Brigham and Women's Hospital, TIMI Study Group, 350 Longwood Avenue, Office Level One, Boston, Massachusetts 02115, USA.
Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA.
Nat Rev Cardiol. 2016 Oct;13(10):591-602. doi: 10.1038/nrcardio.2016.101. Epub 2016 Jun 30.
The cardiovascular research and clinical communities are ideally positioned to address the epidemic of noncommunicable causes of death, as well as advance our understanding of human health and disease, through the development and implementation of precision medicine. New tools will be needed for describing the cardiovascular health status of individuals and populations, including 'omic' data, exposome and social determinants of health, the microbiome, behaviours and motivations, patient-generated data, and the array of data in electronic medical records. Cardiovascular specialists can build on their experience and use precision medicine to facilitate discovery science and improve the efficiency of clinical research, with the goal of providing more precise information to improve the health of individuals and populations. Overcoming the barriers to implementing precision medicine will require addressing a range of technical and sociopolitical issues. Health care under precision medicine will become a more integrated, dynamic system, in which patients are no longer a passive entity on whom measurements are made, but instead are central stakeholders who contribute data and participate actively in shared decision-making. Many traditionally defined diseases have common mechanisms; therefore, elimination of a siloed approach to medicine will ultimately pave the path to the creation of a universal precision medicine environment.
心血管研究和临床界通过开发和实施精准医学,非常适合解决非传染性死亡原因的流行问题,并推进我们对人类健康和疾病的认识。需要新的工具来描述个体和人群的心血管健康状况,包括“组学”数据、暴露组和健康的社会决定因素、微生物组、行为和动机、患者生成的数据以及电子病历中的各种数据。心血管专家可以借鉴他们的经验并利用精准医学来促进发现科学并提高临床研究的效率,以提供更精确的信息来改善个体和人群的健康。克服实施精准医学的障碍将需要解决一系列技术和社会政治问题。在精准医学下的医疗保健将成为一个更加集成和动态的系统,其中患者不再是被动接受测量的实体,而是积极参与数据贡献和共同决策的核心利益相关者。许多传统定义的疾病具有共同的机制;因此,消除医学的孤立方法最终将为创建通用的精准医学环境铺平道路。