What is personalized medicine: sharpening a vague term based on a systematic literature review

Abstract

BackgroundRecently, individualized or personalized medicine (PM) has become a buzz word in the academic as well as public debate surrounding health care. However, PM lacks a clear definition and is open to interpretation. This conceptual vagueness complicates public discourse on chances, risks and limits of PM. Furthermore, stakeholders might use it to further their respective interests and preferences. For these reasons it is important to have a shared understanding of PM. In this paper, we present a sufficiently precise as well as adequate definition of PM with the potential of wide acceptance.MethodsFor this purpose, in a first step a systematic literature review was conducted to understand how PM is actually used in scientific practice. PubMed was searched using the keywords “individualized medicine”, “individualised medicine”, “personalized medicine” and “personalised medicine” connected by the Boolean operator OR. A data extraction tabloid was developed putting forward a means/ends-division. Full-texts of articles containing the search terms in title or abstract were screened for definitions. Definitions were extracted; according to the means/ends distinction their elements were assigned to the corresponding category. To reduce complexity of the resulting list, summary categories were developed inductively from the data using thematic analysis. In a second step, six well-known criteria for adequate definitions were applied to these categories to derive a so-called precising definition.ResultsWe identified 2457 articles containing the terms PM in title or abstract. Of those 683 contained a definition of PM and were thus included in our review. 1459 ends and 1025 means were found in the definitions. From these we derived the precising definition: PM seeks to improve stratification and timing of health care by utilizing biological information and biomarkers on the level of molecular disease pathways, genetics, proteomics as well as metabolomics.ConclusionsOur definition includes the aspects that are specific for developments labeled as PM while, on the other hand, recognizing the limits of these developments. Furthermore, it is supported by the quantitative analysis of PM definitions in the literature, which suggests that it it is widely acceptable and thus has the potential to avoid the above mentioned issues.

Person Centered Care and Personalized Medicine: Irreconcilable Opposites or Potential Companions?

“…This subsequent analysis presented some challenges, as PCC and PM are vague concepts [5,9,18,23,40,41], creating difficulties to determine which ideas in the literature are truly central to either concept and which merely relate to some practical implementation thought (rightly or wrongly) to exemplify PCC or PM. At the same time, a few central themes of the respective notions, sometimes presented separately from one another or expressed differently by different authors, appeared in the material.…”

Pounamu: Integration of kaupapa Mãori concepts in health research: a way forward for Mãori cardiovascular health?

“…Personalised medicine aspires to create efficient and effective care by tailoring evidence-based interventions to individuals. 10 Personalised medicine remains largely focussed on people's physical aspects. Although patient-centred, personalised medicine does not readily accommodate cultural, environmental, sociologic or spiritual based dimensions of health.…”

The integration of genomics testing and functional proteomics in the era of personalized medicine

“…Personalized medicine is defined as a medical system that uses NGS-based tests and/or other omics tests to select the appropriate treatment for individual patients [1,2] or that utilizes clinical tests on disease-causing signaling networks, genomics, proteomics, and metabolomics to improve the stratification and timing of health care [3]. The relatively higher costs associated with personalized medicine are necessary to maximize the benefits and minimize the adverse effects of therapeutics in individual patients because genetic and environmental factors regulate pathophysiology in a context-dependent manner.…”