History of Precision Medicine
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YearMonthDayTimeHeadlineTextGroupMilestonecitationprimary Tagsecond Tagdataset 1dataset 2
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1907The first personalized blood transfusionsReuben Ottenberg and Ludvig Hektoen utilize the growing understanding of blood types to personalize blood transfusions and increase chances of success.MedicineBlood Transfusionspersonalized medicineall
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1908Autism first used to describe a subset of schizophrenia
First use of the term “Autism”. The term was originally used to describe extreme social withdrawal that was common with psychiatric diseases that presented with psychosis. Though autism and schizophrenia are now two distinct diagnoses, autism was not classified as its own disorder in any diagnostic manual until 1980.MedicineAutism as subset of Schizophrenia[https://www.appliedbehavioranalysisprograms.com/history-autism-treatment/]diagnosis / riskautism
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1911Thomas Hunt demonstrates the recombination of genesThomas Hunt discover that traits are passed down through crossover or recombination of chromosomes through his experiments with fruit flies.ScienceGeneticsall
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1913First genetic mapAlfred Sturtevant creates the first genetic map based on his work with Thomas Hunt and fruit flies.Sciencehttps://www.nature.com/scitable/topicpage/Thomas-Hunt-Morgan-Genetic-Recombination-and-Gene-496Geneticsall
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1920Electroconvulsive therapy (Electroshock Therapy) used to treat autism
By electrically stimulating the brain, ECT induces seizures and was thought to provide relief from severe psychiatric illness, including symptoms now associated with severe depression and autism.Medicineautism
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1936Turing machineAlan Turing invents the Turing machine model, which paves the way for data states, computation, and algorithms for computers of the future.Datahttps://en.wikipedia.org/wiki/Turing_machinecomputingall
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1942The concept of "epigenetics" is introducedConrad Waddington coins the term "epigenetics". This is describing the mechanisms inherent to the process of genes becoming phenotypes. This term eventually evolves to mean the study of mechanisms which modify gene expression, which in turn affects phenotypic expression. Sciencehttps://onlinelibrary.wiley.com/doi/pdf/10.1002/mrd.22304Geneticsall
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1943Leo Kanner MD publishes paper on rare disorder, “early infantile autism”The 11 subjects studied shared characteristics such as high intelligence, sensitivity to changing environments and other stimuli, speech delays, and food allergies. Later he named the children’s condition “early infantile autism”.[7], now called autism.MedicineEarly infantile autismdiagnosis / riskautism
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1944Hans Asperger identifies subgroup of high-functioning, socially awkward boysThe children in Hans Asperger's group did not repeat words and they had no speech problems like Kanner's did. However, the children did have problems with fine motor skills such as holding a pencil, and seemed to be clumsier than other children. He described a "milder" form of autism, his discovery is now called Asperger syndrome.Medicineautism
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1944DNA as vehicle of genetic dataOswald Avery demonstrates that genes are made up of deoxyribonucleic acid (DNA was the chemical basis for predictable and heritable transformations in bacteria, meaning that they were not only structurally significant, but functionally activeSciencebiochemistry / molecular biologyall
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1945Genes shown to control protein enzymesGeorge W. Beadle and Edward L. Tatum show how genes encode, or direct the synthesis of protein enzymes that enable the form or function of the organismSciencehttp://www.genomenewsnetwork.org/resources/timeline/1941_Beadle_Tatum.phpbiochemistry / molecular biologyall
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1948The longitudinal study of environmental effects in complex diseases, the Framingham heart study, beginsThis Longitudinal study observes a variety of factors that increased risk of stroke and heart disease in 5,209 individuals in Framingham Massachusetts. It identified that smoking, obesity, high blood pressure can link to heart disease. Now it is in the third generations of participantsScienceEnvironmental Effects Studyhttps://en.wikipedia.org/wiki/Longitudinal_studyallautism
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1953Molecular Structure of Nucleic Acids: A Structure for Deoxyribose Nucleic AcidDiscovery of the double helix structure of DNA, using X-ray diffraction and the mathematics of a helix transform was published by Francis Crick and James D. Watson in the scientific journal Nature. The extent to which Francis and Crick relied upon unauthorized use of Rosalind Franklin's data remains a point of heated controversy.ScienceThe Gene: An Intimate History. Siddhartha Mukherjeebiochemistry / molecular biologyall
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1953Publishing DNA as a double helixRosalind Franklin refines crystolographic techniques to "photograph" DNA, revealing the double helical structure with phosphastes on the outside. The discovery has led to the microbilogical tools needed for decoding of genomic sequences.Sciencehttps://www.genome.gov/12011239/a-brief-history-of-the-human-genome-project/biochemistry / molecular biologyall
