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MetaCensus is built to support the exchange and review of data by various stakeholders and performs multicriteria decision analysis (MCDA) to assess and account for varying perspectives, counterpoints, and biases.
A new tool to catalyze scientific consensus will speed advances in patient care, according to an article authored by experts at ARUP Laboratories. The article, “Leveraging Blockchain to Catalyze Consensus in Precision Medicine Through Meta-Analysis,” was published on January 1, 2024, in Clinical Laboratory News.
A group of volunteer clinicians, data scientists, students, and web developers are working to develop MetaCensus, the first open-access data repository designed for peer-review and meta-analysis. It employs blockchain technology, which can be described as a collection of records that are linked together, strongly resistant to alteration, and protected with cryptography. MetaCensus also features a peer-review voting mechanism, which encourages voting members to analyze the data, provide feedback, and vote on the inclusion of different datasets.
“The beauty of blockchain is that the data are owned by everyone instead of one entity, so everyone will always have access to the same data at the same time. No one person can make changes without consensus voting by the network of voting community members,” said Erik Forsman, senior data consultant. “The platform ensures trust, reliability, and security.”
Stakeholders in industry, government, philanthropy, and science all have different motives for their scientific pursuits, making agreement difficult. MetaCensus aims to break down silos, reduce investigative redundancies, and quickly reach harmonized clinical recommendations and best practices.
“We chose to develop this tool to help catalyze scientific consensus around pharmacogenetics, so all entities—including insurance companies, the FDA, clinicians in community clinics, academics, and industry [professionals]—can review the data, understand it, and apply their conclusions to their [coverage decisions], regulations, guidelines, and [clinical practices],” said Ryan Nelson, PharmaD, medical director of Precision Medicine.
The first target for MetaCensus was genotype-guided chemotherapy. The authors cited the lack of agreement about scientific evidence in the use of DPYD genotype-guided chemotherapy Fluoropyrimidines are a widely utilized chemotherapeutic in cancer care with well-known toxicity risks. Carriers of pathogenic DPYD gene variants who are treated with fluoropyrimidines are reported to have a 25.6 times greater risk of treatment-related death than patients with nonpathogenic DPYD variants.
Preemptive DPYD genotyping is not considered standard of care in North America, but this testing is recommended or even required in various European countries. Many factors have contributed to the disconnect, and MetaCensus aims to bridge the divide by providing a shared data resource in which all stakeholder groups can offer their input on the available data and inform the community about which research steps should be prioritized next.
“Germline pharmacogenetics is usually focused on older drugs that are relatively inexpensive, but in order to use them well, we need to have more information on the patient, and then tailor the dose or the drug selection to that patient based on their genotype,” said Nelson. “If we have better rationale for why we chose the drug at the dose we did, I think people are more likely to adhere to their medications and be less fearful of adverse effects.”
In the case of pharmacogenetics, MetaCensus will facilitate clinicians’ access to timely information so they can make better-informed decisions about which drugs are most likely to be effective for their patients based on their genetic makeup.
MetaCensus plans to expand beyond pharmacogenetics. The structure of the blockchain smart contracts allows for all scientific domains requiring meta-analysis to be included and adapted to the different parameters needed for any topic.
Read more about the development of MetaCensus here.
Those interested in learning more about this project or participating in this community can visit aruplab.com/consensus to apply to become voting members.
Bonnie Stray, bonnie.stray@aruplab.com
