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Author: Walter Fierz Presented by Xiaomin Xu For Journal Club on Sep.13,2005

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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
  • 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
  • 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
  • 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.)
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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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