UCB Biosciences GmbH, Alfred-Nobel-Str. Str. 10, 40789, Monheim, Germany.
University of Bonn, Bonn-Aachen International Center for IT, Endenicher Allee 19c, 53115, Bonn, Germany.
BMC Med. 2018 Aug 27;16(1):150. doi: 10.1186/s12916-018-1122-7.
Personalized, precision, P4, or stratified medicine is understood as a medical approach in which patients are stratified based on their disease subtype, risk, prognosis, or treatment response using specialized diagnostic tests. The key idea is to base medical decisions on individual patient characteristics, including molecular and behavioral biomarkers, rather than on population averages. Personalized medicine is deeply connected to and dependent on data science, specifically machine learning (often named Artificial Intelligence in the mainstream media). While during recent years there has been a lot of enthusiasm about the potential of 'big data' and machine learning-based solutions, there exist only few examples that impact current clinical practice. The lack of impact on clinical practice can largely be attributed to insufficient performance of predictive models, difficulties to interpret complex model predictions, and lack of validation via prospective clinical trials that demonstrate a clear benefit compared to the standard of care. In this paper, we review the potential of state-of-the-art data science approaches for personalized medicine, discuss open challenges, and highlight directions that may help to overcome them in the future.
There is a need for an interdisciplinary effort, including data scientists, physicians, patient advocates, regulatory agencies, and health insurance organizations. Partially unrealistic expectations and concerns about data science-based solutions need to be better managed. In parallel, computational methods must advance more to provide direct benefit to clinical practice.
个性化医学、精准医学、精准医疗或分层医学被理解为一种医疗方法,其中患者根据其疾病亚型、风险、预后或治疗反应使用专门的诊断测试进行分层。其关键思想是根据个体患者的特征(包括分子和行为生物标志物)而不是人口平均值来做出医疗决策。个性化医学与数据科学,特别是机器学习(在主流媒体中常被称为人工智能)紧密相关并依赖于数据科学,特别是机器学习(在主流媒体中常被称为人工智能)。虽然近年来人们对“大数据”和基于机器学习的解决方案的潜力充满热情,但只有少数例子能够影响当前的临床实践。对临床实践缺乏影响在很大程度上归因于预测模型的性能不足,难以解释复杂的模型预测,以及缺乏通过前瞻性临床试验进行验证,这些临床试验与现有护理标准相比证明了明确的益处。在本文中,我们回顾了最先进的数据科学方法在个性化医学中的潜力,讨论了开放的挑战,并强调了未来可能有助于克服这些挑战的方向。
需要跨学科的努力,包括数据科学家、医生、患者权益维护者、监管机构和健康保险公司。需要更好地管理对数据科学解决方案的部分不切实际的期望和担忧。同时,计算方法必须取得更多进展,为临床实践提供直接效益。