Petersen Katelin E, Prows Cynthia A, Martin Lisa J, Maglo Koffi N
Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Public Health Genomics. 2014;17(4):209-20. doi: 10.1159/000362359. Epub 2014 May 21.
The success of personalized medicine depends on factors influencing the availability and implementation of its new tools to individualize clinical care. However, little is known about physicians' views of the availability of personalized medicine across racial/ethnic groups and the relationship between perceived availability and clinical implementation. This study examines physicians' perceptions of key elements/tools and potential barriers to personalized medicine in connection with their perceptions of the availability of the latter across subpopulations.
Study subjects consisted of physicians recruited from Cincinnati Children's Hospital Medical Center and UC Health. An electronic survey conducted from September 2012 to November 2012 recruited 104 physicians. Wilcoxon rank sum analysis compared groups.
Physicians were divided about whether personalized medicine contributes to health equality, as 37.4% of them believe that personalized medicine is currently available only for some subpopulations. They also rated the importance of racial/ethnic background almost as high as the importance of genetic information in the delivery of personalized medicine. Actual elements of personalized medicine rated highest include family history, drug-drug interaction alerts in medical records, and biomarker measurements to guide therapy. Costs of gene-based therapies and genetic testing were rated the most significant barriers. The ratings of several elements and barriers were associated with perceived availability of personalized medicine across subpopulations.
While physicians hold differing views about the availability and implementation of personalized medicine, they likewise establish complex relationships between race/ethnicity and personalized medicine that may carry serious implications for its clinical success.
个性化医疗的成功取决于影响其新工具可用性和实施以实现临床护理个性化的因素。然而，对于医生对跨种族/族裔群体的个性化医疗可用性的看法以及感知可用性与临床实施之间的关系知之甚少。本研究探讨医生对个性化医疗关键要素/工具的看法以及潜在障碍，同时结合他们对后者在亚人群中的可用性的看法。
研究对象包括从辛辛那提儿童医院医疗中心和加州大学健康中心招募的医生。2012年9月至2012年11月进行的一项电子调查招募了104名医生。采用Wilcoxon秩和分析对各组进行比较。
医生们对个性化医疗是否有助于健康平等存在分歧，37.4%的医生认为个性化医疗目前仅适用于某些亚人群。他们还认为种族/族裔背景在提供个性化医疗中的重要性几乎与遗传信息的重要性相当。个性化医疗中实际被评为最高的要素包括家族病史、病历中的药物相互作用警报以及指导治疗的生物标志物测量。基于基因的疗法和基因检测的成本被评为最主要的障碍。几个要素和障碍的评分与亚人群中个性化医疗的感知可用性相关。
虽然医生对个性化医疗的可用性和实施持有不同观点，但他们同样在种族/族裔与个性化医疗之间建立了复杂的关系，这可能对其临床成功产生严重影响。
