intel precision medicine apr 2015

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Taking Precision Medicine Mainstream Ketan Paranjape GM Life Sciences Intel Corp. 1 www.intel.com/healthcare/bigdata

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Page 1: Intel precision medicine apr 2015

Taking Precision

Medicine

Mainstream

Ketan Paranjape

GM Life Sciences

Intel Corp.

1

www.intel.com/healthcare/bigdata

Page 2: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Big Data Analytics

in Health and Life Sciences

Today: Many disparate

data types, streams…

Future: Integrated

computing and data

2

Genomics

Clinical

Claims &

transaction

s

Meds &

labs

Patient

experience

Personal

data

Page 3: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Vision for Precision Medicine1 Patient visit 2

Genes causing disease and key pathways identified

3Gene targeted drugs identified, Treatment begins in earnest

Imaging, parallelism, statistical work, accelerated algorithms

Various algorithms, big data, parallelism, accelerated algorithms, statistical and math puzzles, in memory processing

+ imaging + ML + drug sensitivity assays + mechanistic learning and

systems + correlation work and knowledge systems

1-4 days MonthsWeeks

PRIMARY ANALYSIS SECONDARY ANALYSIS, DNA/RNA PIPELINE + MORE PRECISION MEDICINE

HC

HC

HC

HC

HC

HC

HC

HC

HC

HC

Multiple sample compute starts here

Joint genotyping

Variantstore

Pop/DisstudyIndividual Multiple individual

Predicted Actionable VariantsData Driven Association

Clinically Actionable Variants

Knowledge DtabaseClinical trail groups

Data curation

3GOAL :: Precision Medicine in a Day by 2020 !!

$1K-$5K $10K+$5K-$10K

Page 4: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Life Sciences World Map

4

$11B Japan investments

$100M ETRI Korea

Ontario LS Investments

Genomics France

Beijing Genomics Institute (PRC)

$1.58B line of credit

Geisinger Health

100,000 patients

NY Genome Center (US)

$200M investments

Mt Sinai (US)

Genomics England

100,000 patients

Genomics Qatar

400,000 patients

Broad Institute (US) Wellcome Trust Sanger (UK)

Charité Germany

100,000 patients

Moffitt Health

100,000 patients

We are barely scratching the surface …

Page 5: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Challenges in Life Sciences

5

Big Data in Life

Sciences

• Sequencer advances – 4x data in 50% less time

.5TB/device/day

• 4D molecular imaging produces 2TB/device/day

• Fragmented software ecosystem, lots of open source

Burdens of Data

Management

• Store, manage, share, ingest and move PBs of research

& clinical data

• Need to reliably ‘snapshot’ pipelines with archive to tiered

storage

Innovation Drives

Change

• Rapid iteration of algorithms far outpace IT, requiring

flexibility, agility

• Most applications do not fully leverage available

infrastructure

Converged

Infrastructure

• Workloads converging between local and cloud-based

HPC/Big Data

• Advanced orchestration required to maximize throughput

& efficiency

At the Intersection

of Transformative

Forces

1018 Enabling extreme-

scale computing on

massive data sets

Helping enterprises

build open,

interoperable clouds

Contributing code

and fostering the

ecosystem

Page 6: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Intel Partnerships and Ecosystem Enablement

to resolve challenges

Need for Balanced Compute Infrastructure

*Other names and brands may be claimed as the property of others.

Page 7: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Optimizing Top Applications and PipelinesIntel working with industry experts worldwide

• Genomics, Molecular Dynamics

and Molecular Imaging

applications targeting both Intel®

Xeon® processors and Xeon® Phi™

coprocessors

• Fine- and coarse-grained

optimization at the node and cluster

level

• Work with code authors to release

optimizations, disseminate best

practices

ABySS*

BLAST*

Bowtie*

TopHat*

Cufflinks*

BWA*

GATK*

Picard*

SAMtools*

MPI-HMMER*

Velvet*

*Some names and brands may be claimed as the property of others.

