Towards a unified concept of individualized medicine

International journal of pharmaceutical quality assurance, 2023

With the trend of customizing almost everything, from water bottles to other gift items, it's not surprising that medicine is fully taking root in this area as well. As scientific knowledge has grown over the years, there has been a slow but steady shift away from traditional medicine. Traditionally, the way drugs have been made and how medicine has been practiced has been based on finding treatments that work for a whole population. Patients' unique physiologies and psychological make-ups result in varying therapeutic responses, which has led to the development of treatments specifically designed to address these nuances. In this context, the concept of "personalized medicine" (PM) emerged, which entails adapting a patient's care to their specific molecular or genetic make-up and how that contributes to disease development. Thus, the practice of diagnosing, treating, and preventing sickness in individuals on the basis of insufficient evidence that is extrapolated from population norms is becoming increasingly uncommon. Of late, people have started putting on a lot of faith in "personalized medicine" because they believe it can provide more specific treatment. With more accurate diagnosis, prognosis, and therapies, precision or personalized medicine aims to avoid the "one size fits all" mindset in healthcare. 1-5 One critical aspect driving this change is the emergence of new methods and technologies that tend to provide comprehensive molecular-level biological profiling of people. Much progress has been made in transitioning from disease treatment to patient care. The terms used interchangeably for personalized medicine are 'precision', 'individualized' and 'stratified' medicine in accordance with the National Research Council. Personalized medicine is often referred to as P4 medicine, i.e., predictive, preventive, personalized and participatory. 6,7 However, there was concern that the term "personalized" could be misconstrued to suggest that therapies and prevention strategies are being established uniquely for each individual;

2013

Background: Recently, individualized or personalized medicine (PM) has become a buzz word in the academic as well as public debate surrounding health care. However, PM lacks a clear definition and is open to interpretation. This conceptual vagueness complicates public discourse on chances, risks and limits of PM. Furthermore, stakeholders might use it to further their respective interests and preferences. For these reasons it is important to have a shared understanding of PM. In this paper, we present a sufficiently precise as well as adequate definition of PM with the potential of wide acceptance.

BMC Medicine, 2013

Considerable variety in how patients respond to treatments, driven by differences in their geno-and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer's perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.

British Journal of Sociology, 2015

Systems medicine, which is based on computational modelling of biological systems, is emerging as an increasingly prominent part of the personalized medicine movement. It is often promoted as 'P4 medicine' (predictive, preventive, personalized, and participatory). In this article, we test promises made by some of its proponents that systems medicine will be able to develop a scientific, quantitative metric for wellness that will eliminate the purported vagueness, ambiguity, and incompleteness—that is, normativity—of previous health definitions. We do so by examining the most concrete and relevant evidence for such a metric available: a patent that describes a systems medicine method for assessing health and disease. We find that although systems medicine is promoted as heralding an era of trans-formative scientific objectivity, its definition of health seems at present still nor-matively based. As such, we argue that it will be open to influence from various stakeholders and that its purported objectivity may conceal important scientific, philosophical, and political issues. We also argue that this is an example of a general trend within biomedicine to create overly hopeful visions and expectations for the future.

Over the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care. In this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data. We first explore the gap between the ideal of personalized healthcare and the reality of today’s personalized medicine. We show tha...

Philosophy, Ethics, and Humanities in Medicine

Background Over the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care. Methods In this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data. Results We first explore the gap between the ideal of personalized healthcare and the reality of today’s persona...

Personalized Medicine, 2012

Current Drug Metabolism, 2012

Personalized medicine is an approach to improving the practice of medicine based on understanding the characteristics of individuals that are associated with, and potentially causative of, drug therapeutic and adverse effects. In general terms personalized medicine is not a new ideacharacteristics of a person such as age, weight and gender have long been used by clinicians to guide the most appropriate treatment strategy. Use of molecular and biochemical characteristics of an individual to guide therapy is also not a new ideaserum creatinine is commonly used to personalize the drug dose for individuals with impaired renal function, therapeutic drug monitoring is used adjust dose for many drugs of low therapeutic index [1], antibiotics are matched to specific resistant infections [2], and molecular markers of disease subtype can often guide treatment choice (e.g.

Clinical pharmacology and therapeutics, 2007

Autoimmunity reviews, 2016

Personalized medicine encompasses a broad and evolving field informed by a patient distinctive information and biomarker profile. Although terminology is evolving and some semantic interpretations exist (e.g., personalized, individualized, precision), in a broad sense personalized medicine can be coined as: "To practice medicine as it once used to be in the past using the current biotechnological tools." A humanized approach to personalized medicine would offer the possibility of exploiting systems biology and its concept of P5 medicine, where predictive factors for developing a disease should be examined within populations in order to establish preventive measures on at-risk individuals, for whom healthcare should be personalized and participatory. Herein, the process of personalized medicine is presented together with the options that can be offered in health care systems with limited resources for diseases like rheumatoid arthritis and type 1 diabetes.

Pharmacogenomics, 2006

Personalized Medicine, 2020

Aim: The ICPerMed, international initiative promoting personalized medicine, has realized a survey among a group of experts, to define a common vision for the deployment of personalized medicine across healthcare systems until 2030. Materials & methods: ICPerMed defined five perspectives (p.4) and addressed an online questionnaire to 97 international experts to collect their views. Results: Seventy (72%) of the 97 experts effectively answered the survey from which 69 answers were exploitable. Respondents from a variety of international profiles approved the five proposed perspectives and reported required actions and best practices. Conclusion: There is a large consensus among experts directly involved in shaping international strategies and policies, calling for voluntarist public policies, new IT platforms enabling data-driven approaches, large-scale educational programs and new financing models.

Journal of Evaluation in Clinical Practice, 2011

Personalized Medicine, 2006