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1955The Refrigerator Mother theory popularized the Bruno Bettelheim Refrigerator mother theory identifies autism as a psychological manifestation caused by unexpressive, unloving parents. This theory came to dominate popular mid-century understanding of what causes autism, but has since been invalidated.Medicineautism
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1959Proteins shown to switch genes on and offPardee, Jacob, and Monod publish their study on the lactose operon, demonstrating that proteins act as regulatory sensors or master switches that turn on and off genes or combinations of genesScienceThe Gene: An Intimate History. Siddhartha MukherjeeGeneticsbiochemistry / molecular biologyall
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19601st Super ComputerLivermore Atomic Research Computer (LARC) released what is considered among the first supercomputer.Data1st Super Computerhttps://en.wikipedia.org/wiki/Supercomputercomputingall
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1961Genetic code crackedMarshall Nirenberg demonstrates that triplets of DNA encode specific amino acids, showing how the information in the genome instructs protein synthesis, a key element in the central dogma of molecular biology.Sciencehttp://www.genomenewsnetwork.org/resources/timeline/1961_Nirenberg.phpGeneticsall
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1964Bernie Rimland’s book Infantile Autism debunks Refrigerator Mother theory
Infantile Autism challenges Refrigerator Mother theory by suggesting autism results from “environmental assaults” that triggers a series of biochemical defects.
MedicineInfantile Autism Bookdiagnosis / riskautism
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1964The First Chatbot "Eliza"An early natural language processing computer program created by MIT AI Lab. Eliza simulated conversation by using a 'pattern matching' Datamachine learningcomputingall
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1965Autism Society of America (ASA) foundedRevenue: $2,396,020 (2013)
Founded by a small group of other parents of children with autism. Its original name was the National Society for Autistic Children. ASA's stated goal is to increase public awareness about autism and the day-to-day issues faced by people with autism as well as their families and the professionals with whom they interact. It was one of the first autism organizations in U.S.A.
CultureFirst autism organizations in U.S.A.organizationsautism
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1966Touch screens + Data entryEarly touch screen computers used to enable patients and doctors to enter histories directly at the time of treatment (at Case Western)DataEHRall
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1967Autism Research Institute (ARI) foundedType: Non-profit
Revenue: $1,754,803 (2012) ARI represents the then-controversial belief that autism can be cured.
Cultureorganizationsautism
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19681st EHR system1st EHR system installed at Cleveland Metropolitan General HospitalDataEHRall
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1970Temple Grandin developed a hug machineAs one of the first people to publicly talk about her experience with autism, she becomes a well-known public representative for autistic individuals. She is also an advocate for animal rights.Cultureorganizationsautism
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1970Pharmaceutical treatments for autism become main treatment method
Medicinetreatmentautism
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1972The Introduction of Electronic Medical RecordsThe first EMR was developed in 1972 by the Regenstreif Institute and was welcomed as a major advancement in healthcare/medical practice. Due to the high costs, this EMR wasn’t as widely used as anticipated, and was primarily utilized by government hospitals.DataFirst EMRsThe Evolution of the Electronic Health Recordall
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19734Panel of Scientists Discuss the Future and Safety of Gene ScienceA panel of scientists, including Berg, Watson, Baltimore, and Zinder, meet in Boston to discuss mechanisms to control and regulate gene cloning, instantiating safety measures in research, and placing a moratorium on more hazardous methods of research.ScienceThe Gene: An Intimate History. Siddhartha Mukherjeeall
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19752A Second Panel of Scientists Formalize Recommendations for Regulating Gene SciencesA panel of scientists come together again to discuss the future of gene manipulation. Tempers flare, attorneys remind the panel that the government would enact much more strict regulations than they might impose upon themselves, and in the end formal recommendations of caution are drawn up to mitigate risks, create a schema to rank bio hazard potentials of genetically altered organisms, with recommended containment facilities for each level.Scienceall
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1977Twins study concludes autism is biological condition
Study of 11 twin pairs is published in Journal of Child Psychology concludes that autism is highly heritable, with environmental factors accounting for about 10%.ScienceTwins studiesautism
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1977"The Patients Right to Decide"“The Patient’s Right to Decide,” published in the British journal The Lancet, put forth a then-radical idea of “patient power”—encouraging patients and physicians alike to overturn the traditionally paternalistic nature of healthcare. Patients, Dr. Slack believed, should play a crucial part in determining their own care. Their insight, he often said, was “the least utilized resource in healthcare".Culturepatient rights & autonomyall
