THE FUTURE OF PRECISION MEDICINE
In support of USU’s mission to educate and train the next generation of battlefield surgeons, the USU Surgical Critical Care Initiative (SC2i), a precision medicine Center focused on developing Clinical Decision Support Tools (CDSTs) for critical care, embeds military students (3 from military academies and ~10 from USU via CAPSTONE) as well as 5 residents yearly, three of whom are affiliated with USU Walter Reed Surgery, in any of SC2i’s twenty research projects.
In 2017, SC2i increased its patient enrollment to 1,500, generating well over 30 million data elements to support the development of both knowledge and materiel products. The contributions by students and residents add to the overall academic productivity of SC2i, which in 2017 produced 8 peer-reviewed publications, 23 presentations (14 at MHSRS alone), a Churchill Lecture (American College of Surgeons), and a Chapter to the recently released Out of the Crucible: How the US Military Transformed Combat Casualty Care in Iraq and Afghanistan.
This past year alone, the Center has deployed 3 CDSTs (invasive fungal infection, massive transfusion protocol, decompensation) and is aggressively working with the Defense Health Agency to insert these into the Military Health System’s new Electronic Health Record (Genesis). SC2i is concurrently developing 6 additional CDSTs focused on conditions again associated with a high risk of morbidity or mortality (pneumonia, venous thromboembolism, bacteremia, acute kidney injury, acute respiratory distress syndrome, acute lung injury). All efforts are protected under 9 distinct provisional IP disclosures that will be fully converted in the Summer of 2018.
As part of its advanced development strategy, SC2i leadership met with the FDA on 12 January ahead of submitting an Investigational Device Exemption (IDE) for its WounDx CDST. The Center is in the process of refining its application in anticipation of a trial launch in FY19.
"The Clinical Decision Support Tools (CDSTs) developed by the SC2i will improve clinical outcomes and resource utilization by personalizing diagnoses and surgical interventions across conditions associated with a high-risk of mortality and/or morbidity (e.g. timing of traumatic wound closure pneumonia, venous thromboembolism, acute kidney injury, acute respiratory distress syndrome)."