Medco Research Institute, LLC, 7315 Wisconsin Avenue, Bethesda, MD 20814, USA.
Trends Mol Med. 2012 Apr;18(4):201-5. doi: 10.1016/j.molmed.2012.01.006. Epub 2012 Feb 28.
Teaching old dogs new tricks is difficult, but lessons learned from such efforts can be invaluable. Warfarin is an old drug, difficult to administer and a leading cause of drug-related mortality and hospitalizations. New genetic tests for optimizing warfarin therapy have not been adopted. The debate over precise clinical utility and cost-effectiveness of these tests misses more important points of building a better, cheaper, and more efficient infrastructure to measure the true real-world impact of personalized medicine. However, this same debate about how, when, and where such testing is appropriate has been invaluable to the field of personalized medicine: progress beyond science, in policy, regulations, and logistics can be highlighted along the path to safer and more efficacious warfarin therapy.
教老狗新把戏很难，但从中吸取的教训却非常宝贵。华法林是一种老药，难以管理，也是导致与药物相关的死亡率和住院率的主要原因。新的基因检测方法并未被采用，以优化华法林治疗。关于这些检测的精确临床效用和成本效益的争论忽略了更重要的一点，即建立一个更好、更便宜、更高效的基础设施，以衡量个体化医学的真正实际影响。然而，关于如何、何时以及在何处进行此类测试的争论对于个体化医学领域来说是非常宝贵的：在政策、法规和物流方面的进展超越了科学，可以突出显示通往更安全、更有效的华法林治疗的道路。