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19771st DNA sequencing technologies developedFrederick Sanger develops techniques to sequence DNA. His method has become the most applied technique, and has been commercialized and automated as the "Sanger Sequencing Technology".ScienceDNA Sequencinghttps://www.genome.gov/12011239/a-brief-history-of-the-human-genome-project/Genomicsall
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1980DSM describes autism for the first timeThe Diagnostic and Statistical Manual for Mental Disorders III, published in 1980, includes Autism as its own separate diagnosis for the first time. Calling it a "pervasive developmental disorder", the manual also described features of Autism and provided criteria for diagnosis.Medicinehttps://www.spectrumnews.org/news/evolution-autism-diagnosis-explained/diagnosis / riskautism
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1980Autism incidence is 1 in 10,000Dataautism
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1983Polymerase Chain Reactions (PCR)Kary Mullis invented the polymerase chain reaction (PCR) technique, a method for amplifying DNA concentrations.Sciencebiochemistry / molecular biologyall
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1983Gusella identifies a variant linked to Huntington's disease on chromosome 4Scienceall
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1986Unified Medical Language SystemThe UMLS provides a comprehensive thesaurus and ontology of biomedical concepts, facilitating the development of natural language processing, medical informatics and higher level analysis across medical records. Datadata standardization/usabilityall
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1987The origin of the term "Genomics"The origin of the term "Genomics" as a new science discipline to study a comprehensive DNA organizationsScienceGenomicsall
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1987DoE kickstarts early genome researchThe United States Department of Energy establishes an early genome project, while seeking data on protecting the genome from the mutagenic (gene-mutating) effects of radiationPolicyhttps://www.genome.gov/12011239/a-brief-history-of-the-human-genome-project/initiatives & programsGenomicsall
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1987DSM III expands autism to a “spectrum”. Ivar Lovaas publishes first study on effectiveness of ABA (behavioral therapy) in children with autism. EPA identifies “spike” in autism rates begins this year.MedicineAutism "Spectrum"autism
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1988Rain Man MovieDustin Hoffman’s intelligent but socially awkward character, Raymond, becomes a well known representation of Autism in popular culture.Culturemovies/documentariesautism
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1989National Center for Human Genome ResearchNational Center for Human Genome Research is established by the NIH to work on the Human Genome Project, in collaboration with the US Department of EnergyPolicyinitiatives & programsGenomicsall
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1989Positional cloning technique identifies gene linked to cystic fibrosisBotstein and David's gene mapping technique of positional cloning is used to identify a gene linked to cystic fibrosisScienceall
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1990Data-driven machine learning blossomsAI researchers develop and implement algorithms that analyze large data sets and "learn" from the results.Datacomputingall
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1990Human Genome Project Launched with $2.7 billion fundingHuman Genome Project begins to map the human genomePolicyHuman Genome Projectinitiatives & programsGenomicsall
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1991US Government makes autism a special education categoryWith this new classification, autistic students can receive additional support-- such as separate lesson plans and timelines-- through the public school system. Many of the motor and behavioral symptoms of autism are thought to indicate intellectual disability-- though this view has since changed due to advances in research and therapies. Policydiagnosis / riskautism
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1993Study concludes Applied Behavior Analysis (ABA) Therapy can treat autism UCLA study concludes that “behavioral treatment may produce long-lasting and significant gains for many young children with autism.” ABA therapy is based on the understanding that when a behavior is rewarded, it is more likely to be repeated. After receiving 40 hours per week of ABA treatment over half of the 19 child cohort were identified as having significantly reduced symptoms-- efficacy typically measured via IQ and functional learning testing (typically requiring fine motor skills). The study was conducted as a follow up to Ivar Lovaas’s 1987 study.Sciencehttps://dddc.rutgers.edu/pdf/mceachlin_et_al.pdftreatmentautism
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1993Genome tech to solve diseaseNCHGR establishes the Division of Intramural Research to apply genome technologies to the study of specific diseasesPolicyinitiatives & programsGenomicsall
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1994Simons Foundation created to study math and basic science with ASD focus

Cultureorganizationsautism
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1995CURE AUTISM NOW (CAN) founded. Cultureorganizationsautism
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1995DEFEAT AUTISM NOW (DAN) Movement begins exploring biomedical treatments for ASD
CultureDAN biomedical treatments for ASDorganizationsautism
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1995Gusella's postdoc isolates the Huntington gene - IT15Scienceall
