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Use of Bionetworks to build maps of disease:
           Moving beyond the linear


    Integrating layers of omics data models
          and use of compute spaces

                   Stephen Friend MD PhD

          Sage Bionetworks (Non-Profit Organization)
                 Seattle/ Beijing/ Amsterdam

       International Symposium for 70th Anniversary IDAC
                       November 29, 2011
Alzheimer’s                           Diabetes




     Treating Symptoms v.s. Modifying Diseases
Cancer                                 Obesity
                Will it work for me?
                   Biomarkers?
Why not use data intensive science
   to build models of disease?

    Current Reward Structures

Organizational Structures and Tools

               Pilots
What is the problem?

Most approved therapies assume indications would represent
homogenous populations



Our existing disease models often assume pathway
knowledge sufficient to infer correct therapies
Personalized Medicine 101:
Capturing Single bases pair mutations = ID of responders
Reality: Overlapping Pathways
The value of appropriate representations/ maps
“Data Intensive” Science- Fourth Scientific Paradigm


       Equipment capable of generating
       massive amounts of data

        IT Interoperability

        Open Information System

       Host evolving computational models
       in a “Compute Space”
WHY NOT USE
   “DATA INTENSIVE” SCIENCE
TO BUILD BETTER DISEASE MAPS?
what will it take to understand disease?




    DNA RNA PROTEIN (dark matter)

MOVING BEYOND ALTERED COMPONENT LISTS
2002 Can one build a “causal” model?
How is genomic data used to understand biology?
                                                                RNA amplification




                                                    Tumors
                                                             Microarray hybirdization




                                                    Tumors
                                                             Gene Index

   Standard GWAS Approaches                                          Profiling Approaches
   Identifies Causative DNA Variation but       Genome scale profiling provide correlates of disease
           provides NO mechanism                                  Many examples BUT what is cause and effect?




                                                                      Provide unbiased view of
                                                                      molecular physiology as it
                                                                     relates to disease phenotypes
                                      trait
                                                                        Insights on mechanism
                                                                   Provide causal relationships
                                                                       and allows predictions

                                                                                             19
                   Integrated Genetics Approaches
Gene Co-Expression Network Analysis

    Define a Gene Co-expression Similarity


    Define a Family of Adjacency Functions


         Determine the AF Parameters


      Define a Measure of Node Distance


      Identify Network Modules (Clustering)

       Relate the Network Concepts to
     External Gene or Sample Information           20
                                              Zhang B, Horvath S. Stat Appl Genet Mol Biol 2005
Constructing Co-expression Networks

             Start with expression measures for genes most variant genes across 100s ++ samples

                                                                                                     1       2      3         4            Note: NOT a gene
                                                                                                                                          expression heatmap
                                                                                             1

                                                                                                     1     0.8     0.2        -0.8
                                                 Establish a 2D correlation matrix           2
                                                         for all gene pairs
expression




                                                                                                 0.8         1     0.1        -0.6
                                                                                             3

                                                                                                 0.2       0.1       1         -0.1
                                                                                             4

                                                                                                 -0.8      -0.6    -0.1           1
              Brain sample
                                                                                                     Correlation Matrix
                                                                                                                                                            Define Threshold
                                                                                                                                                             eg >0.6 for edge


                                                                             1       2   4       3                                           1      2          3       4
                                                                 1                                                                    1
             1                  4                                        1       1       1       0                                           1          1          0       1
                                                                 2                                                                    2
                                                                         1       1       1       0                                           1          1          0       1
                                                                         1       1       1       0           Hierarchically           3
                                              Identify modules   4                                                                           0          0          1       0
              2                 3                                                                                cluster
                                                                                                                                      4
                                                                 3       0       0       0       1                                           1          1          0       1
                  Network Module                                     Clustered Connection Matrix                                            Connection Matrix
                  sets of genes for which many
                   pairs interact (relative to the
                   total number of pairs in that
                                set)
Preliminary Probabalistic Models- Rosetta /Schadt

                                                                              Networks facilitate direct
                                                                           identification of genes that are
                                                                                   causal for disease
                                                                          Evolutionarily tolerated weak spots


