PFLPhysiological Fitness Landscape

For funders

A staged programme with explicit go and no-go points.

PFL asks for funding one decisive test at a time. Each stage is registered in advance, and its result decides whether the next one happens.

Already done, without dedicated funding

238 biomarker hazard curves from 492 verified sources. Our own validation on 51,662 US adults with 7,703 deaths, where 29 of 35 published directions reproduce. Replication in Costa Rica and the Health and Retirement Study. Within-person trajectories for 13 measures. A ranking of which tests carry the most information.

All of it is public: evidence and code.

Stages and decision points

StageThe testProceed ifStatus
1. CataloguePublished curves reproduce in a national sampleMost directions reproduceDone: 29 of 35
2. Variability pilotWithin-person variability predicts mortality beyond level and trend (HRS)Decision rules registered at osf.io/kzfs4Analysis running
3. One landscapeShared curves plus personal parameters predict individual trajectories on repeated blood (CLSA, ARIC, Framingham)Better prediction than baseline risk, at a threshold registered before the data arriveNeeds funding
4. Health-system testRetrospective validation on routine labs inside a partner's environmentImproves on current risk scoresPartner discussions
5. Prospective pilotMeasure, locate, intervene and re-measure in a small cohortStages 3 and 4 succeedDesign only

The current ask

Stage 3 is budgeted at $400,000 over 12 months: a data scientist, data access and secure computing, the open platform, and the design of the prospective pilot. Smaller contributions can fund a single piece, such as a trainee on one open problem or a data-access fee.

Funders receive the same thing as everyone else, sooner: registered analysis plans, every result whatever it shows, and open code and data.

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