AMBER*

CAS-Soft Sphere*

CAS-IPE*

CP2K*

CPMD*

DLPOLY*

GAMESS*

Gaussian*

GROMACS*

LAMMPS*

NAMD*

NWChem*

Quantum Espresso*

VASP*

7

Page 8: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Profiling: Single Instance Run of GATKGATK: Genome Analysis Toolkit (The Broad Institute)

• # of Machines = 1

• # of cores/Machine = 24

• Temporary Storage – RAID0 2x4TB HDD

• Input Dataset: G15512.HCC1954.1, coverage:

65x

Average CPU utilization is very low. Most cores not being usedAverage I/O bandwidth is very low. Application not I/O bound

Average memory footprint is small. Application not using memory available in newer systems

There is a lot of room to improve

• Open Source Distribution:

https://01.org/workflow-profiler

Page 9: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

GATK 3.0 with The Broad Institute

• Pair HMM Acceleration using Intel® AVX

resulted in 970x speedup

− Computation kernel and bottleneck in

GATK Haplotype Caller

− AVX enables 8 floating point SIMD

operations in parallel

9

Page 10: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Compression Libraries Tuned for Genomics• Challenge:

− Data compression is a significant performance limiter for

genomics analytics

− With post-analytics archive of large datasets, very good

compression ratios are required

− Within an active workflow, transient data needs very fast

compression with “acceptable” compression ratio, especially

SAM and BAM formats

• Solution:

− igzip is a library for performing high-speed DEFLATE/gzip

compression

− For BAM & SAM files, the compression ratio of igzip is very close

to zlib -1

− igzip is ~4X the speed of zlib* (at fastest settings)

For more information including technical benchmark specification details: https://software.intel.com/en-us/articles/igzip-a-high-performance-deflate-compressor-with-optimizations-for-genomic-data

10

Speedup and Compression Ratio delta of igzip0c* vs. gzip/Zlib -1

Compression Performance (Cycles/Byte) and Compression Ratio

*Some names and brands may be claimed as the property of others.

Page 11: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

BLAST – Basic Local Alignment Search Tool

National Center for Biotechnology Information (NCBI)Xeon BLASTp vs. GPU-BLASTp Xeon + Tesla k40x

• Application:• blastn v.29. Basic Local Alignment Search Tool searching for

alignment in nucleotide query sequences against a known

nucleotide db volume set.

• Availability: • blastn v.29:

ftp:://ftp.ncbi.nlm.nih.gov/blast/executables/blast+/LATEST

• Highlights: − throughput for this offload model has a wide sweet spot for a

sufficiently large query set.

• Results: − Simulation rate with Xeon + Phi™ heterogeneous model is up

to 1.4X

• Code Optimization Strategy:− Xeon: GAT and OFS parallelized (48T)

− KNC: GAT and OFS parallelized (180T)

11

Software and workloads used in performance tests may have been optimized for performance only on Intel microprocessors. Performance tests, such as SYSmark

and MobileMark, are measured using specific computer systems, components, software, operations and functions. Any change to any of those factors may cause the

results to vary. You should consult other information and performance tests to assist you in fully evaluating your contemplated purchases, including the performance

of that product when combined with other products. See benchmark tests and configurations in the speaker notes. For more information go to

http://www.intel.com/performance

1

1.3

1.4

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1 Node

Speedup (Higher is Better)

• 2S Intel® Xeon® processor E5-2697v2 (BLASTn v.29 Baseline)

• 2S E5-2697v2 + Intel® Xeon Phi™ 7120A OFS serial

• 2S E5-2697v2 + Intel® Xeon Phi™ 7120A OFS parallelized

Page 12: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

GROMACS

Application: GROMACS 5.0-RC1Description:

− GROMACS is a versatile package to perform molecular dynamics, i.e. simulate the Newtonian equations of motion for systems with hundreds to millions of particles. It is one of the fastest and the most popular Molecular Dynamics packages