                                 Gene symbol   Gene name                   Variance of OFPM    Mouse   Source
                                                                           explained by gene   model
                                                                           expression*
                                 Zfp90         Zinc finger protein 90      68%                 tg      Constructed using BAC transgenics
                                 Gas7          Growth arrest specific 7    68%                 tg      Constructed using BAC transgenics
                                 Gpx3          Glutathione peroxidase 3    61%                 tg      Provided by Prof. Oleg
                                                                                                       Mirochnitchenko (University of
                                                                                                       Medicine and Dentistry at New
                                                                                                       Jersey, NJ) [12]

                                 Lactb         Lactamase beta              52%                 tg      Constructed using BAC transgenics
                                 Me1           Malic enzyme 1              52%                 ko      Naturally occurring KO
                                 Gyk           Glycerol kinase             46%                 ko      Provided by Dr. Katrina Dipple
                                                                                                       (UCLA) [13]
                                 Lpl           Lipoprotein lipase          46%                 ko      Provided by Dr. Ira Goldberg
                                                                                                       (Columbia University, NY) [11]
                                 C3ar1         Complement component        46%                 ko      Purchased from Deltagen, CA
                                               3a receptor 1
                                 Tgfbr2        Transforming growth         39%                 ko      Purchased from Deltagen, CA
Nat Genet (2005) 205:370                       factor beta receptor 2
Extensive Publications now Substantiating Scientific Approach
              Probabilistic Causal Bionetwork Models
• >80 Publications from Rosetta Genetics


    Metabolic                "Genetics of gene expression surveyed in maize, mouse and man." Nature. (2003)
     Disease     "Variations in DNA elucidate molecular networks that cause disease." Nature. (2008)
                 "Genetics of gene expression and its effect on disease." Nature. (2008)
                 "Validation of candidate causal genes for obesity that affect..." Nat Genet. (2009)
                 ….. Plus 10 additional papers in Genome Research, PLoS Genetics, PLoS Comp.Biology, etc
   CVD                               "Identification of pathways for atherosclerosis." Circ Res. (2007)
                           "Mapping the genetic architecture of gene expression in human liver." PLoS Biol. (2008)
                                     …… Plus 5 additional papers in Genome Res., Genomics, Mamm.Genome

   Bone          "Integrating genotypic and expression data …for bone traits…" Nat Genet. (2005)
                                                            d
                   ..approach to identify candidate genes regulating BMD…" J Bone Miner Res. (2009)
   Methods       "An integrative genomics approach to infer causal associations ... Nat Genet. (2005)
                 "Increasing the power to detect causal associations… PLoS Comput Biol. (2007)
                 "Integrating large-scale functional genomic data ..." Nat Genet. (2008)
                 …… Plus 3 additional papers in PLoS Genet., BMC Genet.
List of Influential Papers in Network Modeling




                                        50 network papers
                                        http://sagebase.org/research/resources.php
(Eric Schadt)
“Data Intensive” Science- Fourth Scientific Paradigm
       Score Card for Medical Sciences

    Equipment capable of generating
    massive amounts of data                A-

    IT Interoperability                    D

    Open Information System                D-

    Host evolving computational models
    in a “Compute Space                    F
.




We still consider much clinical research as if
 We were hunter gathers - not sharing
 TENURE   	
     	
  	
  FEUDAL	
  STATES	
  	
     	
  
Clinical/genomic data
 are accessible but minimally usable




Little incentive to annotate and curate
       data for other scientists to use
Mathematical
models of disease
 are not built to be
   reproduced or
versioned by others
Assumption that genetic alterations
in human conditions should be owned
Lack of standard forms for future rights and consents
sharing as an adoption of common standards..
      Clinical Genomics Privacy IP
Publication Bias- Where can we find the (negative) clinical data?
Sage Mission
      Sage Bionetworks is a non-profit organization with a vision to
   create a commons where integrative bionetworks are evolved by
       contributor scientists with a shared vision to accelerate the
                       elimination of human disease

Building Disease Maps                              Data Repository




Commons Pilots                                    Discovery Platform
 Sagebase.org
Sage Bionetworks Collaborators

  Pharma Partners
     Merck, Pfizer, Takeda, Astra Zeneca,
      Amgen, Johnson &Johnson
  Foundations
     Kauffman CHDI, Gates Foundation

  Government
     NIH, LSDF

  Academic
     Levy (Framingham)
     Rosengren (Lund)
     Krauss (CHORI)

  Federation
     Ideker, Califarno, Butte, Schadt       36
NEW MAPS
                                        Disease Map and Tool Users-
                             ( Scientists, Industry, Foundations, Regulators...)

