Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore.
Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
Nat Genet. 2023 Feb;55(2):178-186. doi: 10.1038/s41588-022-01274-x. Epub 2023 Jan 19.
Precision medicine promises to transform healthcare for groups and individuals through early disease detection, refining diagnoses and tailoring treatments. Analysis of large-scale genomic-phenotypic databases is a critical enabler of precision medicine. Although Asia is home to 60% of the world's population, many Asian ancestries are under-represented in existing databases, leading to missed opportunities for new discoveries, particularly for diseases most relevant for these populations. The Singapore National Precision Medicine initiative is a whole-of-government 10-year initiative aiming to generate precision medicine data of up to one million individuals, integrating genomic, lifestyle, health, social and environmental data. Beyond technologies, routine adoption of precision medicine in clinical practice requires social, ethical, legal and regulatory barriers to be addressed. Identifying driver use cases in which precision medicine results in standardized changes to clinical workflows or improvements in population health, coupled with health economic analysis to demonstrate value-based healthcare, is a vital prerequisite for responsible health system adoption.
精准医学有望通过早期疾病检测、精准诊断和定制治疗来改变群体和个体的医疗保健模式。对大规模基因组-表型数据库的分析是精准医学的关键推动因素。尽管亚洲拥有全球 60%的人口,但现有的数据库中亚洲血统的代表性不足,导致错失了新发现的机会,尤其是对这些人群最相关的疾病。新加坡国家精准医学计划是一项为期 10 年的政府主导的计划,旨在生成多达 100 万人的精准医学数据,整合基因组、生活方式、健康、社会和环境数据。除了技术,要在临床实践中常规采用精准医学,还需要解决社会、伦理、法律和监管方面的障碍。确定驱动用例,即精准医学导致临床工作流程标准化改变或改善人口健康的用例,并结合健康经济学分析来证明基于价值的医疗保健,是负责任地采用医疗体系的重要前提。