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June 4, 2014

Studying the Elusive Environment in Large Scale

Author Affiliations
  • 1Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
  • 2Stanford Prevention Research Center, Department of Health Research and Policy, Department of Medicine, Stanford University School of Medicine, Stanford, California
  • 3Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California
  • 4Meta-Research Innovation Center at Stanford (METRICS), Stanford, California
JAMA. 2014;311(21):2173-2174. doi:10.1001/jama.2014.4129

It is possible that more than 50% of complex disease risk is attributed to differences in an individual’s environment.1 Air pollution, smoking, and diet are documented environmental factors affecting health, yet these factors are but a fraction of the “exposome,” the totality of the exposure load occurring throughout a person’s lifetime.1 Investigating one or a handful of exposures at a time has led to a highly fragmented literature of epidemiologic associations. Much of that literature is not reproducible, and selective reporting may be a major reason for the lack of reproducibility. A new model is required to discover environmental exposures associated with disease while mitigating possibilities of selective reporting.