                                                PLATFORM
                                 Sage Platform and Infrastructure Builders-
                              ( Academic Biotech and Industry IT Partners...)

                                  PILOTS= PROJECTS FOR COMMONS
                                     Data Sharing Commons Pilots-
                                   (Federation, CCSB, Inspire2Live....)

                                                 NEW TOOLS
                       ORM
  APS




                                  Data Tool and Disease Map Generators-
                                  (Global coherent data sets, Cytoscape,
M




                      F
                  PLAT




                               Clinical Trialists, Industrial Trialists, CROs…)
  NEW




        RULES GOVERN                    RULES AND GOVERNANCE
                                       Data Sharing Barrier Breakers-
                                     (Patients Advocates, Governance
                                      and Policy Makers,  Funders...)
Alzheimer’s Disease



•  Cross-tissue coexpression networks for both
   normal and AD brains
    –  prefrontal cortex, cerebellum, visual
       cortex
•  Differential network analysis on AD and
   normal networks
•  Integrate coexpression networks and
   Bayesian networks to identify key regulators
   for the modules associated with AD



                                                  38
Identification of Disease (AD) Pathways via Comparative
                      Gene Network Analysis
40,000 genes from three tissues

                                                         Glutathione transferase
                                                          Gain connectivity by 91 fold

                           AD
                     (PFC, CB, VC)

                                                            nerve ensheathment
      Control
                                                            Lose connectivity by 40%
     (PFC, CB, VC)




                Module Connectivity Change (AD/Normal)




                                                                                                                39
                                                                                         Bayesian Subnetworks
Key Regulators
GlutathioneTransferase NerveEnsheathment ExtracellularMatrix               PECAM1: Platelet-endothelial cell
                                                                           adhesion molecule, a tyrosine
                                                                           phosphatase activator that plays a role
                                                                           in the platelet activation, increased
                                                                           expression correlates with MS, Crohn
                                                                           disease, chronic B-cell leukemia,
                                                                           rheumatoid arthritis, and ulcerative
                                                                           colitis

                                                                           ENPP2: Phosphodiesterase I alpha, a
                                                                           lysophospholipase that acts in
                                                                           chemotaxis, phosphatidic acid
                                                                           biosynthesis, regulates apoptosis and
                                                                           PKB signaling; aberrant expression is
                                                                           associated with Alzheimer type
                                                                           dementia, major depressive disorder,
                                                                           and various cancers

                                                                           SLC22A25: solute carrier family 22,
                                                                           member 25, Protein with high similarity
                                                                           to mouse Slc22a19, which is a renal
                                                                           steroid sulfate transporter that plays a
                                                                           role in the uptake of estrone sulfate,
                                                                           member of the sugar (and other)
                                                                           transporter family and the major
                                                                           facilitator superfamily




  Glutathione Transferase Module (Pink)
•  983 probes from all three brain regions (9% from CB, 15% from PFC and 76% from VC)
                                                                                                                   40
•  Most predictive of Braak severity score
The Federation
(Nolan and Haussler)
sage federation:
model of biological age




                                              Faster Aging
           Predicted Age (liver expression)




                                                                               Slower Aging

                                                                      Clinical Association
                                                                      -  Gender
                                                                      -  BMI
                                                                      -  Disease
                                               Age Differential       Genotype Association
                                                                      Gene Pathway Expression




                                                   Chronological Age (years)
Non-Responders Project
     To identify Non-Responders to approved
   Oncology drug regimens in order to improve
 outcomes, spare patients unnecessary toxicities
from treatments that have no benefit to them, and
              reduce healthcare costs
The Non-Responder Cancer Project Leadership Team

               Stephen Friend, MD, PhD
                                                      Todd Golub, MD
                                                      Founding Director Cancer Biology
               President and Co-Founder of
                                                      Program Broad Institute, Charles Dana
               Sage Bionetworks, Head of
                                                      Investigator Dana-Farber Cancer
               Merck Oncology 01-08,
                                                      Institute, Professor of Pediatrics Harvard
               Founder of Rosetta
                                                      Medical School, Investigator, Howard
               Inpharmatics 97-01, co-
                                                      Hughes Medical Institute
               Founder of the Seattle Project



