Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine
Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine
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DOI：
10.1038/s41591-023-02502-5
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发表时间：
2023-10-05
期刊：
影响因子：
82.9
通讯作者：
Franks，Paul W.
中科院分区：
文献类型：
--
作者：
Tobias，Deirdre K.;Merino，Jordi;Franks，Paul W.
精确医学是当代循证医学逻辑演变的一部分，它寻求在做出医疗决定和健康建议时减少错误并优化结果。糖尿病影响全球数亿人，其中许多人会出现危及生命的并发症并过早死亡。精确医学可能通过考虑常见形式糖尿病的病因、临床表现和发病机制以及并发症风险的异质性来解决这一巨大问题。这份关于精准糖尿病医学的第二份国际共识报告总结了精准医学关键支柱(预防、诊断、治疗、预后)对四种公认的糖尿病形式(单基因、妊娠期、1型、2型)进行的系统证据审查的结果。这些综述涉及将精确医学研究转化为实践的关键问题。尽管不完整，但由于关于这一主题的大量文献，它们揭示了立即或近期在临床上实施精确糖尿病药物的机会；此外，我们暴露了知识中的重要差距，重点是需要获得新的临床相关证据。差距包括需要为临床准备情况制定共同标准，包括考虑成本效益、卫生公平、预测准确性、责任和可获得性。概述了精准糖尿病医学广泛临床实施的关键里程碑。
Precision medicine is part of the logical evolution of contemporary evidence-based medicine that seeks to reduce errors and optimize outcomes when making medical decisions and health recommendations. Diabetes affects hundreds of millions of people worldwide, many of whom will develop life-threatening complications and die prematurely. Precision medicine can potentially address this enormous problem by accounting for heterogeneity in the etiology, clinical presentation and pathogenesis of common forms of diabetes and risks of complications. This second international consensus report on precision diabetes medicine summarizes the findings from a systematic evidence review across the key pillars of precision medicine (prevention, diagnosis, treatment, prognosis) in four recognized forms of diabetes (monogenic, gestational, type 1, type 2). These reviews address key questions about the translation of precision medicine research into practice. Although not complete, owing to the vast literature on this topic, they revealed opportunities for the immediate or near-term clinical implementation of precision diabetes medicine; furthermore, we expose important gaps in knowledge, focusing on the need to obtain new clinically relevant evidence. Gaps include the need for common standards for clinical readiness, including consideration of cost-effectiveness, health equity, predictive accuracy, liability and accessibility. Key milestones are outlined for the broad clinical implementation of precision diabetes medicine.