− Workload: 512K H2O with RF method

Availability: − VERSION 5.0-rc1 is available from http://www.gromacs.org/Downloads &

− ftp://ftp.gromacs.org/pub/gromacs/gromacs-5.0-rc1.tar.gz

− Recipe: https://software.intel.com/en-us/articles/gromacs-for-intel-xeon-phi-coprocessor

Results: − Highly optimized for Intel® Xeon® Processors (AVX-intrinsics)

− Able to run full simulation on Intel® Xeon Phi™ coprocessor natively + host processor using a symmetric model

− Optimized with intrinsics for 512-bit vectorization on Intel Xeon Phi coprocessors

12

Software and workloads used in performance tests may have been optimized for performance only on Intel microprocessors. Performance tests, such as SYSmark

and MobileMark, are measured using specific computer systems, components, software, operations and functions. Any change to any of those factors may cause the

results to vary. You should consult other information and performance tests to assist you in fully evaluating your contemplated purchases, including the performance

of that product when combined with other products. See benchmark tests and configurations in the speaker notes. For more information go to

http://www.intel.com/performance

1.0x

1.56x

1.79x

2S Intel® Xeon® processor E5-2697 v2

2S Intel® Xeon® processor E5-2697 v2 + 1 Intel® Xeon

Phi™ coprocessor 7120P/X

2S Intel® Xeon® processor E5-2697 v2 + 2 Intel® Xeon

Phi™ coprocessor 7120P/X

Page 13: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Genomics Data Processing Pipeline

Lustre

*Some names and brands may be claimed as the property of others.

Page 14: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

HPC Appliances for Life Sciences• Challenge: Experiment processing takes 7 days with current

infrastructure. Delays treatment for sick patients

• Solution: Dell Next Generation Sequencing Appliance

− Single Rack Solution; 9 Teraflops, Lustre File Storage; Intel SW tools

• Benefits: RNA-Seq processing reduced to 4 hour

• Includes everything you need for NGS - compute, storage, software,

networking, infrastructure, installation, deployment, training, service &

supportDell HSS (Lustre)(up to 360TB)

Dell NSS (NFS)(up to 180TB)

Infrastructure: Dell PE, PC & F10

M420 (Compute)(up to 32 nodes)

2U Plenum

Actual placement in racks may vary.

NSS-HA Pair

NSS User Data

HSS Metadata

Pair

HSS OSS Pair

HSS User Data

** 2-socket Intel(R) Xeon(R) CPU E5-2687W / 3.1 GHz*Other names and brands may be claimed as the property of others.

Page 15: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

HPC Appliances for Life Sciences

• Challenge: Set up personalized medicine competency – DNA seq. analysis, Finite

Element Analysis, Natural Language Processing, Image Processing, Computational

Fluid Dynamics

• Solution: Dell Next Generation Sequencing Appliance

− 400 cores derived from 40 Intel® Xeon® E5-2680v2 2.8 GHz Ivy Bridge processors in 20 Dell®

PowerEdge M620 nodes providing 9 teraflops

− Room for 12 additional nodes in the Dell M1000e blade enclosure

− 270 terabytes of usable Intel® Enterprise Edition for Lustre* software scalable file system in

a 60-drive Dell® PowerVault MD3260 with 60-drive MD3060e expansion enclosure

− Deployed with Intel® Parallel Studio XE development environment

− InfiniBand backplane and multiple 10 gigabit/ sec uplinks to 1 petabyte replicated grid storage

and the network backbone

• Software:

− CentOS Linux 6.5 64-bit; Bright Cluster Manager® 7.0

− MPI Library: OpenMPI 1.8.1; Intel® MKL; GCC; IEEL v2.1.0.0

− SLURM (Simple Linux Utility for Resource Management) v14.03.0-2462U Plenum

Actual placement in racks may vary.

