Cohort profile: The I AM Frontier prospective cohort study in Flanders
Authors: Heylen D , De Clerck C. , Pusparum M. , Rojo A. Correa , Van Den Heuvel R. , Baggerman G. , Standaert A. , Theunis J. , Hooyberghs J. , Ertaylan G. , Lambrechts N. 
Published: May 2024

AbstractPurposeThe I AM Frontier cohort was set up to support proof-of-concepts aimed at precision health and more specifically personalized prevention and health promotion. The study was designed to identify patterns, markers and processes, that play a role in the spectrum between health and early onset of disease and may provide actionable information in a clinical setting, taking into account all ethical, legal and logistical aspects.ParticipantsThe first phase of the I AM Frontier study ran for 12 months as a longitudinal small-scale cohort study (n=30) in the Antwerp region of Flanders, Belgium. Participants were employees of the company hosting the study, they did not have a clinical diagnosis and were between 45-60 years old.Findings to dateEven though no severe health problems are recorded at baseline, participants did report several physical complaints. There is a clear difference in longitudinal variation between clinical and research grade omics types, which might affect their respective ability to detect intermediate molecular changes that can be linked to phenotype changes.Future plansThis cohort is being used to further support the design and implementation of a larger population health cohort with selected modalities for investigating feasibility of personalized prevention in real life setting. Future research will build on this longitudinal dataset to derive healthy yearly fluctuations (or normal ranges) at individual level for predicting early on-set deviationsRegistrationThe study was approved by the ethical committee of the Antwerp University Hospital (RegN°:B300201837314).Strengths and limitations summaryThe I AM Frontier proof-of-concept (POC) cohort study is unique in that it collected an extensive range of samples, with high longitudinal frequency, of healthy individuals for 12 months. The implemented sampling technologies (for clinical parameters, whole genome sequencing (WGS), methylation, quantitative proteomics, metabolomics, microbiome, retina scans, wearables, and standardized questionnaires on e.g. food intake and medical status in combination with genome sequencing at the start of the study) were selected to maximize overlap with large cross-sectional studies and biobanks such as e.g. UK biobank to allow comparison of phenotypical profiles present across different studies.The highly granular (i.e. collected with high longitudinal frequency) data within this study allows us to construct dense participant profiles. Frequent longitudinal data collection of multi-omics data is emerging with new technical advancements for the in-depth analyses of molecules in small blood volumes. To allow the routine usage of such measurements in clinical practice, the temporal changes observed in this cohort can serve to evaluate the frequency and added value of such highly granular measurements.Perceptions of precision health, such as communication of clinical follow-up data, personal risks from genomics, behavioral aspects, and the ethical dilemmas that go together with all of this, are included in the scope of the cohort.