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1995DNA microarrayComplementary DNA (cDNA) microarray was developed by Patrick O. Brown's group at Stanford University in 1995. Biochip technology enables researchers and clinicians to conduct SNP genotyping efficiently by creating the ability to store and rapidly analyze a patient’s genome in its entirety, allowing for the rapid development of protein-based diagnostics and therapeuticsDatahttps://pdfs.semanticscholar.org/7556/bfe922f81368b06747f9932c4a01235206fa.pdf https://www.managedcaremag.com/archives/2011/8/history-and-future-personalized-medicinesequencing & genotypingall
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1995First bacterial genome is sequencedScienceall
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19961st Mammal ClonedDolly, a female domestic sheep, was the first mammal cloned from an adult somatic cell, using the process of nuclear transfer.Scienceall
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1996HIPAA EnactedThe Health Insurance Portability and Accountability Act of 1996 is passed in Congress, enacting new regulation for the maintenance and use of personally identifiable health information and data in the healthcare industry, protecting patients from fraud and theft.Policyhttps://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Actregulationall
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1996Center for Inherited Disease Research startedCenter for Inherited Disease Research is established to study the genetic components of complex disorders.Policyinitiatives & programsGeneticsall
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1997AUTISM INCIDENCE 1 in 5000DataIncidenceautism
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1997AGRE database createdCreated by CAN, the AGRE aggregates over 2,000 families’ worth of clinical and genetic information. It becomes the largest private, open-acess repository and fuels 150 research groups’ search for the causal factors of autism.DataAGRE databasehttps://www.autismspeaks.org/about-agreautism
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1997National Human Genome Research Institute of NIHThe United States Department of Health and Human Services renames NCHGR the National Human Genome Research Institute (NHGRI), officially elevating it to the status of research institute - one of 27 institutes and centers that make up the NIHPolicyinitiatives & programsGenomicsall
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199891st personalized medicine approved by FDAFDA approves Herceptin (trastuzumab), for treating HER-2 positive breast cancerMedicinehttps://www.technologyreview.com/s/601843/precision-medicine-pioneer/pharmaceuticalsall
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199812Health Sector Database ActIn December 1998, Iceland's Althing passed the Health Sector Database Act, for the control of citizen health information as a “national resource”
to be controlled by the state and allocated to private industry for inclusion into a commercial genomic database of national scope.
Policypatient rights & autonomyall
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199912Chromosome22 is the first chromosome fully sequencedAn international team of researchers decipher the sequence of 23 million letters, the longest continuous stretch of DNA to be sequenced at the time.Sciencehttps://www.genome.gov/10002104/1999-release-first-human-chromosome-sequenced/all
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2000Development of first prenatal diagnosticBlood tests and ultrasounds are used in combination to diagnose possible Trisomy, genetic conditions, or heart defects in the first trimester.Medicinehttp://www.totalbiopharma.com/wp-content/uploads/sites/7/2016/09/the-history-of-precision-medicine-where-science-meets-technology.png https://www.thehastingscenter.org/prenatal/evolution-prenatal-testing/diagnosis / riskall
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200212World's first Genome-Wide Association Study completed in JapanResearchers at the Center for Genomic Medicine (formly SNP Research Center) in Japan perform the first GWAS to identify genes associated with suseptibility to mycardial infarction.Sciencehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543921/#B7genetic banksdiagnosis / riskall
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2002Mouse is the first non-human mammal to have genome sequencedThe international Mouse Genome Sequencing Consortium, building off the work of the Human Genome Project, sequences the first non-human mammal, allowing for comparison of the sequences and aiding further laboratory work with DNA.Sciencehttps://www.genome.gov/10005831/2002-release-the-mouse-genome-and-the-measure-of-manall
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2002Development of SNP GenotypingSingle nucleotide polymorphisms are single nucleotide differences in the genome that are responsible for much patient susceptibility to various disease processes and drug therapy responsiveness. The ability to identify these polymorphisms in samples rapidly and efficiently has been critical in identifying distinct populations and identifying therapeutic targets.Sciencesequencing & genotypingall
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2003414Announcement of First Complete Human Genome SequenceHuman Genome Project reports the human genome sequence completion, meaning human genome was sequenced for the first time. This changes the practise of medicine, using genomic to guide and tailor the care of the patient.Datahttps://www.genome.gov/11006943/human-genome-project-completion-frequently-asked-questions/sequencing & genotypingall
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20039ENCODE project launchedThe Encyclopedia of DNA Elements (ENCODE) project is launched by NHGRI as a follow-up to the Human Genome Project, aiming to interperet the genome sequence and to identify all functional elements in the human genome.Policyhttps://ghr.nlm.nih.gov/primer/genomicresearch/encodeinitiatives & programs all
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2003Autism Genome Project completed with inconclusive findings.