NSS-HA Pair

NSS User Data

HSS Metadata

Pair

HSS OSS Pair

HSS User Data

** 2-socket Intel(R) Xeon(R) CPU E5-2687W / 3.1 GHz*Other names and brands may be claimed as the property of others.

Page 16: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

IBM, CLC bio Genomics Sequencing Analytics

Solution• Challenge: Need for processing power and storage

capacity in order to correlate the variants in the genome with the relevant patient symptoms

• Solution: IBM®, CLC Genomics server SW, Genomics Workbench client SW; Small (48 Cores, 192 GB), Medium, Large (192 Cores, 768 GB) Analytics Solutions

• Benefits:

– Reference Mapping for 37x coverage human genome – ~9hr (1 node) to ~30mins (37 nodes)

– Variant Calling and annotation for 37x coverage – ~40 hrs (1 node) to ~3hrs (23 nodes)

• Infrastructure– IBM System x® 3550 M4, E5-2650; 48 CPU cores and 192 GBs of memory to 192 CPU

cores and 768 GBs of memory

– IBM Storwize® V7000

– CLC Genomics Server 5.0.2 , Workbench 6.0.1

– 7x 3TB SAS 6 Gbps HDD (16 TB usable)

http://www-148.ibm.com/bin/newsletter/tool/landingPage.cgi?lpId=6155

Page 17: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

BIONANO Appliance

http://www.thinkmate.com/systems/solutions/bionanogenomics#specs17

System Specs

•2x Ten-Core Intel® Xeon® Processor

E5-2680 V2 2.80GHz 25MB Cache (115W)

•8x 16GB (128GB Total) PC3-14900 1866MHz

DDR3 ECC Registered DIMM

•2x 1.0TB SATA 6.0Gb/s 7200RPM 2.5"

Seagate Constellation.

•6x Intel® Xeon Phi Co-Processor 5110P

1.053GHz - 8GB - 60 Cores

•2x Intel 10-Gigabit Ethernet Ports

via Intel® X540 Chipset - 10GBase-T (RJ-45)

http://www.thinkmate.com/systems/solutions/bionanogenomics#spec

s

Page 18: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Genomics & Clinical Analytics Appliances

18

2U Plenum

Actual placement in racks may vary.

NSS-HA Pair

NSS User Data

HSS Metadata Pair

HSS OSS Pair

HSS User Data

Page 19: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Aspera* & Intel optimized solutions for Science DMZ

– Moving the World’s Data at Maximum Speed

• Challenge: Enterprise to Cloud Transmission of Terabyte Payloads

• Solution:

− Demonstrated effective throughput of 73.3Gbps

− Equivalent to downloading 254 whole human genomes per

hour (7.3x speed-up), as compared with baseline Aspera using

commodity 10GbE at 35 whole human genomes per hour

• Benefits with Intel® Xeon® E5 v3 product family:

− AES-NI encryption provides 2x faster inline data encryption,

securely transporting sensitive workloads from enterprise-to-cloud.

− Intel® DPDK, Intel® XL710 40GbE, Intel® NVMe SSDs and Intel®

Xeon® E5 v3 processors significantly boost overall system

performance by moving data closer to the processor, avoiding

unnecessary memory copies, and reducing protocol-related

latencies.

19

Infrastructure and Data Characteristics:

Aspera High-Throughput Transport, featuring Intel pre-production system (Intel® Server Board S2600WT) with

two Intel® Xeon® processor E5-2697 v3 (45M Cache, 2.30 GHz, Intel® Hyper-Threading Technology enabled),

128GB DDR4 memory (2133 MHz), Intel® Communications Chipset 89xx Series, 2x dual-port Intel® XL710

Ethernet Controller (40GbE), 5x Intel® DC P3700 PCIe NVMe Solid-State Drives (800GB), Intel® DPDK 1.7,

Intel® DDIO, Intel® AES-NI GCM encryption, Fedora 20 with custom kernel. Aspera A4 (based on Aspera

fasp* 4). Source: Aspera testing as of August 2014.