                                                        Richard Schilsky, MD
           Garry Nolan, PhD                             Chief, Hematology- Oncology, Deputy
           Professor, Baxter Laboratory of Stem         Director, Comprehensive Cancer
           Cell Biology, Department of Microbiology     Center, University of Chicago; Chair,
           and Immunology, Stanford University          National Cancer Institute Board of
           Director, Proteomics Center at Stanford      Scientific Advisors; past-President
           University
                                                        ASCO, past Chairman CALGB clinical
                                                        trials group




                                                                                         11
Why not share clinical /genomic data and model building in the
        ways currently used by the software industry
         (power of tracking workflows and versioning
Leveraging Existing Technologies



Addama




                                  Taverna
               tranSMART
sage bionetworks synapse project
         Watch What I Do, Not What I Say           Reduce, Reuse, Recycle




                                                 My Other Computer is Amazon
      Most of the People You Need to Work with
                 Don’t Work with You
Networking Disease Model Building
Why not use data intensive science
   to build models of disease

    Current Reward Structures

Organizational Structures and Tools

               Pilots

          Opportunities




                        IMPACT ON PATIENTS

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Stephen Friend Institute of Development, Aging and Cancer 2011-11-28

  • 1. Use of Bionetworks to build maps of disease: Moving beyond the linear Integrating layers of omics data models and use of compute spaces Stephen Friend MD PhD Sage Bionetworks (Non-Profit Organization) Seattle/ Beijing/ Amsterdam International Symposium for 70th Anniversary IDAC November 29, 2011
  • 2.
  • 3. Alzheimer’s Diabetes Treating Symptoms v.s. Modifying Diseases Cancer Obesity Will it work for me? Biomarkers?
  • 4.
  • 5.
  • 6.
  • 7. Why not use data intensive science to build models of disease? Current Reward Structures Organizational Structures and Tools Pilots
  • 8. What is the problem? Most approved therapies assume indications would represent homogenous populations Our existing disease models often assume pathway knowledge sufficient to infer correct therapies
  • 9. Personalized Medicine 101: Capturing Single bases pair mutations = ID of responders
  • 11. The value of appropriate representations/ maps
  • 12.
  • 13. “Data Intensive” Science- Fourth Scientific Paradigm Equipment capable of generating massive amounts of data IT Interoperability Open Information System Host evolving computational models in a “Compute Space”
  • 14.
  • 15.
  • 16. WHY NOT USE “DATA INTENSIVE” SCIENCE TO BUILD BETTER DISEASE MAPS?
  • 17. what will it take to understand disease? DNA RNA PROTEIN (dark matter) MOVING BEYOND ALTERED COMPONENT LISTS
  • 18. 2002 Can one build a “causal” model?
  • 19. How is genomic data used to understand biology? RNA amplification Tumors Microarray hybirdization Tumors Gene Index Standard GWAS Approaches Profiling Approaches Identifies Causative DNA Variation but Genome scale profiling provide correlates of disease provides NO mechanism   Many examples BUT what is cause and effect?   Provide unbiased view of molecular physiology as it relates to disease phenotypes trait   Insights on mechanism   Provide causal relationships and allows predictions 19 Integrated Genetics Approaches
  • 20. Gene Co-Expression Network Analysis Define a Gene Co-expression Similarity Define a Family of Adjacency Functions Determine the AF Parameters Define a Measure of Node Distance Identify Network Modules (Clustering) Relate the Network Concepts to External Gene or Sample Information 20 Zhang B, Horvath S. Stat Appl Genet Mol Biol 2005