Hundreds of genes identified but none linked exclusively to ASD.
Scienceautism
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2004The Personalized Medicine CoalitionThe Personalized Medicine Coalition is founded to support investment in and adoption of personalized medicine through education, advocacy, and evidence developmentPolicyinitiatives & programsall
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20053FDA Pharmacogenomic Data GuidelinesFDA releases guidance for pharmacogenomic data submissions, outlining the expectations and attitudes of the FDA related to these submissions. This marks a major step towards clear regulation for pharmacogenomics and Precision Medicine approaches.Policypolicyregulationall
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2005Autism Speaks (AS) founded incorporating CAN. Autism Treatment Network (ATN) created.Cultureautism
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2005The concept of "exposome" is introducedThe concept of an "exposome", the totality of human environmental exposures from birth to death, is proposed.Sciencehttps://www.ncbi.nlm.nih.gov/pubmed/16103423multi-data humanall
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2006Interactive Autism Network (IAN) database developedTo address the increase in incidence and research, IAN database is established to collect data for autism researchers.Data
https://www.ianresearch.org/
autism
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2006Cost of sequencing a human genome reduced significantlyThe price for genome sequencing has been continuously reduced from ~$1,000,000,000 (with the process time of 6-8 years) to ~$1,000 (within 1-3 days) or less. Because of new technology improvementDatahttps://www.genome.gov/27565109/the-cost-of-sequencing-a-human-genome/sequencing & genotypingall
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2006Nike+iPodNike introduces the [first?] wearable tracker to sync wirelessly with your mobile device, as well as software to use your mobile device itself as a fitness tracker. Datawearable devicesall
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2007629iPhone ReleasedWith the iPhone, it brought in the era of having a computer in the palm of your hand and and 24/7 tracking.Datahttps://en.wikipedia.org/wiki/IPhonewearable devicesall
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2007AUTISM INCIDENCE 1 in 150Datadiagnosis / riskautism
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2007Cure Autism Now (CAN) merges with Autism SpeaksThe merger includes CAN’s AGRE database, which, though no longer used, provides the foundation for a new data collection initiative (DCC).Cultureautism
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2007NIH human microbiome project beginsNIH initiative for characterizing the human microbiome. A natural research extension after the Human Genome ProjectPolicyMicrobiome Projecthttps://en.wikipedia.org/wiki/Human_Microbiome_Project#Achievementsinitiatives & programsmulti-data humanall
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20089First Autism Disease Genes Were DiscoveredAt the 21st Congress of the ECNP 2008 in Barcelona, professor Marion Leboyer, University of Paris, France, presented the compelling neurobiological story of discovering the first autism gene. The role of gene mutations, their association with synapse abnormalities, and -- surprisingly -- a connection between circadian rhythms and autism risk was discussed at a recent conference.Sciencehttps://www.sciencedaily.com/releases/2008/09/080901205626.htmall
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2009Autism Incidence 1 in 110Data
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2009The term Precision Medicine coined by Clayton ChristensenScienceall
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2009Precision Medicine World Conference (PMWC) established in SFThe term gains wide acceptance in 2011Policyinitiatives & programsall
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2009GINA EnactedTitle II of the Genetic Information Nondiscrimination Act of 2008 (GINA), which prohibits genetic information discrimination in employment, took effect on November 21, 2009.Policyhttps://www.eeoc.gov/laws/types/genetic.cfmpolicymulti-data humanall
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2009HITECH act expands available data beyond genomicsDigitization of medical records and widespread deployment of Electronic Health Record systems exposes real world clinical data. Precision medicine promises to become multi-data and not just based on genomics.DataEHRmulti-data humanall
