Predict susceptibility to a disease or a treatment side effect

Example: What’s causing a rise in liver cancers in the military population?

Problem/Issue: Without known predisposition, many civilians and military personnel develop a condition known as nonalcoholic fatty liver disease (NAFLD), which can be a precursor to liver disease and cancer.

Researchers are concerned that active duty and veterans appear more susceptible, due to co-occurrence of additional risks such as unappreciated environmental factors in regions of deployment, behavioral health stresses, and access to or acceptance of good nutrition.

Goal: An initial UC Davis-led pilot study will identify military personnel at greatest risk for liver disease and liver cancer, setting the stage for prevention or earlier detection and improved care.

Approach: Researchers will use military databases to create and analyze new data sets for cohorts of Vietnam-era, Gulf War-era, and current-duty service members, with biostatisticians and informaticists then working with liver experts and machine learning algorithms to produce a risk index. A more extensive index after the pilot grant is expected to integrate phenotype, biomarkers, environmental exposures and behavioral patterns.

Principal investigators: UC Davis, UCSF, Utah, Boston and USUHS. Uniquely, retired and active-duty personnel will help guide research and results-sharing.

Personalize treatment

Example: Improving co-treatment of burns and traumatic brain injuries in soldiers.

Problem/Issue: Traumatic brain injury or TBI is a leading cause of death in the U.S. military and civilian populations. When combined with burn injury, TBI mortality doubles. When the two injuries occur together, medical teams face a decision about strategy; TBI treatments usually focus on minimizing intravenous fluid administration to avoid brain swelling, whereas burn treatments use large amounts of IV fluid to replace those lost.

Goal: Improve outcomes by developing a precision medicine approach — a precise, personalized and proactive classification of injury using biomarkers and data — that gives medical teams a roadmap to determine the best way to provide care for improved survival and recovery.

Approach: Led by Drs. Tina Palmieri, M.D., F.A.C.S., and Meyers, researchers are characterizing the entire continuum of polytrauma care, incorporating the use of biomarkers.

Principal investigators: Meyers and Palmieri, assistant chief of burn surgery at UC Davis and Shriners Hospitals for Children – Northern California; UC Davis colleagues; Major Ian Stewart, David Grant Medical Center; Mary Jo Pugh, University of Utah/Department of Veterans Affairs.

Advance participatory wellness and prevention

Example: Precision Nutrition Program

Problem/Issue: Poor diet is the leading cause of U.S. mortality, contributing to heart disease, stroke, diabetes and cancer.

Goal: A new Precision Nutrition Program will develop and test interventions which provide, prescribe and educate patients regarding healthy and medically appropriate diets. It aims to leverage UC Davis Medical Center’s executive chef Santana Diaz, a national "farm-to-fork" leader working to substitute processed hospital food with local, whole and plant-based foods.

Approach: Develop programs that improve health by providing healthy patient meals, then quantify impacts on patient health and overall health care costs. An initial one-year retrospective study will look at quality improvement in food and patient satisfaction outcomes at UC Davis Medical Center, comparing data and patient satisfaction at different times to assess impact of farm-to-fork initiatives. A two-year trial will then enroll 50 patients and families on the hospital’s cardiac floor to receive medically tailored meals. Ultimately, the data will inform a pilot project of food-based interventions, such as medically tailored patient or family meals and prescriptions for healthy food.

Principal investigators: Meyers. The UC Davis Health Food and Nutrition Services and UC Sustainable Agriculture Research and Education Program are collaborators.