National Heart, Lung, and Blood Advisory Council September 2018 Meeting Summary

DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH
NATIONAL HEART, LUNG, AND BLOOD ADVISORY COUNCIL

MEETING SUMMARY OF THE
NATIONAL HEART, LUNG, AND BLOOD ADVISORY COUNCIL

September 5, 2018

The 279th meeting of the National Heart, Lung, and Blood Advisory Council (NHLBAC) was convened on Wednesday, September 5, 2018, in Building 35A, the Porter Neuroscience Center Conference Center, National Institutes of Health (NIH), Bethesda, Maryland and included the National Heart Lung, and Blood Institute’s Board of External Experts. The Council meeting began at 9:05 a.m. and concluded at 4:10 p.m. Two working groups met from 1:45 p.m. to 3:20 p.m. Dr. Gary H. Gibbons, Director of the National Heart, Lung, and Blood Institute (NHLBI), presided as Chair.

Council Members attending

Dr. Donna K. Arnett
Dr. Nancy J. Brown
Dr. Michael R. DeBaun
Ms. Grace A. Dorney Koppel
Dr. Serpil C. Erzurum
Dr. Karen Glanz
Dr. Garth Graham
Dr. M. Luisa Iruela-Arispe
Dr. Monica Kraft
Dr. Diane J. Nugent
Dr. Pilar N. Ossorio
Dr. Robert C. Robbins
Dr. Dean Sheppard
Dr. Kim M. Smith-Whitley
Dr. Sally E. Wenzel
Dr. Andrew S. Weyrich
Dr. Phyllis C. Zee

Council Members attending via teleconference

Dr. Richard S. Schofield (ex officio)
Dr. E. Dale Abel

BEE Members attending

Dr. Michelle Albert
Dr. Judy Ascher
Dr. Timothy Blackwell
Dr. Nadian Hansel
Dr. Bertha Hidalgo
Dr. Mukesh Jain
Dr. Darrell Kotton
Dr. Brian Mittman
Dr. Matthias Nahrendorf
Dr. Ellis Neufeld
Dr. Laura Newby
Dr. Bruce Psaty
Dr. Susan Redline
Dr. Celeste Simon
Dr. Griffin M. Weber

Public attending

Ms. Heidi Chang, McAllister & Quinn
Ms. Alison Evans, Lewis-Burke Associates
Dr. Dina Katabi, Massachusetts Institute of Technology

NHLBI employees attending

A number of NHLBI staff members were in attendance.

I. CALL TO ORDER AND OPENING REMARKS

Dr. Gary H. Gibbons, Director of the National Heart, Lung, and Blood Institute (NHLBI), called the 279th meeting of the National Heart, Lung, and Blood Advisory Council (NHLBAC) to order and welcomed members and other attendees.

II. ADMINISTRATIVE ANNOUNCEMENTS

Dr. Laura K. Moen, Director, Division of Extramural Research Activities, NHLBI, made the required announcements for the Council meeting, including the publication of a notice in the Federal Register as well as reminders to Council members regarding conflict of interest and lobbying activities.

III. HOW ARTIFICIAL INTELLIGENCE AND DIGITAL TECHNOLOGY CAN TRANSFORM HEALTHCARE

Dina Katabi, Ph.D., Andrew & Erna Viterbi Professor of Electrical Engineering and Computer Science at Massachusetts Institute of Technology, described a new technology that she and her colleagues developed to monitor the health of a home’s occupants in a noninvasive way.

Dr. Katabi’s laboratory has developed a small sensor that can be placed in the home and uses wireless signals to monitor occupants’ movements, breathing, sleep, heart rate, and gait speed without a single sensor on occupants’ bodies. The device does not need to be in the same room as the occupants, and it uses machine learning algorithms to detect changes in various health-related parameters. The device can alert caregivers of important health-related events, such as patient falls.

IV. STRATEGIC VISION IMPLEMENTATION UPDATES

Division of Cardiovascular Sciences (DCVS). Dr. David Goff, Director of DCVS, explained that to develop its strategic vision, DCVS conducted a landscape analysis and mapped its major initiatives to the eight NHLBI strategic objectives. The division identified six major goals for the next few years, including: 1) Intervening on social determinants of CVH & health equity; 2) Understanding and promoting resilience; 3) Promoting cardiovascular health (CVH) across the lifespan; 4) Eliminating hypertension-related CVD; 5) Reducing heart failure burden; and 6) Preventing vascular dementia.

Division of Lung Diseases (DLD). Dr. James Kiley, Director of DLD, explained that DLD activities span a broad range of diseases and conditions, including asthma, COPD, sleep, and pulmonary vascular diseases. The division also conducts research on developmental biology and pediatric diseases, sponsors training, and special programs. Dr. Kiley presented a list of DLD initiatives that address each of the eight objectives in the NHLBI strategic vision.

