Tonelli Mark R
University of Washington, Seattle, WA, USA.
J Eval Clin Pract. 2018 Jun;24(3):646-648. doi: 10.1111/jep.12892. Epub 2018 Feb 21.
Precision medicine, which aims to individualize care based upon the unique combination of genetic, environmental, and lifestyle features in particular patients, will require an evolution in clinical decision making. Practitioners of precision medicine will need to utilize an expanded body of medical knowledge derived from a wide variety of sources. Clinical judgement in the case-based reasoning necessary for individualizing care will involve understanding and utilizing methodological approaches not commonly invoked in medicine, including mechanistic and qualitative research results. Instead of searching for an answer in the published literature, precision medicine demands clinical judgement that finds the reasons for clinical decisions within, not without, the patient.
精准医学旨在根据特定患者基因、环境和生活方式特征的独特组合实现个体化医疗，这将需要临床决策方式的转变。精准医学从业者需要运用从广泛来源获取的更丰富的医学知识。个体化医疗所需的基于案例推理中的临床判断，将涉及理解和运用医学中不常用的方法，包括机制性研究和定性研究结果。精准医学并非在已发表的文献中寻找答案，而是要求临床判断在患者自身而非外部去探寻临床决策的依据。
