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超越基因和分子——为精准医学制定精准供给计划
Beyond Genes and Molecules — A Precision Delivery Initiative for Precision Medicine


Ravi B. Parikh ... 其他 • 2017.04.27

2015年,美国总统巴拉克·奥巴马启动了精准医学计划(Precision Medicine Initiative,PMI),旨在开启“一个通过研究、技术和政策使患者、研究人员和医疗服务提供者共同协作,向着个体化医疗发展的医疗新纪元1”。奥巴马总统要求从他2016年的预算中为该计划划拨2.15亿美元——作为致力于创造根据每例患者的生物(基因和分子)特征定制诊断和治疗的公共研究基金。

所有医师都迫切希望进行个体化医疗。然而,通常情况下患者接受的医疗并未匹配他们的意愿,且患者一般没有充分获得其健康信息。PMI带来的科学进步可能进一步增加了为维护患者价值观而提供高质量、实惠的医疗的复杂性。如果我们不努力克服这种复杂性,那么患者可能要等待数年才能获得PMI在诊断和治疗上带来的益处。医疗供给科学领域的互补工作除生物学之外,也研究和实施根据个体需求和意愿定制的供给系统干预措施,从而促进现今以患者为中心的医疗。





作者信息

Ravi B. Parikh, M.D., M.P.P., J. Sanford Schwartz, M.D., and Amol S. Navathe, M.D., Ph.D.
From Brigham and Women’s Hospital, Boston (R.B.P.); and the Perelman School of Medicine, the Wharton School of Business, and the Leonard Davis Institute of Health Economics, University of Pennsylvania (J.S.S., A.S.N.), and the Corporal Michael J. Crescenz Veterans Affairs Medical Center (A.S.N.) — both in Philadelphia.

 

参考文献

1. The Precision Medicine Initiative. Washington, DC: White House (https://www.whitehouse.gov/precision-medicine).

2. National Research Council (US) Committee on a Framework for Developing a New Taxonomy of Disease. Toward precision medicine: building a knowledge network for biomedical research and a new taxonomy of disease. Washington, DC: National Academies Press, 2011.

3. Amarasingham R, Patel PC, Toto K, et al. Allocating scarce resources in real-time to reduce heart failure readmissions: a prospective, controlled study. BMJ Qual Saf 2013;22:998-1005

4. Poulin C, Shiner B, Thompson P, et al. Predicting the risk of suicide by analyzing the text of clinical notes. PLoS One 2014;9:e85733-e85733

5. Salathé M, Freifeld CC, Mekaru SR, Tomasulo AF, Brownstein JS. Influenza A (H7N9) and the importance of digital epidemiology. N Engl J Med 2013;369:401-404

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