  • 21. Constructing Co-expression Networks Start with expression measures for genes most variant genes across 100s ++ samples 1 2 3 4 Note: NOT a gene expression heatmap 1 1 0.8 0.2 -0.8 Establish a 2D correlation matrix 2 for all gene pairs expression 0.8 1 0.1 -0.6 3 0.2 0.1 1 -0.1 4 -0.8 -0.6 -0.1 1 Brain sample Correlation Matrix Define Threshold eg >0.6 for edge 1 2 4 3 1 2 3 4 1 1 1 4 1 1 1 0 1 1 0 1 2 2 1 1 1 0 1 1 0 1 1 1 1 0 Hierarchically 3 Identify modules 4 0 0 1 0 2 3 cluster 4 3 0 0 0 1 1 1 0 1 Network Module Clustered Connection Matrix Connection Matrix sets of genes for which many pairs interact (relative to the total number of pairs in that set)
  • 22. Preliminary Probabalistic Models- Rosetta /Schadt Networks facilitate direct identification of genes that are causal for disease Evolutionarily tolerated weak spots Gene symbol Gene name Variance of OFPM Mouse Source explained by gene model expression* Zfp90 Zinc finger protein 90 68% tg Constructed using BAC transgenics Gas7 Growth arrest specific 7 68% tg Constructed using BAC transgenics Gpx3 Glutathione peroxidase 3 61% tg Provided by Prof. Oleg Mirochnitchenko (University of Medicine and Dentistry at New Jersey, NJ) [12] Lactb Lactamase beta 52% tg Constructed using BAC transgenics Me1 Malic enzyme 1 52% ko Naturally occurring KO Gyk Glycerol kinase 46% ko Provided by Dr. Katrina Dipple (UCLA) [13] Lpl Lipoprotein lipase 46% ko Provided by Dr. Ira Goldberg (Columbia University, NY) [11] C3ar1 Complement component 46% ko Purchased from Deltagen, CA 3a receptor 1 Tgfbr2 Transforming growth 39% ko Purchased from Deltagen, CA Nat Genet (2005) 205:370 factor beta receptor 2
  • 23. Extensive Publications now Substantiating Scientific Approach Probabilistic Causal Bionetwork Models • >80 Publications from Rosetta Genetics Metabolic "Genetics of gene expression surveyed in maize, mouse and man." Nature. (2003) Disease "Variations in DNA elucidate molecular networks that cause disease." Nature. (2008) "Genetics of gene expression and its effect on disease." Nature. (2008) "Validation of candidate causal genes for obesity that affect..." Nat Genet. (2009) ….. Plus 10 additional papers in Genome Research, PLoS Genetics, PLoS Comp.Biology, etc CVD "Identification of pathways for atherosclerosis." Circ Res. (2007) "Mapping the genetic architecture of gene expression in human liver." PLoS Biol. (2008) …… Plus 5 additional papers in Genome Res., Genomics, Mamm.Genome Bone "Integrating genotypic and expression data …for bone traits…" Nat Genet. (2005) d ..approach to identify candidate genes regulating BMD…" J Bone Miner Res. (2009) Methods "An integrative genomics approach to infer causal associations ... Nat Genet. (2005) "Increasing the power to detect causal associations… PLoS Comput Biol. (2007) "Integrating large-scale functional genomic data ..." Nat Genet. (2008) …… Plus 3 additional papers in PLoS Genet., BMC Genet.
  • 24. List of Influential Papers in Network Modeling   50 network papers   http://sagebase.org/research/resources.php
  • 26. “Data Intensive” Science- Fourth Scientific Paradigm Score Card for Medical Sciences Equipment capable of generating massive amounts of data A- IT Interoperability D Open Information System D- Host evolving computational models in a “Compute Space F
  • 27. . We still consider much clinical research as if We were hunter gathers - not sharing
  • 28.  TENURE      FEUDAL  STATES      
  • 29. Clinical/genomic data are accessible but minimally usable Little incentive to annotate and curate data for other scientists to use
  • 30. Mathematical models of disease are not built to be reproduced or versioned by others
  • 31. Assumption that genetic alterations in human conditions should be owned
  • 32. Lack of standard forms for future rights and consents
  • 33. sharing as an adoption of common standards.. Clinical Genomics Privacy IP
  • 34. Publication Bias- Where can we find the (negative) clinical data?
  • 35. Sage Mission Sage Bionetworks is a non-profit organization with a vision to create a commons where integrative bionetworks are evolved by contributor scientists with a shared vision to accelerate the elimination of human disease Building Disease Maps Data Repository Commons Pilots Discovery Platform Sagebase.org
  • 36. Sage Bionetworks Collaborators   Pharma Partners   Merck, Pfizer, Takeda, Astra Zeneca, Amgen, Johnson &Johnson   Foundations   Kauffman CHDI, Gates Foundation   Government   NIH, LSDF   Academic   Levy (Framingham)   Rosengren (Lund)   Krauss (CHORI)   Federation   Ideker, Califarno, Butte, Schadt 36
