scholarly journals Why precision medicine is not the best route to a healthier world

2018 ◽  
Vol 52 ◽  
pp. 12 ◽  
Author(s):  
Juan Pablo Rey-López ◽  
Thiago Herick de Sá ◽  
Leandro Fórnias Machado de Rezende
Keyword(s):  
Precision Medicine ◽  
Population Health ◽  
Physical Inactivity ◽  
Cost Savings ◽  
Health Impact ◽  
Economic Resources ◽  
Current Crisis ◽  
Scientific Debate ◽  
Vested Interests ◽  
Based Medicine

Precision medicine has been announced as a new health revolution. The term precision implies more accuracy in healthcare and prevention of diseases, which could yield substantial cost savings. However, scientific debate about precision medicine is needed to avoid wasting economic resources and hype. In this commentary, we express the reasons why precision medicine cannot be a health revolution for population health. Advocates of precision medicine neglect the limitations of individual-centred, high-risk strategies (reduced population health impact) and the current crisis of evidence-based medicine. Overrated “precision medicine” promises may be serving vested interests, by dictating priorities in the research agenda and justifying the exorbitant healthcare expenditure in our finance-based medicine. If societies aspire to address strong risk factors for non-communicable diseases(such as air pollution, smoking, poor diets, or physical inactivity), they need less medicine and more investment in population prevention strategies.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

Are You Making an Impact? Evaluating the Population Health Impact of Community Benefit Programs

2018 ◽  
Vol 24 (4) ◽  
pp. 335-339 ◽  
Author(s):  
Catherine M. Rains ◽  
Greta Todd ◽  
Nicole Kozma ◽  
Melody S. Goodman
Keyword(s):  
Population Health ◽  
Health Impact ◽  
Community Benefit

scholarly journals Leveraging Implementation Science to Address Health Disparities in Genomic Medicine: Examples from the Field

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 187-192
Author(s):  
Megan C. Roberts ◽  
George A. Mensah ◽  
Muin J. Khoury
Keyword(s):  
Public Health ◽  
Implementation Science ◽  
Population Health ◽  
Public Health Practice ◽  
Genomic Medicine ◽  
Genomic Data ◽  
Health Impact ◽  
Cancer Syndrome ◽  
Public Health Agencies ◽  
Multi Stakeholder

The integration of genomic data into screen­ing, prevention, diagnosis, and treatment for clinical and public health practices has been slow and challenging. Implementa­tion science can be applied in tackling the barriers and challenges as well as exploring opportunities and best practices for integrat­ing genomic data into routine clinical and public health practice. In this article, we de­fine the state of disparities in genomic medi­cine and focus predominantly on late-stage research findings. We use case studies from genetic testing for cardiovascular diseases (familial hypercholesterolemia) and cancer (Lynch syndrome and hereditary breast and ovarian cancer syndrome) in high-risk populations to consider current disparities and related barriers in turning genomic advances into population health impact to advance health equity. Finally, we address how implementation science can address these translational barriers and we discuss the strategic importance of collaborative multi-stakeholder approaches that engage public health agencies, professional societ­ies, academic health and research centers, community clinics, and patients and their families to work collectively to improve population health and reduce or eliminate health inequities.Ethn Dis. 2019;29(Suppl 1):187-192; doi:10.18865/ed.29.S1.187.

scholarly journals Modelling the impact of a new tobacco product: review of Philip Morris International’s Population Health Impact Model as applied to the IQOS heated tobacco product

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s82-s86 ◽  
Author(s):  
Wendy B Max ◽  
Hai-Yen Sung ◽  
James Lightwood ◽  
Yingning Wang ◽  
Tingting Yao
Keyword(s):  
Population Health ◽  
New Product ◽  
Health Impact ◽  
Tobacco Product ◽  
Dynamic State ◽  
Model Parameters ◽  
Impact Model ◽  
Tobacco Products ◽  
Philip Morris ◽  
The Impact

ObjectivesWe review the Population Health Impact Model (PHIM) developed by Philip Morris International and used in its application to the US Food and Drug Administration (FDA) to market its heated tobacco product (HTP), IQOS, as a modified-risk tobacco product (MRTP). We assess the model against FDA guidelines for MRTP applications and consider more general criteria for evaluating reduced-risk tobacco products.MethodsIn assessing the PHIM against FDA guidelines, we consider two key components of the model: the assumptions implicit in the model (outcomes included, relative harm of the new product vs cigarettes, tobacco-related diseases considered, whether dual or polyuse of the new product is modelled, and what other tobacco products are included) and data used to estimate and validate model parameters (transition rates between non-smoking, cigarette-only smoking, dual use of cigarettes and MRTP, and MRTP-only use; and starting tobacco use prevalence).ResultsThe PHIM is a dynamic state transition model which models the impact of cigarette and MRTP use on mortality from four tobacco-attributable diseases. The PHIM excludes morbidity, underestimates mortality, excludes tobacco products other than cigarettes, does not include FDA-recommended impacts on non-users and underestimates the impact on other population groups.ConclusionThe PHIM underestimates the health impact of HTP products and cannot be used to justify an MRTP claim. An assessment of the impact of a potential MRTP on population health should include a comprehensive measure of health impacts, consideration of all groups impacted, and documented and justifiable assumptions regarding model parameters.