Page 20: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Charite “Real-time” Cancer Analysis – Matching proper

therapies to patients using in-memory techniques

• Challenge: Real-time analysis of cancer

patients using in-memory SAP HANA

Oncolyzer database running on Intel®

Xeon® family infrastructure. (3.5M Data

points per Patient, Up to 20 TB of

data/patient)

• Solution: Using structured and unstructured

data to collect and analyze tables used to

take up to two days -- now takes seconds

• Benefits: Improves medical quality in

disruptive way for Patient, Doctor, Hospital,

Research

http://moss.ger.ith.intel.com/sites/SAP/SAP%20account%20team%20documents/Marketing/SAP%20HANA/SAPHANA_Charite_case_study_HI.PDF

Page 21: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

High Throughput Science: Embracing Cloud-based

Analytics for Computational Chemistry Simulation • Challenge: Sustaining 50000+ compute

cores for large scale simulations, for less

than a week; CapEX v. OpX

• Solution: Novartis leveraged software from

AWS partner, Cycle Computing, and

MolSoft to provision a fully secured cluster

of 30,000 CPUs, powered by the Intel®

Xeon® processor E5 family.

− Completed screening of 3.2 million

compounds in approximately 9 hrs,

compared to 4 -14 days on existing

resources.

Powerof60.com

Page 22: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meetIntel Confidential

• Solution: Intel Distribution for

Hadoop (IDH), Map Reduce, Hbase,

Hive

• Benefits: Ability to compare 14

million proteins and more, reducing

the processing time from days to

hours.

• Project Characteristics:

SLA: reducing processing time

from 30 days to less then a day

and scale to 4x4 million samples

comparison

Data: Multi-Terabyte database

Problem Statement:

Comparing all pairs of 14 million proteins,

using BLAST search.

Big Data, Bioinformatics

Team websiteBlast

Program

Genome data

Proteins comparison

High performance scalable

Hadoop/Hbase cluster

Page 23: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Drug Information Network Analysis

for Treatment & Chemoinformatics

Integration of heterogeneous data sets

reveals relationships among drug compounds,

enabling insight into treatment efficacy

Business Outcomes• Faster, cheaper discovery of new drugs via focusing research

• Improving patient outcomes by reducing toxic drug reactions

• Reduce cost of treatment by predicting novel efficacy of existing

compounds

25 Pharmacological

Data sets

41 Million

Compounds

• Data preparation

• Feature engineering

• Network/graph modeling

• Visualization

• Machine Learning

• Query

Advanced Analytics

• Medical Research

• Toxicity

• Drug interactions

• Efficacy prediction

Page 24: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Accelerating Secondary Genomic Analysis Using

Intel Reference Architecture• Challenge: How to accelerate Secondary Analysis and

Interpretation in Whole Genome Sequencing

• Solution: Intel Genomics Reference Architecture

(IGRA) utilizing Big Data Technologies (Cloudera

CDH5 Hadoop Distro/Impala/Hive/Python) and Intel

Hardware and Infrastructure. (E5-2650, 8 GB*16, 300

GB SSD, E10G42BFSR)

• Benefits:

− 732x acceleration in Query

− 242x acceleration in statistical function (histogram of indel

lengths)

− 15x acceleration in Annotation

− 11x acceleration in Intersect

* 1000 genome data set, comparison of VCFtools vs. IGRA, cumulative runtime for 23 chromosomes

24

Page 25: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

High-Performance Interconnect (InfiniBand)

Intel® True Scale Fabric

• Challenge: Can high performance interconnect

technology (InfiniBand) keep up with increase in

number of processor cores?