  • 37. NEW MAPS Disease Map and Tool Users- ( Scientists, Industry, Foundations, Regulators...) PLATFORM Sage Platform and Infrastructure Builders- ( Academic Biotech and Industry IT Partners...) PILOTS= PROJECTS FOR COMMONS Data Sharing Commons Pilots- (Federation, CCSB, Inspire2Live....) NEW TOOLS ORM APS Data Tool and Disease Map Generators- (Global coherent data sets, Cytoscape, M F PLAT Clinical Trialists, Industrial Trialists, CROs…) NEW RULES GOVERN RULES AND GOVERNANCE Data Sharing Barrier Breakers- (Patients Advocates, Governance and Policy Makers,  Funders...)
  • 38. Alzheimer’s Disease •  Cross-tissue coexpression networks for both normal and AD brains –  prefrontal cortex, cerebellum, visual cortex •  Differential network analysis on AD and normal networks •  Integrate coexpression networks and Bayesian networks to identify key regulators for the modules associated with AD 38
  • 39. Identification of Disease (AD) Pathways via Comparative Gene Network Analysis 40,000 genes from three tissues Glutathione transferase Gain connectivity by 91 fold AD (PFC, CB, VC) nerve ensheathment Control Lose connectivity by 40% (PFC, CB, VC) Module Connectivity Change (AD/Normal) 39 Bayesian Subnetworks
  • 40. Key Regulators GlutathioneTransferase NerveEnsheathment ExtracellularMatrix PECAM1: Platelet-endothelial cell adhesion molecule, a tyrosine phosphatase activator that plays a role in the platelet activation, increased expression correlates with MS, Crohn disease, chronic B-cell leukemia, rheumatoid arthritis, and ulcerative colitis ENPP2: Phosphodiesterase I alpha, a lysophospholipase that acts in chemotaxis, phosphatidic acid biosynthesis, regulates apoptosis and PKB signaling; aberrant expression is associated with Alzheimer type dementia, major depressive disorder, and various cancers SLC22A25: solute carrier family 22, member 25, Protein with high similarity to mouse Slc22a19, which is a renal steroid sulfate transporter that plays a role in the uptake of estrone sulfate, member of the sugar (and other) transporter family and the major facilitator superfamily Glutathione Transferase Module (Pink) •  983 probes from all three brain regions (9% from CB, 15% from PFC and 76% from VC) 40 •  Most predictive of Braak severity score
  • 41.
  • 44. sage federation: model of biological age Faster Aging Predicted Age (liver expression) Slower Aging Clinical Association -  Gender -  BMI -  Disease Age Differential Genotype Association Gene Pathway Expression Chronological Age (years)
  • 45. Non-Responders Project To identify Non-Responders to approved Oncology drug regimens in order to improve outcomes, spare patients unnecessary toxicities from treatments that have no benefit to them, and reduce healthcare costs
  • 46. The Non-Responder Cancer Project Leadership Team Stephen Friend, MD, PhD Todd Golub, MD Founding Director Cancer Biology President and Co-Founder of Program Broad Institute, Charles Dana Sage Bionetworks, Head of Investigator Dana-Farber Cancer Merck Oncology 01-08, Institute, Professor of Pediatrics Harvard Founder of Rosetta Medical School, Investigator, Howard Inpharmatics 97-01, co- Hughes Medical Institute Founder of the Seattle Project Richard Schilsky, MD Garry Nolan, PhD Chief, Hematology- Oncology, Deputy Professor, Baxter Laboratory of Stem Director, Comprehensive Cancer Cell Biology, Department of Microbiology Center, University of Chicago; Chair, and Immunology, Stanford University National Cancer Institute Board of Director, Proteomics Center at Stanford Scientific Advisors; past-President University ASCO, past Chairman CALGB clinical trials group 11
  • 47.
  • 48. Why not share clinical /genomic data and model building in the ways currently used by the software industry (power of tracking workflows and versioning
  • 50. sage bionetworks synapse project Watch What I Do, Not What I Say Reduce, Reuse, Recycle My Other Computer is Amazon Most of the People You Need to Work with Don’t Work with You
  • 52. Why not use data intensive science to build models of disease Current Reward Structures Organizational Structures and Tools Pilots Opportunities IMPACT ON PATIENTS