Precision Medicine, Genome Sequencing, and Improved Population Health

JAMA ◽  
2018 ◽  
Vol 319 (19) ◽  
pp. 1979 ◽  
Author(s):  
W. Gregory Feero ◽  
Catherine A. Wicklund ◽  
David Veenstra
Keyword(s):  
Precision Medicine ◽  
Population Health ◽  
Genome Sequencing

The Role of Average Health Status

2016 ◽  
pp. 884-899
Author(s):  
Jordan Panayotov
Keyword(s):  
Health Status ◽  
Population Health ◽  
Gold Standard ◽  
Health Impact ◽  
Local Context ◽  
Policy Options ◽  
The Matrix ◽  
The Right ◽  
No Gold Standard ◽  
Average Health

Economic, social and environmental policies, programs and projects have impact on health. Health in All Policies (HiAP) aims to improve population health by taking into account these impacts. HiAP needs appropriate tools for assessing impacts on population health. When making choices between policy options, decision-makers rely on predictions from Health Impact Assessment. Currently there is no gold standard for establishing and assessing validity of predictions. This paper distinguishes between two levels of causal pathways regarding health impacts – specific and conditional, and proposes the Average Health Status – Health Inequalities Matrix as gold standard. The Matrix facilitates making the right choices at any level and local context, thus is useful for researchers, policy-makers and practitioners for designing, analysing and evaluating all kinds of policies. By allowing quick, reliable and inexpensive appraisal of different policy options the matrix makes feasible taking into account the impacts on population health and paves the way for institutionalizing of HiAP.

Precision and personalized assessment, diagnosis and treatment in psychiatry

CNS Spectrums ◽  
2020 ◽  
pp. 1-7
Author(s):  
Konstantinos N. Fountoulakis ◽  
Stephen M. Stahl
Keyword(s):  
Precision Medicine ◽  
Legal Framework ◽  
Clinical Predictors ◽  
And Biological Markers ◽  
Definition Of ◽  
Specific Disorders ◽  
Based Medicine ◽  
Personalized Psychiatry ◽  
Radical Shift ◽  
And Personalized Medicine

Abstract “Precision medicine” and “personalized medicine” constitute goals of research since antiquity and this was intensified with the arrival of the “evidence-based medicine.” precision and personalized psychiatry (3P) when achieved will constitute a radical shift in our paradigm and it will be even more transformative than in other fields of medicine. The biggest problems so far are the problematic definition of mental disorder, available treatments seem to concern broad categories rather than specific disorders and finally clinical predictors of treatment response or side effects and biological markers do not exist. Precision and personalized psychiatry like all precision medicine will be a laborious and costly task; thus the partnership of scientists with industry and the commercialization of new methods and technologies will be an important element for success. The development of an appropriate legal framework which will both support development and progress but also will protect the rights and the privacy of patients and their families is essential.

scholarly journals Mental disorders of known aetiology and precision medicine in psychiatry: a promising but neglected alliance

2016 ◽  
Vol 47 (2) ◽  
pp. 193-197 ◽  
Author(s):  
D. Fraguas ◽  
C. M. Díaz-Caneja ◽  
M. W. State ◽  
M. C. O'Donovan ◽  
R. E. Gur ◽  
...  
Keyword(s):  
Personalized Medicine ◽  
Mental Disorders ◽  
Precision Medicine ◽  
Psychiatric Disorders ◽  
Evidence Based Medicine ◽  
Prediction Models ◽  
Deletion Syndrome ◽  
Clinical Approach ◽  
Evidence Based ◽  
Based Medicine

Personalized or precision medicine is predicated on the assumption that the average response to treatment is not necessarily representative of the response of each individual. A commitment to personalized medicine demands an effort to bring evidence-based medicine and personalized medicine closer together. The use of relatively homogeneous groups, defined using a priori criteria, may constitute a promising initial step for developing more accurate risk-prediction models with which to advance the development of personalized evidence-based medicine approaches to heterogeneous syndromes such as schizophrenia. However, this can lead to a paradoxical situation in the field of psychiatry. Since there has been a tendency to loosely define psychiatric disorders as ones without a known aetiology, the discovery of an aetiology for psychiatric syndromes (e.g. 22q11.2 deletion syndrome in some cases of schizophrenia), while offering a path toward more precise treatments, may also lead to their reclassification away from psychiatry. We contend that psychiatric disorders with a known aetiology should not be removed from the field of psychiatry. This knowledge should be used instead to guide treatment, inasmuch as psychotherapies, pharmacotherapies and other treatments can all be valid approaches to mental disorders. The translation of the personalized clinical approach inherent to psychiatry into evidence-based precision medicine can lead to the development of novel treatment options for mental disorders and improve outcomes.

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