Division of Blood Diseases and Resources (DBDR). Dr. Keith Hoots, Director of DBDR, described the three DBDR branches. A significant focus of the DBDR efforts to advance the NHLBI strategic vision is on the interface of biology preserved across all categorical organ systems. The blood, vascular system, and blood-brain barrier are paradigmatic of finite injury responses to an infinite number of noxious stimuli. For the vasculature, deciphering how single components (e.g., signaling proteins, receptors, jettisoned organelles, cytoplasm, and nuclear elements of damaged cells) can influence multiple injury responses is essential for targeting therapeutic strategies.

Center for Translation Research and Implementation Science (CTRIS). Dr. George Mensah, Director of CTRIS, explained that the Center conducts evidence synthesis and integration as well as rigorous systematic reviews, which it uses to identify research gaps and work with other NHLBI divisions to develop evidence that can fill these gaps. In addition, CTRIS develops clinical practice guidelines with partners and conducts research on the science of implementing the best evidence. Dr. Mensah shared initiatives that address five of the objectives in the NHLBI strategic vision and gave examples of CTRIS global health initiatives.

V. CHARGE TO WORKING GROUPS

Dr. Gina Wei, Associate Director of DCVS, explained that NHLBAC and BEE members would separate into two working groups to discuss NHLBI programs that address the strategic vision objectives related to precision medicine and data science. Dr. Wei charged the two breakout groups with discussing how the NHLBI can build, foster, and support a community of data users to realize the goals of precision medicine and maximally leverage data-sharing platforms and resources.

One working group was charged with identifying ways the NHLBI might attract new data scientists into HLBS research and advance data science capabilities in current HLBS investigators. The charge for the second working group was to provide input on how the NHLBI can support and foster data science and precision medicine research efforts, including leveraging omics data, cohort studies, and deep phenotyping in the short, medium, and long terms.

VI. REPORTS FROM WORKING GROUP DISCUSSIONS

The reports summarized below are ideas that were discussed by Council and BEE members and will be taken under advisement by NHLBI staff in future decision making.

Working Group A. Dr. Donna Arnett, Dean and Professor in the College of Public Health at the University of Kentucky, summarized the discussions by answering key questions.

1. How can the NHLBI build, foster, and support a vibrant community for data science and precision medicine?
   • Foster development of user-friendly, cloud-based tools and datasets.
   • Promote early-career scientists.
   • Promote cross-disciplinary interactions.
   • Use existing datasets (TOPMed) and tools (Data STAGE) to promote data science researchers.
   • Allow supplements to existing grants for training costs to benefit midcareer and established scientists.
   • Publicize the importance of data science research and the availability of NHLBI datasets and tools.

2. How can the NHLBI attract, engage, and educate data science experts in other scientific fields and the private sector in HLBS research?
   • Promote data science in K–12 and undergraduate curriculums.
   • Make data science training part of biomedical curriculums.
   • Issue requests for applications for collaborations between several principal investigators with expertise in data science and biomedical research.
   • Include data scientists in study sections and form data science study sections.
   • Hire data scientists to run analysis cores.
   • Foster industry partnerships to use the best data science talent.
   • Offer training to data scientists through co-mentoring with biomedical researchers.
   • Promote methods and results sharing between industry and academic researchers.
   • Bring patients into collaborations with academic and industry researchers.
   • Reduce the administrative burden of obtaining industry and academic collaborative research grants.

3. What are the data science training needs of the extramural community?
   • Use training grants to link data science to important HLBS questions.
   • Address the limits on what can be accomplished given interoperability problems.

4. How can the NHLBI advance data sciences skills in current NHLBI researchers from trainees to senior investigators?
   • Create supplements for midcareer training in data science.
   • Foster development of user-friendly, cloud-based tools.
   • Offer courses and workshops during existing meetings and conferences.

Working Group B. Dr. Bruce M. Psaty, Professor of Medicine and Epidemiology at the University of Washington, summarized the discussions by offering the following recommendations.

• Provide funding and accessibility for investigators to use the TOPMed data and conduct analyses.
• Promote TOPMed to investigators through workshops and webinars.
• Ensure that investigators use this resource well.
• Create a searchable catalog of data, possibly within a coordinating center that would determine which data are available and that would harmonize these data.
• Bring the NHLBI’s datasets together and organize them so that investigators can obtain phenotypic data.
• Create multidisciplinary working groups (to include experts in phenotypes, biostatistics, data science, and bioinformatics) focused on specific phenotypes or research questions.
• Involve young investigators early on.
• Arrange for senior investigators to mentor junior investigators by helping them understand how the data were collected and what they mean.
• Create unidentifiable, open-access datasets.
• Increase awareness for study sections of the work required for data harmonization and data analysis.
• Provide mechanisms that facilitate funding for inter-institutional data science.
• Make analytic services and modules available to perform simple analyses for inexperienced investigators.
• Encourage studies to collect certain standard data elements to ensure cross-study consistency and harmonization.

Dr. Gibbons thanked the Council and BEE members for their hard work and thought-provoking discussion. He added that NHLBI staff will review the feedback offered at this meeting and will use it in future planing and development.

ADJOURNMENT

The meeting was adjourned at 4:10 p.m.

CERTIFICATION

I hereby certify that the foregoing minutes are accurate and complete.