AAAS Symposium Report Convergence Science: A Revolution for Health Solutions AAAS Symposium February 15, 2014 at the 2014 Annual AAAS Meeting Organizers: Joseph M. DeSimone, University of North Carolina at Chapel Hill and NC State University Amanda Arnold, Massachusetts Institute of Technology with Crista Farrell, University of North Carolina at Chapel Hill Sarah Mueller, University of North Carolina at Chapel Hill Moderator: Susan J. Hockfield, Massachusetts Institute of Technology Speakers: Dennis A. Ausiello, Massachusetts General Hospital Belinda Seto, National Institute of Biomedical Imaging and Bioengineering Chad Mirkin, Northwestern University Joseph M. DeSimone, University of North Carolina at Chapel Hill and NC State University Introduction In biomedical research, significant breakthrough potential exists at the intersection of the life sciences, the physical sciences, and engineering disciplines. This deliberate collaboration, known as Convergence science, has inspired leading U.S. research institutions—including Stanford University, Georgia Institute of Technology, Harvard University, University of Michigan, University of Chicago, Northwestern University, Massachusetts Institute of Technology, and many more—to develop dedicated multidisciplinary centers on their campuses. Convergence science enhances the multidimensional promising areas such as cell- based therapeutics, nanobiotechnology, engineering approaches to microbial threats, imaging at all scales, immune-engineering, and microbiome engineering. During the first portion of this symposium, leaders in relevant fields discussed Convergence as a framework for advancing efforts in predictive health and illustrative examples of health risk predictors with genomic, neuroimaging and big data, as well as how to stand up a Convergence- style institute. Additionally, panelists reviewed education and workforce questions in the context of Convergence that must be addressed to meet the scientific and technological challenges of the 21st Century. The potential benefit of taking a broader perspective on Convergence, expanding beyond the life sciences, physical sciences, and engineering fields, to incorporate the social sciences and humanities, was also discussed. Following the presentations, forty attendees participated in small group discussions with the panelists and moderators on questions regarding data for predictive health; the breadth and depth of Convergence; implementing Convergence; and Convergence grand challenges. Susan J. Hockfield of the Massachusetts Institute of Technology moderated this event. Speakers included Dennis A. Ausiello, Massachusetts General Hospital; Belinda Seto, National Institute of Biomedical Imaging and Bioengineering; Joseph M. DeSimone, University of North Carolina at Chapel Hill and NC State University; and Chad Mirkin, Northwestern University. Summary Using Convergence to Reorganize Medicine Towards A Gold Standard of Wellness Dennis Ausiello urges us to develop a gold standard for wellness by establishing phenotypes at the population level, taking into account all possible information and measurements (‘omics’, wearable sensors, e-medical records, biospecimens, and integrative analytics on research populations). Milestone goals include 1) uniting clinical care with discovery and individual medical information that the patient aggregates and controls; and, in time, 2) enhancing predictability and wellness outcomes that prevent serious illness. Dr. Ausiello offers the CATCH program as one example of a Convergence-style program in this area. More online here: http://catch-health.org/Home_Page.html Framing the Research Question as a Critical Convergence Moment NIH is beginning to adopt Convergence approaches to maximize funding opportunities and extramural research capabilities on grand challenges, like those associated with brain research. In order to distill big data into knowledge, researchers have had to reach beyond their comfort zones and into areas with a history of working with big data (e.g. weather forecast modeling, astrophysics, etc). Dr. Seto reviewed past and present examples of Convergence-style research with a focus on projects funded through the Alzheimer’s Disease Neuroimaging Initiative (ADNI), http://adni-info.org, and the NIH Big Data to Knowledge (BD2K), http://bd2k.nih.gov/, effort. New Education and Entrepreneurship Opportunities Emerging at Convergence Centers Based on his experience developing the International Institute for Nanotechnology, http://www.iinano.org/, Chad Mirkin outlined the many responsibilities incumbent on the executive director of a new Convergence-style center on a university campus. From inception to build-out, a wide variety of university actors, most notably faculty from disparate disciplines, have to agree on space, tools, and other resources. They must see the benefit of pursuing resources as a team as opposed to individually. Despite significant barriers, Mirkin argued that universities across the country are building these centers because of the transformative accomplishments such centers can achieve. Convergence Training Requires Celebrating Diversity in Both Discipline and Socioeconomic Backgrounds Starting with a broader perspective on Convergence to recognize the important roles of the humanities disciplines and the social sciences in shaping how problem-solving is viewed and approached, Joseph DeSimone used examples like Apple, Inc. and Stanford’s d.school (Hasso Plattner Institute of Design) to explain how inclusion of disciplines outside of the traditional Convergence framework can augment the potential for innovation using a Convergence approach. On the question of training, Joseph also presented a view in which diversity is critical to the framework since, as he noted, we learn the most from the people with whom we have the least in common. Accordingly, while those who dive deeply into and focus their work within one discipline are necessary and extremely important to manifest Convergence success (i.e. “I” shaped individuals), there is also a great need for “T-shaped”, “Pi-shaped”, and “Comb-shaped” thinkers to go beyond pursuing a common language and enable a cultural shift toward a “multilingual” approach. To solve significant 21st century challenges, we will make the greatest progress through Convergence efforts that involve those who have in-depth understanding of multiple fields and the unique capability to foster better respect, communication, and collaboration among them. Critical Conclusions It became clear during this session that we have to answer the question: “How is Convergence different from the decades-long exhortation to cross-disciplinary work?” That is, how are today and tomorrow different from yesterday? While the Convergence Approach, which celebrates transdisciplinarity in organization and education, may not be new, it is gaining traction because it offers an organizing framework (much like the National Nanotechnology Initiative did in practice) to overcome traditional obstacles to funding, promotion, and appointment that have slowed transdisciplinary approaches and stymied access to knowledge potential. According to our panelists: Belinda Seto of NIH argues that Convergence approaches do not manifest simply by bringing people of different disciplines together; instead, the Convergence approach depends on a transdisciplinary approach at the outset – at the framing of the research questions. Dennis Ausiello of MGH argued that the Convergence capability is fostered early on with multiple disciplinary deep-dive capabilities residing in individual researchers. Joseph DeSimone of UNC built on this arguing that the 18th century-style peer review systems are inhibiting reward systems for these kinds of “comb shaped” individuals, and that we need a system that honors and supports the diversity of individuals (including I, T, Pi and Comb- shaped), teams, disciplines, and expertise. In application, Chad Mirkin argued that the Convergence model, the tearing down of siloes, is already proving itself at Convergence-style centers, like the IIN, where students who are educated in this way are getting superior research and job opportunities as compared to their peers. Susan Hockfield of MIT reminds us that Convergence is not necessarily a new idea but that it is becoming a rallying call to finally address the inhibitory structures and challenges that hinder transdisciplinary research movements. Recommendations Convergence Approaches to Data for Predictive Health Given the significant promise of precision medicine and the integration of digital medical records with real-time monitoring to revolutionize health care, we asked attendees to give us recommendations for actionable steps towards wellness. • Acknowledge the failure of disease management historically and identify toolkits, theories, etc. that can be applied towards new interrogation models that manage complexity and chaos with the goals of greater reproducibility and predictability. • In the short-term, take steps towards establishing a gold standard for wellness by building phenotypic models of discrete populations wherever possible. • Take advantage of an emerging interest by the public for their health data (via wearable devices, direct-to-consumer testing, apps that track diet and activity, etc.) to be interrogated by a medical professional on a continuous basis. Implementing Convergence We asked attendees to address critical barriers to Convergence including administrative and financial barriers and potential