Challenge of personalized health care: To what extent is medicine already individualized and what ar

1
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

2
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

3
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

4
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

5
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

6
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

7
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

8
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.

9
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

10
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