Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Emergency Medicine, Regions Hospital, St. Paul, Minnesota, USA.
Acad Emerg Med. 2024 Aug;31(8):805-816. doi: 10.1111/acem.14932. Epub 2024 May 23.
Precision medicine is data-driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency medicine (EM) has been peripheral to the precision medicine discourse, lacking both a unified definition of precision medicine and a clear research agenda. We convened a national consensus conference to build a shared mental model and develop a research agenda for precision EM.
We held a conference to (1) define precision EM, (2) develop an evidence-based research agenda, and (3) identify educational gaps for current and future EM clinicians. Nine preconference workgroups (biomedical ethics, data science, health professions education, health care delivery and access, informatics, omics, population health, sex and gender, and technology and digital tools), comprising 84 individuals, garnered expert opinion, reviewed relevant literature, engaged with patients, and developed key research questions. During the conference, each workgroup shared how they defined precision EM within their domain, presented relevant conceptual frameworks, and engaged a broad set of stakeholders to refine precision EM research questions using a multistage consensus-building process.
A total of 217 individuals participated in this initiative, of whom 115 were conference-day attendees. Consensus-building activities yielded a definition of precision EM and key research questions that comprised a new 10-year precision EM research agenda. The consensus process revealed three themes: (1) preeminence of data, (2) interconnectedness of research questions across domains, and (3) promises and pitfalls of advances in health technology and data science/artificial intelligence. The Health Professions Education Workgroup identified educational gaps in precision EM and discussed a training roadmap for the specialty.
A research agenda for precision EM, developed with extensive stakeholder input, recognizes the potential and challenges of precision EM. Comprehensive clinician training in this field is essential to advance EM in this domain.
精准医学是一种基于个体患者独特属性(包括生物特征、疾病表现、局部环境和社会经济状况)为其量身定制的个体化医疗模式,其以数据为驱动。急诊医学(EM)在精准医学讨论中一直处于边缘地位,既缺乏对精准医学的统一定义,也缺乏明确的研究议程。我们召集了一次全国共识会议,旨在构建一个共同的思维模型,并为精准 EM 制定研究议程。
我们召开了一次会议,旨在(1)定义精准 EM,(2)制定基于证据的研究议程,以及(3)确定当前和未来 EM 临床医生的教育差距。九个会前工作组(生物医学伦理、数据科学、医疗保健教育、医疗保健提供和获取、信息学、组学、人口健康、性别以及技术和数字工具),由 84 名成员组成,收集专家意见、审查相关文献、与患者接触,并使用多阶段共识建立过程来完善精准 EM 研究问题。在会议期间,每个工作组都在其领域内分享了他们对精准 EM 的定义,展示了相关概念框架,并让广泛的利益相关者参与进来,以完善精准 EM 研究问题。
共有 217 人参与了这项倡议,其中 115 人是会议当天的与会者。共识建立活动产生了精准 EM 的定义和关键研究问题,这些问题构成了一个新的 10 年精准 EM 研究议程。共识过程揭示了三个主题:(1)数据的至上地位,(2)各领域研究问题的相互关联性,以及(3)健康技术和数据科学/人工智能进步的前景和陷阱。医疗保健教育工作组确定了精准 EM 方面的教育差距,并讨论了该专业的培训路线图。
一项具有广泛利益相关者投入的精准 EM 研究议程,认识到了精准 EM 的潜力和挑战。在这一领域全面培训临床医生对于推进 EM 至关重要。