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Challenge of personalized health care: To what extent is medicine already individualized and what are the future trends?. Author: Walter Fierz Presented by Xiaomin Xu For Journal Club on Sep.13,2005. Backgound. Before the advent of scientific medicine Lack of standardization

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Challenge of personalized health care: To what extent is medicine already individualized and what are the future trends?

Author: Walter Fierz

Presented by Xiaomin Xu

For Journal Club on Sep.13,2005


Backgound
Backgound medicine already individualized and what are the future trends?

  • Before the advent of scientific medicine

    • Lack of standardization

    • Individualize medical care

  • Introduction of the scientific medicine

    • Personal aspects of treatment were endangered

  • Challenge: regain individualism on a scientific basis


Personalized medicine
Personalized medicine medicine already individualized and what are the future trends?

  • Occurred at post-genomic era

  • Individualized medicine is not new

  • New are: Molecular diagnostics based on comprehensive and high-throughput genetic testing & pharmacogenomics

  • Focus of this article: infectious diseases and clinical immunological disorders


Six dimensions of pm
Six dimensions of PM medicine already individualized and what are the future trends?

  • Disease: disease evolution

  • Environment: the infecting microbe

  • Genes: the molecular traits and mechanisms underlying the individual characteristics of both the patient and the microbe


Six dimensions of pm cont
Six dimensions of PM (Cont.) medicine already individualized and what are the future trends?

  • Medication: drug development

  • Health care: health-care process

  • Information management: patient-specific and knowledge-based

  • Properties along these six dimensions are not independent from each other


Individual character of infectious diseases
Individual character of infectious diseases medicine already individualized and what are the future trends?

  • Interaction between host and microbes is very individual

  • Individuality: based on many factors

  • Molecular technology has been introduced into the third dimension


Individual character of immune responses
Individual character of immune responses medicine already individualized and what are the future trends?

  • Innate immune system and adaptive immune system both show high degree of polymorphism

  • Overwhelming complexity of the immune system make personalizing prevention and treatment difficult


Within health care process
Within health care process medicine already individualized and what are the future trends?

  • Personalized medicine and patient-centered care are mutually supportive.

  • Put emphasis on the integration of disparate personalized medical approaches and on the integration of fragmented personal records.

  • Personalized information management

  • Clinical laboratory should provide electronic links between personal lab data and electronic information from digital libraries and databases.


Social and ethical risks
Social and ethical risks medicine already individualized and what are the future trends?

  • Personal values are at stake: privacy, protection of minorities, prevention of discrimination

  • Regulation:

    • Inform consent in the diagnostic process

    • Clinical lab as trusted intermediaries

    • Legal protection

    • Protect genetic minorities

    • Rational and irrational discrimination


Conclusions
Conclusions medicine already individualized and what are the future trends?

  • Personalized medicine is promising

  • Challenge is to adapt the health-care process to the needs of personalized medicine and to cope with its social risks


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