A population approach to precision medicine.

A population approach to precision medicine.
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DOI:
10.1016/j.amepre.2012.02.012
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发表时间:
2012-06
影响因子:
5.5
通讯作者:
Kramer, Barnett S.
Kramer, Barnett S.
中科院分区:
医学2区
文献类型:
--
作者:
Khoury, Muin J.;Gwinn, Marta L.;Glasgow, Russell E.;Kramer, Barnett S.

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术语P4医学用于表示一个不断发展的医学领域,该领域使用系统生物学方法和信息技术来增强健康,而不仅仅是治疗疾病。它的四个组成部分包括预测性,预防性,个性化和参与性医学。在目前的论文中,有人认为,为了实现P4医学的承诺,必须将“第五个P”-人口视角-整合到其他四个组成部分中。人口视角将预测医学整合到健康的生态模型中;将人口筛查的原则应用于预防医学;使用循证实践来个性化医学;并将参与式医学建立在公共卫生的三个核心功能之上:评估,政策制定和保证。人口科学-包括流行病学;行为,社会和传播科学;卫生经济学,实施科学和成果研究-需要显示P4医学的价值。实施人口和个人层面干预的平衡战略可以最大限度地提高健康效益,最大限度地减少危害,并避免不必要的医疗费用。
The term P4 medicine is used to denote an evolving field of medicine that uses systems biology approaches and information technologies to enhance wellness rather than just treat disease. Its four components include predictive, preventive, personalized, and participatory medicine. In the current paper, it is argued that in order to fulfill the promise of P4 medicine, a “fifth P” must be integrated--the population perspective--into each of the other four components. A population perspective integrates predictive medicine into the ecologic model of health; applies principles of population screening to preventive medicine; uses evidence-based practice to personalize medicine; and grounds participatory medicine on the three core functions of public health: assessment, policy development, and assurance. Population sciences--including epidemiology; behavioral, social, and communication sciences; and health economics, implementation science, and outcomes research--are needed to show the value of P4 medicine. Balanced strategies that implement both population- and individual-level interventions can best maximize health benefits, minimize harms, and avoid unnecessary healthcare costs.
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