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What Are The Implications Of Being Imprecise In Medicine?
This personalized era of precision medicine has dawned with customized medical therapies that are provided based on individual’s own measurement reading of genes. This provides a roadmap for more clarity and informed decision vs. flying blind
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The phenomenon of personalization has permeated in all verticals of human life. The ‘one-size-fits-all’ approach is no longer relevant for Retail, IT, Academia, Travel, and Hospitality; it is also impacting Medicine paving the way for potentially remarkable changes that improve overall patient care.
This personalized era of precision medicine has dawned with customized medical therapies that are provided based on individual’s own measurement reading of genes. This provides a roadmap for more clarity and informed decision vs. flying blind. This rapidly evolving field is getting mainstream with the centre of excellence for precision medicine being established across institutions globally. The goals of precision medicine are simple: to offer individual patients the right medical care at the right time, by taking their genes and clinical information into account. And by understanding the patient’s tumor characteristics predict diet sources which support the treatment paradigm. However, to bring the promise of precision in health requires a fundamental change from population-based solutions to sub-population based solutions with segmentation identified by genomic and clinical attributes.
Traditionally, medicine decision has been based on pre-defined one-size-fits-all treatment strategies. In the past few years, the amount of available patient data has exploded, to the point where it has become overwhelming. To take full advantage of these breakthroughs, doctors must add a working knowledge of data and molecular biology science to the clinical sciences that have traditionally been the focus of professional training. With the help of data specialists and genomic specialists, one can assess large pools of information through the lens of the individual patient.
Imprecision of modern medicine
Data reveal that drugs for diseases like cancer work in about 30% of patients, and also they are efficacious for a limited period of time. For cancer patients, treatment options are hit-or-miss. The oncologist can access large quantum of patient data but not the technology and tools to research the options, and then select one or more drugs that may impact the tumor. When one round of therapy does not work, another is tried, but there is no clear way to tell which treatment will work best for that patient, at that precise moment. Hence lack of precision is indeed a life-and-death situation for cancer patients. This hit-and-miss treatment strategy, coupled with the associate drug side effects to be managed by the physician, skyrocketing costs of treatments, further emphasis the implications of being imprecise.
Considering genetic variations of patients
The key characteristics of cancer is the variations in tumor abnormalities across patients. This heterogeneity is further complicated by the fact that the patient tumours are not static and change based on treatment pressures and other factors. While we now have technologies to measure patient-specific tumor variations – we are limited to looking at individual measurements or dots and do not have the means to connect all the dots. The treatment personalization using point information has improved treatment response rates but resistance to therapies are developed quickly. In this context – being precise for treatments will imply patient-specific measurements which holistically influence decision making for treatments. And also influence diet decisions – namely precision diet.
The underlying intent of healthcare should be to diagnose a condition quickly and unambiguously, and then to match the diagnosis to a specific medicine or therapy, determined in part by the patient’s genotype or phenotype. Ineffective treatments, waste, and late-stage pipeline attrition can be mitigated with precision medicine approaches.
In cancer, for example, the one big variability is a cancer tumour across patients even within the same indication. And the technology to measure this variability exists now - making it possible to collect big data measurements per patient.
For the cancer patient on a wrong treatment path, can be a life-and-death decision. Hence being precise benefits patients. The physicians benefit from not avoiding managing adverse effects of these treatments when not needed and rationale information for making treatment decisions. The pharma benefits for running smaller and very targeted clinical trials for getting drugs approved for marketing. Consequently, the time is now to make use of the genomics measurements and other clinical data to impact patient care and outcomes.
Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.