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200923andMe begins research endeavors with genetic data23andMe begins genomic research, also contributing data to outside research partners, like the Parkinson's Research Initiative.Sciencehttps://www.23andme.com/publications/ https://blog.23andme.com/23andme-research/23andme-parkinsons-research-initiative-progress-update/sequencing & genotypinggenetic banksall
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2010Glytec FDA approvalGlytec's glycemic management system becomes the first FDA approved product to provide precision dosing recommendations for patients with diabetesMedicinehttps://www.glytecsystems.com/News/glytec-announces-fda-510-k-clearance-on-g-enterprise-edition-insulin-dosing-software.htmlall
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2011Study highlights the importance of environmental causal factors in autism
A 192 twin-pair study conducted by Stanford/UCSF Twin Study concludes that genes account for 38% of autism risk, environment accounts for 62%
ScienceEnvironmental factors in autismGeneticsautism
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2011Word shift from "Personalized Medicine" to "Precision Medicine"National Academies releases a report distinguishing Personalized from Precision medicine. Although both communicate individualized medicine, precision medicine conveys that medicine is more accurate for individuals, rather than each individual receiving unique treatments.Culturehttp://www8.nationalacademies.org/onpinews/newsitem.aspx?recordid=13284cultureall
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2012The view of "junk DNA" began to changeA significant shift in the understanding of the way our DNA operates, when it was discovered that our bodies are built and controlled by far fewer genes than expected, providing new leads for scientists looking for treatments for conditions such as heart disease, diabetes and Crohn's diseaseSciencehttps://www.theguardian.com/science/2012/sep/05/genes-genome-junk-dna-encodebiologyall
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2012the Obama administration announced the Big Data Research and Development InitiativeBig Data plays a big role in Precision Medicine research, comprising of 3 big data: Omics data, mobile internet real-time data and electronic health record data are the top three areas for Big Data in medical researchPolicyhttps://www.omicsonline.org/open-access/precision-medicine-personalized-medicine-omics-and-big-data-concepts-and-relationships-2153-0645-1000e144.php?aid=54567all
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2012CRISPR/Cas-9 editingDoudna and Charpentier publishes data on the use of CRISPR/Cas-9 in which a cut at the site recognized by a microbial defense system can be programmed and redirected to attack a selected gene, mutating that geneScienceall
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2013613SCOTUS rules human genes cannot be patentedHuman genes are a "product of nature" and are therefore beyond the reach of patents. This strikes down two patents held by a Utah company seeking to profit from the identification of genes linked to breast and ovarian cancer.Policyhttps://www.theguardian.com/law/2013/jun/13/supreme-court-genes-patent-dnapatient rights & autonomyregulationall
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20131122FDA challenges reliability of direct-to-consumer genetic testingThe FDA releases a warning to 23andMe, asserting that the company has failed to provide adequate evidence that the tests it delivers to consumers are accurate and reliable. The letter included the statement "“Even after these many interactions with 23andMe, we still do not have any assurance that the firm has analytically or clinically validated the P.G.S. for its intended uses, which have expanded from the uses that the firm identified in its submissions.” Discussion around genetic testing and FDA approval began around 2009, and continued on until 2018 (described later).Policyhttps://www.nytimes.com/2013/11/26/business/fda-demands-a-halt-to-a-dna-test-kits-marketing.htmlsequencing & genotypingregulationall
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2013Study concludes autism is curable
University of Pennsylvania study finds that “10% of kids studied recovered from ASD.”Medicinetreatmentautism
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2013Autism diagnosis relies on behavioral subcategories
ASD is defined by two categories: 1) Impaired social communication and/or interaction. 2) Restricted and/or repetitive behaviors.
Medicinediagnosis / riskautism
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2014Verily launches baseline projectThe baseline project collects multi-dimensional data including wearable, clinical, imaging, and behavioral data from 100,000 participants.Datadata collectionmulti-data humanall
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