Web Client
Leonard: FDA, CMS, NIH, PCORI, D of VA, DoD, other partners. DB to include prospective, integrated, structured data #AMP2016
7:22am November 11th 2016 via Twitter Web Client
Bob Nussbaum (In Vitae, CA) continuing: Rec 7: nat'l DB - HHS should charge FDA, NIH to form a Task Force to create it #AMP2016
7:21am November 11th 2016 via Twitter Web Client
Leonard: As physicians learn, they can get credit for usage of decision support. #AMP2016
7:20am November 11th 2016 via Twitter Web Client
Leonard: Patient portals linked to EHRs should provide biomarker resutls in a pt-friendly manner. W/decision support, CME, CEU, MOC #AMP2016
Leonard: Data structured in such a way to capture data in a national DB. Also enable HER to facilitate POC decision support #AMP2016
7:18am November 11th 2016 via Twitter Web Client
Leonard: Rec 6:EHR and other LIS enables capture/linkage of biomarker tests, targeted Rx, longitudinal data in EHR #AMP2016
7:17am November 11th 2016 via Twitter Web Client
Leonard: CMS should clarify, expand implement of coverage w/evidence for additional coverage. PCORI and NIH also #AMP2016
7:16am November 11th 2016 via Twitter Web Client
Leonard: Rec 5: Ensure ongoing assessment of clin utility. Reimbursement model should support ongoing collection of data #AMP2016
7:15am November 11th 2016 via Twitter Web Client
Leonard: Current CLIA inadequate; 'don't shoot the messenger' here. #AMP2016
7:14am November 11th 2016 via Twitter Web Client
Leonard: Rec 4:Update and strengthen oversight and accreditation. HHS should 'est and enforce up-to-date lab accreditation stds' #AMP2016
7:13am November 11th 2016 via Twitter Web Client
Leonard: Rec 3: enhance communication to pts for label. Gives example of CFTR G551D 'Test Facts' mock-up, user-friendly #AMP2016
