How precision medicine improves chronic disease management
In the 2015 State of the Union address, President Barack Obama talked about funding a National Precision Medicine Initiative, catapulting a new term into the limelight.
Precision medicine began picking up speed as a result of a report from the National Research Council back in November of 2013. Fortune 500 companies like General Electric have started using the term liberally, and medical centers like Weill Cornell and New York Presbyterian have since announced a new institute for precision medicine.
While definitions of precision medicine vary, one thing is generally agreed upon: precision medicine is about being able to classify people precisely based on their genome, lifestyle and medical susceptibilities to diseases, drugs and various foods. As the National Research Council has explained, “preventive or therapeutic interventions can then be concentrated on those who will benefit...” Precision medicine is about how personalized data can maximize the effect of disease treatment and prevention for each patient.
Read more: Exploring precision medicine's value: plans, providers are rolling out initiatives; government pledges new support.
What healthcare executives therefore need to understand about precision medicine is its incredible power to reduce risk and improve the overall health of populations who are susceptible to chronic disease. However, precision medicine is predicated upon the ability to manipulate a wide swath of personalized data that most providers and practitioners do not currently have at their disposal.
One of the most interesting use cases of precision medicine is its application for Type 2 diabetes. The disease we call “Type 2 diabetes” is arguably an amalgamation of a large number of specific conditions that together make up a much larger cohort called “diabetes sufferers.” Twenty nine million people in the U.S. suffer from Type 2 diabetes. Eighty million more Americans have prediabetes, meaning they are susceptible to developing the disease. Diabetes is therefore a continuum—your diabetes is not my diabetes. As such, the disease is the ideal proving ground for precision medicine.
It would be a big mistake to equate precision medicine solely with genomics data. Genomic precision is only one part of a more holistic view of a disease such as Type 2 diabetes and how it is interacting with an individual. The trick is being able to correlate genomic insights with environmental, behavioral, and medical factors. Your genes do not alone determine whether and when you get a disease, such as Type 2 diabetes, or how acutely you experience it. It is rather the unique combination of your genotype data and your phenotype data that we as providers and practitioners must account for. And so, any sufficient precision medicine initiative is only as precise as the data it collects.