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1. 
enclosures and openings
http://genomemedicine.com/content/5/3/27
as much as 84% of the genes in the human genome 
http://genomemedicine.com/content/5/3/27
and very little changes, very slowly.
(but if an iPhone bends, we are ON IT)
2. 
! 
a new methodology for 
research
not just solo labs, but 
communities.
TCGA Pan-Cancer Consortium
TCGA Pan-Cancer Consortium
TCGA Pan-Cancer Consortium
TCGA Pan-Cancer Consortium
TCGA Pan-Cancer Consortium
TCGA Pan-Cancer Consortium 
doi:10.7303/syn1710680.4
TCGA Pan-Cancer Consortium 
N1PG 8papers 248 c6ore pr8ojects researchers 28 institutions 1070 datasets 1723 results
29
30 
groups datasets subtypes 
A 
B 
C 
D 
E 
F 
1 
2 
3 
4 
5 
6
31 
A 
B 
C 
D 
E 
F 
1 
2 
3 
4 
5 
6 
G ...
not just solo labs, but 
challenges.
code sharing a prerequisite. 
http://synapse.org
accuracy of model 
jumped three orders of 
magnitude in nine days.
76% accurate. 
36
generated an entire suite of 
available math models attacking 
the problem.
21 february 2013 
17 april 2013 
ongoing...
SHOW ME THE CODE!
...
(all code is free as in beer and as 
in freedom) 
! 
http://synapse.org 
https://github.com/Sage- 
Bionetworks/Synapse-Repository- 
Services
not just solo labs, but 
the general public.
how do we scale engagement 
when our systems weren’t 
built for it?
https://www.scienceexchange.com/
3. 
! 
informed consent as vector 
for scaling engagement
written by a doctor 
edited by a lawyer 
re-edited by a committee 
presented to a participant 
for zero-sum game
written by a doctor 
edited by a lawyer 
re-edited by a committee 
presented to a participant 
for zero-sum game
comprehension 
language 
time 
format 
regulatory issues 
liability fears
57
58
59
key insights: 
! 
make the interface visual 
! 
bring the experience into the 
consent process itself
1. initial metaphor
62 
2. initial design
63 
3. second revision
implementation in 2 Sage 
Bionetworks clinical 
studies (parkinsons, 
post-chemo cognition)
user interface to 
consent 
informed consent 
document 
map between 
form and interface 
IRB 
reviews for ethical 
and scientific propriety 
reviews for effectiveness 
in informing 
mobile clinical 
use standard, vetted interface study protocol 
and open source software 
code for consent 
write locally appropriate 
consent forms
66 
4. PD mobile study (IRB approved)
67
68
69
70
71
72
73
74
75
76
77
78
79
4. 
! 
the participant-centered 
consent toolkit
81
82 
PCC Visual Language 
PCC consent workflows 
Sample clinical documents 
Implementation support
83 
everything needed to create visual 
consent interfaces…
84 
only requirement is attribution.
Release Strategy 
! 
• article in E-GEMS methods journal 
• website with open source tools (attribution licenses) 
! 
• apps implementing 
• pre-committed beta testers 
• public presentations through autumn 
• social media promotion 
! 
• liase with PRIM&R and others to smooth review of 
protocols using toolkit
technical architecture for open science 
86
87 
(the price is freedom)
this is not an abstract 
thing, this open science.
“our competitors' reliance on public 
databases with high VUS and error 
rates will further restrict patient 
access to this life-saving medicine.”
open systems allow for 
evolution, for experimentation, 
for adaptation.
94
no company could have 
built it.
don’t we deserve that 
kind of freedom to 
“make” in health care?
thank you. 
! 
@wilbanks 
john.wilbanks@sagebase.org

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