Sustainable medical research by effective and comprehensive medical skills: overcoming the frontiers by predictive, preventive and personalized medicine.
Sustainable medical research by effective and comprehensive medical skills: overcoming the frontiers by predictive, preventive and personalized medicine.
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DOI：
10.1186/1878-5085-5-14
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Trovato GM
中科院分区：
文献类型：
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作者：
Trovato GM
临床研究和实践需要负担得起的目标，可持续的工具，有价值的培训策略和有意义的合作。我们的单位提供有关项目设计和管理的课程，促进思想，有用的技能，教学和探索网络和现有合作的实施。我们调查了综合诊断和护理的可持续方法的有效性及其在研究项目教学方法的具体模型中的实用性。展示了自1976年以来开发且仍然有效的青少年高血压预测性、预防性和个性化医学（PPPM）模型。这是一个综合PPPM的范例，旨在管理一个公认的，但实际上被忽视的社会和临床问题。第二个模型是针对门诊诊断和治疗单位的性能分析及其与急诊科的关系。部分患者，4，057名在急诊室就诊的癌症患者，被送往门诊诊断和治疗单位进行进一步评估，治疗和随访。在卫生署的住院时间为6.3 ± 2.1天，与住院时间相比，费用较低。研究规划课程，这些模型的基础上，随之而来的竞争性项目提交和成功的资金增加。有必要积极促进跨学科知识和技能。误导性的信息不仅对健康人和病人有害，而且同样对所有卫生专业人员有害：任何声明都需要努力以研究证据为基础。个性化医疗的实际先决条件是连贯和明确地提高工作人员的专业素质。卫生专业人员应该而且能够熟练掌握可持续的非侵入性诊断程序、非药物干预、转化研究（从流行病学到个性化治疗）和及时传播信息。根据PPPM提供建议：拟议的模式是基于财务可持续性和病人的满意度标准，并针对研究项目和传播也通过电子学习。欧盟呼吁个性化医疗的指导方针能够通过准确的规划，评估的透明度和无偏见的报告，传播和利用提供关键的附加值。
Clinical research and practice require affordable objectives, sustainable tools, rewarding training strategies and meaningful collaboration. Our unit delivers courses on project design and management promoting ideas, useful skills, teaching and exploring implementation of networks and existing collaborations. We investigated the effectiveness of a sustainable approach of comprehensive diagnosis and care and its usefulness within concrete models of research project teaching methodology. The model of predictive, preventive and personalized medicine (PPPM) of adolescent hypertension, developed since 1976 and still active, was displayed. This is a paradigm of comprehensive PPPM aimed at the management of a recognized, but actually neglected, societal and clinical problem. The second model was addressed to the analysis of performance of an outpatient diagnostic and therapy unit and its relationship with the emergency department. Part of the patients, 4,057 cancer patients presenting at the emergency care, were addressed to the outpatient diagnostic and therapy unit for further assessment, treatment and follow-up. The stay in DH was 6.3 ± 2.1 non-consecutive days, with shortage of costs, vs. in-hospital stays. Research planning courses, based on these models, ensued in an increase of competitive project submission and successful funding. Active promotion of interdisciplinary knowledge and skills is warranted. Misleading messages and information are detrimental not only to healthy and sick people but, equally, to all health professionals: efforts for basing on evidence by research any statement are needed. The actual pre-requisite of personalized medicine is the coherent and articulated promotion of the professional quality of staff. Health professionals should and can be skilled in sustainable non-invasive diagnostic procedures, in non-pharmacological intervention, in translational research (from epidemiology to personalized therapy) and in timely dissemination of the information. Recommendations are provided according to PPPM: proposed models are based on financial sustainability and patient's satisfaction criteria and are addressed to research projects and dissemination also by e-learning. The guidelines of the EU calls in personalized medicine are able to provide a critical added value by accurate planning, transparency of assessment and unbiased reports, dissemination and exploitation.