Will Genomics widen or help heal the schism between medicine and public health?
Will Genomics widen or help heal the schism between medicine and public health?
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DOI：
10.1016/j.amepre.2007.05.010
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发表时间：
2007-10-01
影响因子：
5.5
通讯作者：
Zimmern, Ron
中科院分区：
文献类型：
--
作者：
Khoury, Muin J.;Gwinn, Marta;Zimmern, Ron
我们根据基因组学的进步和医疗保健向个性化治疗和预防的预期演变，讨论医学和公共卫生之间的“分裂”。毫无疑问，基因组学可能加深两个世界之间的鸿沟，但考虑到新科学发现的数量及其在健康和疾病的所有领域的潜在应用，它也代表了一个重要的，也许是治愈分裂的独特机会。我们认为，将基因组学整合到医疗保健和疾病预防中，需要在人口方法的背景下建立强有力的医学-公共卫生伙伴关系，以实现包括四个重叠领域的转化研究议程：(1)共同关注预防——一个传统的公共卫生问题，但现在基因组学在个体化初级预防和早期检测领域的前景；(2)人口视角，这需要大量人口水平的数据来验证基因发现的临床应用；(3)致力于基于证据的知识整合，在实践中有数千种潜在的基因组应用；(4)重视卫生服务研究，以评估结果。现实世界中的成本和收益。基因组学时代需要强有力的医学-公共卫生伙伴关系，以便将所有科学发现转化为有利于人口健康的成果。
We discuss the "schism" between medicine and public health in light of advances in genomics and the expected evolution of health care toward personalized treatment and prevention. Undoubtedly, genomics could deepen the divide between the two worlds, but it also represents an important and perhaps unique opportunity for healing the schism, given the volume of new scientific discoveries and their potential applications in all areas of health and disease. We argue that the integration of genomics into health care and disease prevention requires a strong medicine-public health partnership in the context of a population approach to a translational research agenda that includes four overlapping areas: (1) a joint focus on prevention-a traditional public health concern but now a promise of genomics in the realm of individualized primary prevention and early detection, (2) a population perspective, which requires a large amount of population-level data to validate gene discoveries for clinical applications, (3) commitment to evidence-based knowledge integration with thousands of potential genomic applications in practice, and (4) emphasis on health services research to evaluate outcomes, costs, and benefits in the real world. A strong medicine-public health partnership in the genomics era is needed for the translation of all scientific discoveries for the benefit of population health.