This week’s spotlight shines on Ryanne Wu, MD, who talks about her work designing individualized risk assessment tools, the future of personalized medicine, and other topics.
How long have you been at Duke? How long have you been at the Division?
Those are two different questions for me. I first came to Duke as an undergraduate more years ago than I like to admit. I then left for medical school and residency training. I came back to Duke in 2012 as a fellow in health services research and joined the faculty just last month.
What does a typical day for you at the Division look like?
I don't think there is a typical day as every day is different! I spend 30% of my time in clinical care and the remainder doing research. When doing research, my days are a mix of team meetings, individual meetings with my mentors, and time in my office working on manuscripts, grants, etc.
You’re working on a screening tool to help people come up with individualized risk assessments and screening recommendations. Can you tell me more about that research?
We developed an IT platform, MeTree, that allows patients to enter their own personal and family health history prior to the medical encounter. Computer algorithms then use this data to create personalized risk assessment reports for patients and their providers based on current clinical guidelines. We have tested the tool in a pilot study with ~ 1,000 patients in a primary care setting in North Carolina. We found that a significant number of patients qualified for increased screening or referrals to genetic counselling based on current guidelines. We are currently testing the tool in an implementation study across five healthcare systems, including Duke.
What are some of the benefits of having tailored cancer risk assessments and recommendations? What are the challenges you face in creating them?
We know from the literature and our research that while medical providers and patients recognize the importance of family health history in risk stratification, in practice it is rarely collected in enough detail to be used for that purpose. The benefit of a tool like MeTree is it takes the responsibility for data collection and risk calculation out of the hands of medical providers, thus freeing them up to focus their time on application of that personalized risk and discussing guideline-based recommendations with the patient. The challenges to use of a tool like MeTree largely involve 1) educating patients sufficiently so that they know what FHH they need to provide and 2) integrating the reports into the EMR in an interactive way so as to maximize their utility.
Where do you see the field of personalized medicine in 5 years?
That is a great question. I think in five years we will see more clinical application of personalized and precision medicine tools and the development and integration of clinical decision support to help clinicians maximize the benefits and minimize the harms of medical care for their individual patient.
What’s one passion or hobby you have outside of the Division?
That depends on if you asked me before or after having kids! Before kids, I enjoyed travel and reading. Since having my two boys (ages 2 and 4), I still enjoy those things but the travel destinations are a bit more local and the books are often written by the acclaimed author, Dr. Seuss.