Dr. Maria Mitchell: Profile in Medicine
Interviewed by Dr. Pola Rosen and Elise Grace, Transcribed by David Beltran, edited by Mohammad Ibrar
Dr. Maria Mitchell is no stranger to innovation, government work, medicine and collaboration. As an adviser to Mayor Giuliani on health issues, Chair of the Board of the Health and Hospitals Corporation, and founder of the New York City Office of Family Violence and Abuse, Mitchell has led AMDeC since its founding in 1997. AMDeC, the Academy for Medical Development and Collaboration, provides leadership in facilitating collaboration between academia and industry in biomedical research and in creating efficiencies to help members progress toward medical breakthroughs and discoveries.
Mitchell spoke with Education Update at her offices in Rockefeller Center recently. She mentioned many aspects of her life that have led to the success of AMDeC, but she focused on describing a new program called AMDeC F.I.R.S.T. (Facilities, Instrumentation, Resources, Services & Technologies).
Mitchell, always involved in medicine, was a pediatric nurse at Sloan Kettering and went on to begin the New York Cancer Project, a first in the city, with an ethnically diverse population of 20,000 people. Partnering with several major New York City research institutions, Mitchell created a type of Framingham longitudinal study for cancer research. The blood samples are now housed at Rutgers University while Columbia University has the informatics.
Dr. Maria Mitchell (MM): The cancer project was finished in 2001. Twelve of our 14 years have been spent in funding these kinds of projects and studies. We have one ongoing project on obesity and type 2 diabetes in children. Our member institutions were looking for ways to enhance services and maximize resources, so we now focus on creating revenue and savings for them as well as sharing information. We developed an online real-time registry of almost 1,000 services and technologies in core laboratories across our 19 member medical institutions. Core laboratories are shared resources that offer anything from gene sequencing to animal facilities, where the individual investigators go to the core lab in their institution to get services. Because there are so many institutions providing these services, they all wanted to know who is doing what, so they could share, buy, sell from each other, and make these services available to biotech and pharma companies, as well. New biotech companies don’t have the resources to do a lot of that work themselves, so they’ll buy them from an academic institution. Because we’ve been in this space for so long, we were able to collect that information from the core labs in probably three or four months, and nobody’s ever been able to do that. That has proven to be a huge resource for the institutions.
Dr. Pola Rosen (PR): What about Michelle Obama’s initiative for obesity and diabetes? Can some of this information that has been collected now be tapped into? I’m talking about your original sampling of all those people in New York City and maybe they can look at certain specific groupings.
MM: What we do have is a study that Michelle Obama should see because we have something that’s called R.O.A.D. [Reduce Obesity and Diabetes], and that is a five-year study where five different institutions have gone into the middle schools in their communities and recruited kids to look at the genetic pre-disposition to type 2 diabetes and obesity. So they take blood and anthropometric measures.
PR: Is this your study?
MM: We’ve raised the money. I raised $5 million for that study and AMDeC coordinates this study. But I was very involved in the development. The study’s not complete and we have the fourth publication going to print, so there have already been findings. Also, there’s an intervention component with exercise and nutrition in the schools and family nutrition education for those who participate. As you know, a lot of the New York City schools no longer have gym or don’t have gym every day, so they go in the schools and they design an exercise program that is geared to the population in the school, because it’s looking at diverse populations.
PR: Who designs the exercise program?
MM: Well there’s a team of pediatricians, nutritionists and others from five of our member institutions: Columbia, Maimonides, North Shore-LIJ, Mount Sinai, and Winthrop University hospital in Mineola.
PR: Did those individuals from the five institutions put together the obesity and diabetes prevention program?
MM: There were two of the principals, Dr. Michael Rosenbaum at Columbia and Dr. Steve Shelov at North Shore, who had programs that were looking at this. Dr. Rosenbaum did a pilot at Columbia in a school. Dr. Shelov was doing it in Brooklyn. So because of AMDeC, we were able to put all these people together to design a further study of what they were doing — a much larger study that we could expand. We have nearly 1,000 kids in five middle schools. When she [Obama] first talked about this, I felt like she was talking about what we were already doing, because the unique thing about this study is that it’s tailored to individuals and groups. It’s not just one mass intervention. It’s directly geared toward specific children and trying to understand the cause of obesity in specific populations. You can’t apply one intervention to everybody.
PR: Do you offer integrated service where people can see what is happening in cancer research?
MM: We do not. We primarily focus on our members. We are working with AMDeC F.I.R.S.T. to allow companies to find investigators in particular areas, which we hope will draw more industry to New York. Our goal is to expand the platform to do other things. For example, a comparison that will tell you what’s at each lab, if they’re open to outsiders, etc. Our goal for the next year is to make this an e-commerce business so they can do this online.
PR: What are some of the universities you work with? What services do you provide for them?
MM: Nineteen institutions from the New York region are members of AMDeC. Our Members include such institutions as Columbia University Medical Center, Mount Sinai, Memorial Sloan-Kettering, Cold Spring Harbor Laboratory, and N.Y.U Langone Medical Center. The AMDeC F.I.R.S.T. registry is a huge help for them. They didn’t know what’s available at other institutions, and now can share information. The technology is expensive, but to support the equipment is even more expensive. For example, The American Museum of Natural History is a Ph.D.-granting institution and a member of AMDeC. They’re using the information available to locate and use different equipment and services so they don’t have to buy everything themselves. That’s a good example of the sharing and cost efficiency. Take gene sequencing. Sequencers cost around $1 million, but to service that equipment, it’s extraordinarily expensive; that’s a cost that doesn’t have to be borne by every institution for every service. Another example, if a researcher’s core lab can’t run his samples, he can go on the site and find one that can.
PR: Were there any major milestones with the formation of AMDeC?
MM: We’ve been around for fourteen years and keeping these very competitive people at the table is a huge accomplishment, particularly in a city like this. Another study we funded that was done primarily at Cornell was looking at the use of CT scans and the early detection of lung cancer. We funded $6 million at 11 institutions across New York State. The New York Community Trust gave $600,000, which was the largest grant they ever gave. That whole area was controversial because the radiologists in New York didn’t want to use controls; they felt it was unethical. Because of the two views, it prompted the NIH to do its own study, and they came out in support of CT scans, so we really contributed to the fact that the NIH looked at this.
PR: Are there any new initiatives?
MM: We’re discussing with some biotech companies putting money through AMDeC to our member institution CLIA certified labs to develop cancer diagnostics, which would create more of a New York industry academic partnership and a New York solution to particular diseases. This is in a very early stage of discussion. Anybody that is in our member institutions can access the information. One of the things we did, and everybody at Rockefeller University, another of our members, loved this, when gene sequencing first started, you needed a number of Affymetrix chips, which were about $2,500 a piece. We negotiated about an 80 percent discount on these chips just for AMDeC members and that speeded up research. Our members can buy more, effectively do more, which makes them more competitive for grants.
PR: Anything we haven’t asked you that you feel you should mention? Do you have any competition?
MM: Nobody. There is no other organization like AMDeC in the country. We’ve been really good at being nimble. When our members look for something, we can switch gears and do what they need us to do. Someone made the comment that it’s a Darwinian thing where it keeps evolving and it never really gets to the perfect place; it just keeps evolving. We’re not doing what we did three years ago — we’re doing what our members need us to do now. The financial climate has changed what they need and we have responded.
PR: You mentioned Darwin who said that the survival of the fittest is not dependent on strength or intelligence but on adaptability.
MM: Exactly. We have adapted to this changing environment. #