• Workloads: VASP, WIEN2K

• Benchmarks: MVAPICH (MPI over InfiniBand), IMPI

(Intel MPI)

• Results:

− Scale-up research – 5 to 10x speed up when

scaling from single node to 16 nodes

− Intel® True Scale Fabric QDR-40 shows

excellent price/performance results

25

High Performance Scale-out Storage

Challenge:

• Challenge: Need to accelerate and optimize

“time to results” clinical trial simulation

environment; resource allocation and job

prioritization was manual/ad-hoc

• Solution: Scale-Out” architecture: SAS Visual

Analytics, Enterprise Miner, Grid Manager, Red

Hat Enterprise Linux, Xeon E5 servers (HP)

• Benefits:

− Clinical trial simulation exercises reduced

from hours to < 5 minutes; registration

decisions accelerated with multi-hundred

million USD impact

Page 26: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Genomic Assembly of Non-Human Species

• Challenge: Complete assembly of non-human

genome on existing clusters

• Solution: Intel Xeon E7 4800 V3 + SSDs

(S3700)

• Benefits:

− 29.92 hours (on their cluster) vs. 4.03 hours

(on HSW-EX) for a dataset of 73GB.

High Performance Scale-out Storage

Challenge:

• Challenge: 10-15TB data added weekly, small

fraction of overall storage capacity and need a

system to scale, be flexible and efficient

• Solution: HPC-class storage, powered by Intel®

Enterprise Edition for Lustre software

• Benefits:

− Openess, global namespace

− Performance of upwards of 1 TB/s

− Virtually unlimited file system and per file

sizes, and management simplicity

26

Page 27: Intel precision medicine apr 2015

www.intel.com/healthcare/bigdataIntel Health & Life Sciences

Where information and care meet

Intel/Intermountain Collaboration

An Idea For New CDS Applications Combining

Clinical, Genetic/Genomic, and Family Health History

Data

• Goal - Promote widespread use of clinical decision

support that will help clinicians/counselors in

assessing risk and assist genetic counselors in

ordering genetic tests.

• Build a scalable CDS that leverages standardized data

that includes:

− Family Health History

− Clinical and Screening

− Genomic data

• The solution will:

• Be agnostic to data collection tools. The solution Be

scaled to different clinical domains (grow beyond

Breast Cancer) and other healthcare institutions.

• Be standards based where they exist

• Work across all EHRs, but starting with Cerner.

• Leverage Intel technologies (infrastructure, Intel Data

Platform etc.).

• Be flexible to incorporate other data sources (e.g.

Imaging data, personal device data)

Page 28: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

Policy – United States, European

Union Snapshot of US, EU Recommendations

Develop an ICT-enabled European Strategy for Personalised

Medicine

2014-2020

Driving research to unleash the potential of ICT at the point-of-care

EU R&D initiatives must address:

Interoperability of technical standards for managing and sharing sequence data in research and clinical samples;

Development of hardware, software and workflow algorithms to accelerate cost efficient analysis of genetic abnormalities that cause cancer and other complex diseases;

Research to ensure convergence of Big Data and Cloud Computing infrastructure to meet the requirements of High Performance Computing and data throughout the life sciences and healthcare value chains

The eHealth Action Plan 2020 should include Personalised Medicine as a

priority

Gain knowledge of the challenges and barriers (technical, organizational, legal and political) to the adoption of ICT in support of Personalised Medicine leveraged by genomic information;

Evaluate how to change workflows and education requirements to facilitate adoption of ICT mediated personalized medicine in clinical practice;

Expand collaboration with other regions of the world in matters of common interest, e.g. by leveraging the eHealth MoU with the United States of America;

Study, evaluate and disseminate technology neutral risk assessment frameworks for data privacy and security, covering the entire ICT enabled Personalised Medicine delivery chain;

Develop effective methods for enabling the use of medical information for public health and research

Page 29: Intel precision medicine apr 2015

Health & Life Sciences at IntelWhere information and care meet

29

Genes causing it

identified & disease

pathways determined

Precision

medicine regime

Precision Medicine: All in a day by 2050 2020

Page 30: Intel precision medicine apr 2015

Intel Confidential — Do Not Forward