精准医学是什么?
What is precision medicine?
机构信息
Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany.
出版信息
Eur Respir J. 2017 Oct 19;50(4). doi: 10.1183/13993003.00391-2017. Print 2017 Oct.
The term "precision medicine" has become very popular over recent years, fuelled by scientific as well as political perspectives. Despite its popularity, its exact meaning, and how it is different from other popular terms such as "stratified medicine", "targeted therapy" or "deep phenotyping" remains unclear. Commonly applied definitions focus on the stratification of patients, sometimes referred to as a novel taxonomy, and this is derived using large-scale data including clinical, lifestyle, genetic and further biomarker information, thus going beyond the classical "signs-and-symptoms" approach.While these aspects are relevant, this description leaves open a number of questions. For example, when does precision medicine begin? In which way does the stratification of patients translate into better healthcare? And can precision medicine be viewed as the end-point of a novel stratification of patients, as implied, or is it rather a greater whole?To clarify this, the aim of this paper is to provide a more comprehensive definition that focuses on precision medicine as a process. It will be shown that this proposed framework incorporates the derivation of novel taxonomies and their role in healthcare as part of the cycle, but also covers related terms.
近年来,“精准医学”一词受到了科学界和政治界的关注,变得非常流行。尽管它很流行,但它的确切含义,以及它与其他流行术语(如“分层医学”、“靶向治疗”或“深度表型”)的区别仍然不清楚。通常应用的定义侧重于患者的分层,有时被称为一种新的分类法,这是使用包括临床、生活方式、遗传和进一步的生物标志物信息在内的大规模数据得出的,从而超越了经典的“症状和体征”方法。虽然这些方面是相关的,但这种描述留下了许多问题。例如,精准医学从何时开始?患者的分层在何种程度上转化为更好的医疗保健?精准医学是否可以被视为新的患者分层的终点,就像所暗示的那样,或者它更像是一个更大的整体?为了澄清这一点,本文的目的是提供一个更全面的定义,该定义侧重于将精准医学作为一个过程。将表明,所提出的框架包含了新的分类法的推导及其在医疗保健中的作用,作为循环的一部分,但也涵盖了相关术语。