What is this blog about?

Personalized medicine is an inherently interdisciplinary endeavor. Biological sciences meet medicine, all operating within the ethical and legal framework that governs our society. Or better societies, as such rules and customs vary considerably between Europe and the United States of America or even within the European community (not to mention the entirely different mind sets of African or Asian countries). However, new terms have been introduced or existing terms reinterpreted independent of or maybe even based on these socio-economic differences.

 

Leroy Hood coined the term “P4-medicine” to reflect the enormous dimensionality of Personalized Medicine (nicely detailed in Hood et al, 2012). My choice of this P4 medicine definition is based on the generality of the approach, which offers a comprehensive framework for almost all aspects of personalized medicine I regard as important. Therefore, I prefer P4 medicine for its clear structure although every major definition describes essentially a very similar content.

 

For example, the National Institute of Health (NIH, Bethesda, Maryland, USA) prefers the term “precision medicine”, which they used as the main theme of their Precision Medicine Initiative (PMI) launched by President Obama January, 30, 2015. This term will be part of the “Personalized” topic of P4 medicine and I will address it there. 

 

I will address the following subtopics of the four big Ps of P4-medicine:

 

    Preventive (staying healthy rather than treating disease)

    Predictive (Advanced molecular diagnostics)

    Personalized (Precision Medicine)

    Participatory (Stakeholders)

 

Going deeper into these subdivisions reveals the full range of disciplines and stakeholders involved:

 

Preventive (staying healthy rather than treating disease)

    Scientific Wellness

    Lifestyle

    Health monitoring

    Education on health/ethics issues

    Education on risks/benefits

 

Predictive (Advanced molecular diagnostics)

    Molecular diagnostics (Companion diagnostics)

    Prediction of risk (Molecular prognosis)

    Selecting optimal treatment

    Monitoring of risks

    Predicting side effects

 

Personalized (Precision Medicine)

    Omics Technologies (the complete set of measurable values fro one methods in one biological compartment)

    Precision Medicine (diagnosis and treatment guided by the particular features of patients)

    Patient stratification (grouping of patients by common features)

    Individualized Medicine (really geared towards a single patient)

    Therapy monitoring

 

Participatory (Stakeholders)

    The main stake-holders and their representatives

    Patients - basically all of us

    Medical Doctors (MDs),both practicing as well as in hospitals

    Clinical Laboratories carrying out all the test    

    Pharmaceutical Industry

    Health care providers and other organizations paying for health care

    Economists, trying to calculate a benefit/cost analysis 

    Scientists in academia (universities and public research institutes) and industry

    Data protection officers in Hospitals and at companies

    Members of ethical committees

    Lawyers, judges, and courts monitoring and enforcing obedience to laws and rules

    Politicians / parliaments who will have to create and modify the pertinent laws

 

I will try to address the important question what individuals can do to ensure accessibility of personalized medicine for everybody.

 

Each of the subtopics will receive at least one separate blog entry. Some will require several consecutive blog entries, which I will indicate by a running number next to the blog entry title. My intention with this systematic is to facilitate the relocation of past blog entries for reference. 

 

References 

 

Hood, L., Balling, R. & Auffray, C. Revolutionizing medicine in the 21st century through systems approaches. Biotechnol J 7, 992-1001, doi:10.1002/biot.201100306 (2012).

 

 

What’s coming up next?

 

Next week will focus on a concise, general definition of personalized medicine as the range of this term is still subject to discussions. 

info@m4.de