New roadmap will guide program’s steps to advance precision medicine
Since launching the Researcher Workbench just four years ago, the All of Us Research Program has made data available from more than 400,000 participants across the United States to power new health discoveries. The program plans to release additional data from more participants in the coming years, pending the availability of funds. These data releases and other activities will be guided by the program’s scientific priorities—now outlined in a new roadmap to show how All of Us aims to advance precision medicine for all.
“Our vision is that research findings that come out of All of Us will eventually inform health care practices and improve public health,” said All of Us Chief Medical and Scientific Officer Geoffrey Ginsburg, M.D., Ph.D. “Our scientific priorities roadmap is our ‘North Star.’ It points to where All of Us is headed and how we’ll get there, working together with participants and the researcher community.”
Download a PDF version of the Scientific Priorities Roadmap.
The roadmap is the culmination of years of discussions among NIH staff, program partners, participants, and researchers about key research areas that the program can enable in the near term and long term. These priorities are grounded in the program’s original blueprint and further informed by present health concerns, such as the nation’s leading causes of death. Dr. Ginsburg and colleagues described an initial version of the roadmap in their 2023 article in Science Translational Medicine.
The path to precision medicine
In the roadmap, All of Us charts a path from the program’s core protocol and foundational infrastructure investments to specific areas of inquiry and, finally, to the translation of research findings into precision health care approaches.
The strategy begins with the data and tools in the Researcher Workbench. Within this cloud-based platform, researchers can collaborate to explore information that participants share over time, including survey responses, electronic health record data, Fitbit data, physical measurements, and genomic data. Researchers can analyze these data with a suite of research tools, including Jupyter Notebook, RStudio, SAS Studio, and more. With each release of new data and tools, the platform’s capacity to support new research grows.
These resources enable research on the factors that inform how people stay healthy and whether they may develop health conditions. The program focuses on four of these exposures and drivers:
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Lifestyle, substance use, and behavior
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Environmental influences
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Health inequity
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Genetics and biology
“In our daily lives, we're exposed to pollution. We're exposed to stress. Our health is also shaped by our diet, physical activity, biology, and more. We want to understand how all of these different variables combine to affect the health of both individuals and communities,” said Dr. Ginsburg. “Those insights will help researchers identify strategies to intervene against disease at the right time and in the right way.”
The exposures and drivers that shape our health lead to the third part of the roadmap: causality and outcomes. This area captures conditions that are influenced by exposures and drivers, either individually or in combination. The program has identified four areas of focus:
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Common and rare health conditions
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Maternal and child health
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Healthy aging and resilience across the lifespan
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The impact of returning results to research participants
Researchers interested in these areas may seek to answer numerous questions. For example: What factors impede cognitive decline? How may exposures in childhood increase the risk of certain conditions later in life? Are there novel biomarkers that may predict how people experience pain or respond to treatments? How might we best leverage new technologies to deliver genetic test results and increase participants’ understanding of their results?
Research on health exposures and outcomes—based on data from All of Us’ diverse participant cohort—can, in turn, pave the way for advancements in individual and population health. This could include changes in health policy or standards of care. For example, Dr. Ginsburg envisions a future in which doctors routinely provide patients with individualized risk assessments spanning a range of health conditions. These may inform patients’ choices and health care decisions and prompt helpful conversations within their families and communities. Ultimately, greater access to personalized risk assessments, diagnostics, and treatments may improve patient outcomes and reduce health disparities.
“The success of the Scientific Priorities Roadmap will be felt in how well the program advances the practice of precision medicine and how much these practices impact individual and population health,” said Dr. Ginsburg.
Guiding research
Already, researchers have started more than 12,000 projects on the Researcher Workbench, yielding new insights that will spark additional research opportunities. A 2023 analysis of projects that use All of Us data found that more than 90% map onto the program’s current scientific priorities. The approximately 10% that don’t may influence the next version.
“The roadmap is meant to be a catalyst for research. At the same time, we’ll be learning from the All of Us researcher community and the studies underway to help guide future versions of the roadmap,” said Dr. Ginsburg. “Our priorities will evolve as the program develops and science advances.”
Today, the scientific priorities help the program make decisions about potential protocol updates, new data linkages, and ancillary studies, like Nutrition for Precision Health. All of Us also refers to the scientific priorities in curating a list of relevant funding opportunities from across NIH that would support the use of All of Us data.
“We are building a global community of researchers who are driving precision medicine research and practice,” said Dr. Ginsburg. “I hope researchers around the world see their interests reflected in our priorities and join us on the Researcher Workbench.”
To learn more about All of Us’ scientific resources and to register for data access, visit ResearchAllofUs.org.
