Precision Medicine: Ready for Prime Time??
One of the unforeseen wonders of the modern technological age was the rate at which computer-processing power accelerated. Not only has this resulted in laptops and smartphones, which can access more information more rapidly than the mega computers of merely a decade ago, but has also facilitated the rapid analyzation of millions of pieces of information in record time. In fact, the Human Genome Project (HGP) finished well ahead of schedule due to the unexpected increase in processing capability available at completion.
Although the implications for the medical world from HGP’s results are vast, one area, which has proven increasingly intriguing, is the potential to now answer a classic medical dilemma. While evidence-driven medical care might identify an appropriate treatment for a disease, the question remains—how to determine the best treatment for a given patient at a given time? For example, the prospective randomized double-blind study, well-conducted in thousands of trials, may determine that mortality from a certain common disease is cut in half, from 10% to 5% with a given treatment. Potentially thousands of lives might be saved. In reality, if applied to the entire population with that syndrome, only 5% will actually benefit. The other 95% incur all the risks associated with that therapy yet do not derive the benefit.
The questions that scream for response are:
- How can we identify the 5% who will benefit?
- How do we know who will suffer side effects?
- How can we provide the best care, to right patient, at the optimal time?
That is precision medicine—cheaper, safer, and much more effective. The answers will come from the convergence of two different approaches—both of which rely heavily on computer processing:
1. Exploration of the correlations between genetic composition and clinical manifestation, and
2. Careful and robust assessment of risk-adjusted outcomes.
Although the ability to rapidly sequence the human genome lead to promises of instant cure of all disease and the ability to access “big data” in electronic medical records promised to answer all clinical questions, the actual process of engaging these abilities has proven more challenging than anticipated and today the questions abound more rapidly than the answers. But, nonetheless, the quest has begun…
To learn more about Precision Medicine and what it means for the cardiovascular community, join us October 6th on the Columbia University Medical Center campus for our annual Network Day Event ~ details at http://columbiaheartsource.org/annual-network-day