The current understanding of precision medicine and personalised medicine in selected research disciplines: study protocol of a systematic concept analysis

Brew‐Sam, Nicola; Parkinson, Anne; Lueck, Christian J.; Brown, Ellen; Brown, Karen; Brüstle, Anne; Chisholm, Katrina; Collins, Simone; Cook, Matthew C.; Daskalaki, Elena; Drew, Janet; Ebbeck, Harry; Elisha, Mark; Fanning, Vanessa; Henschke, Adam; Herron, Jessica R.; Matthews, Emma; Murugappan, Krishnan; Neshev, Dragomir N.; Nolan, Christopher; Pedley, Lachlan; Phillips, Christine; Suominen, Hanna; Tricoli, Antonio; Wright, Kristine; Desborough, Jane

doi:10.1136/bmjopen-2021-060326

Cited by 6 publications

(6 citation statements)

References 23 publications

(43 reference statements)

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“…Personalized medicine in pharmacotherapy, although not a new concept, is currently gaining interest not only by the medical community and other health professionals, but also by the scientific community and academic institutions [ 43 ]. TDM together with PopPK accurately support the design of pharmacotherapeutic schemes according to the specific characteristics of each patient and their pathological state.…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Analysis of Perampanel in Portuguese Patients Diagnosed with Refractory Epilepsy

et al. 2023

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Perampanel is a promising antiepileptic drug (AED) for refractory epilepsy treatment due to its innovative mechanism of action. This study aimed to develop a population pharmacokinetic (PopPK) model to be further used in initial dose optimization of perampanel in patients diagnosed with refractory epilepsy. A total of seventy-two plasma concentrations of perampanel obtained from forty-four patients were analyzed through a population pharmacokinetic approach by means of nonlinear mixed effects modeling (NONMEM). A one-compartment model with first-order elimination best described the pharmacokinetic profiles of perampanel. Interpatient variability (IPV) was entered on clearance (CL), while the residual error (RE) was modeled as proportional. The presence of enzyme-inducing AEDs (EIAEDs) and body mass index (BMI) were found as significant covariates for CL and volume of distribution (V), respectively. The mean (relative standard error) estimates for CL and V of the final model were 0.419 L/h (5.56%) and 29.50 (6.41%), respectively. IPV was 30.84% and the proportional RE was 6.44%. Internal validation demonstrated an acceptable predictive performance of the final model. A reliable population pharmacokinetic model was successfully developed, and it is the first enrolling real-life adults diagnosed with refractory epilepsy.

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Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Analysis of Perampanel in Portuguese Patients Diagnosed with Refractory Epilepsy

et al. 2023

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“…They automatically process unstructured text from publications, electronic health records or even clinical notes, extract information and by this facilitate interpretation 60. Finally, investigating language use in different research disciplines will add value to this direction, and a study protocol has announced focusing on this issue 61…”

Section: Discussionmentioning

confidence: 99%

“… 60 Finally, investigating language use in different research disciplines will add value to this direction, and a study protocol has announced focusing on this issue. 61 …”

Section: Discussionmentioning

confidence: 99%

Individualisation, personalisation and person-centredness in mental healthcare: a scoping review of concepts and linguistic network visualisation

Mayer,

Zafar,

Hummel

et al. 2023

BMJ Ment Health

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BackgroundTargeted mental health interventions are increasingly described as individualised, personalised or person-centred approaches. However, the definitions for these terms vary significantly. Their interchangeable use prevents operationalisations and measures.ObjectiveThis scoping review provides a synthesis of key concepts, definitions and the language used in the context of these terms in an effort to delineate their use for future research.Study selection and analysisOur search on PubMed, EBSCO and Cochrane provided 2835 relevant titles. A total of 176 titles were found eligible for extracting data. A thematic analysis was conducted to synthesise the underlying aspects of individualisation, personalisation and person-centredness. Network visualisations of co-occurring words in 2625 abstracts were performed using VOSViewer.FindingsOverall, 106 out of 176 (60.2%) articles provided concepts for individualisation, personalisation and person-centredness. Studies using person-centredness provided a conceptualisation more often than the others. A thematic analysis revealed medical, psychological, sociocultural, biological, behavioural, economic and environmental dimensions of the concepts. Practical frameworks were mostly found related to person-centredness, while theoretical frameworks emerged in studies on personalisation. Word co-occurrences showed common psychiatric words in all three network visualisations, but differences in further contexts.Conclusions and clinical implicationsThe use of individualisation, personalisation and person-centredness in mental healthcare is multifaceted. While individualisation was the most generic term, personalisation was often used in biomedical or technological studies. Person-centredness emerged as the most well-defined concept, with many frameworks often related to dementia care. We recommend that the use of these terms follows a clear definition within the context of their respective disorders, treatments or medical settings.Scoping review registrationOpen Science Framework: osf.io/uatsc.

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“…Terms such as ‘precision medicine’, ‘personalized medicine’ or ‘individualized treatment’ have exponentially been used in recent years. The definitions vary (Brew‐Sam et al., 2022) and it is beyond the scope of the present paper to discuss the terms in detail. However, we want to emphasize here that for NSLBP as a biopsychosocial problem, it does not suffice to apply the individualization to the pathology.…”

Section: Personalized Management Of Nslbpmentioning

confidence: 99%

Personalized assessment and management of non‐specific low back pain

Wirth,

Schweinhardt

2023

European Journal of Pain

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Background and ObjectiveLow back pain (LBP), and in particular non‐specific low back pain (NSLBP), which accounts for approximately 90% of LBP, is the leading cause of years lived with disability worldwide. In clinical trials, LBP is often poorly categorized into ‘specific’ versus ‘non‐specific’ and ‘acute’ versus ‘chronic’ pain. However, a better understanding of the underlying pain mechanisms might improve study results and reduce the number of NSLBP patients.Databases and Data TreatmentNarrative review.ResultsNSLBP is a multi‐dimensional, biopsychosocial condition that requires all contributing dimensions to be assessed and prioritized. Thereby, the assessment of the contribution of nociceptive, neuropathic and nociplastic pain mechanisms forms the basis for personalized management. In addition, psychosocial (e.g. anxiety, catastrophizing) and contextual factors (e.g. work situation) as well as comorbidities need to be assessed and individually weighted. Personalized treatment of NSLBP further requires individually choosing treatment modalities, for example, exercising, patient education, cognitive‐behavioural advice, pharmacotherapy, as well as tailoring treatment within these modalities, for example, the delivery of tailored psychological interventions or exercise programs. As the main pain mechanism and psychosocial factors may vary over time, re‐assessment is necessary and treatment success should ideally be assessed quantitatively and qualitatively.ConclusionsThe identification of the main contributing pain mechanism and the integration of the patients' view on their condition, including beliefs, preferences, concerns and expectations, are key in the personalized clinical management of NSLBP. In research, particular importance should be placed on accurate characterization of patients and on including outcomes relevant to the individual patient.Significance StatementHere, a comprehensive review of the challenges associated with the diagnostic label ‘non‐specific low back pain’ is given. It outlines what is lacking in current treatment guidelines and it is summarized what is currently known with respect to individual phenotyping. It becomes clear that more research on clinically meaningful subgroups is needed to best tailor treatment approaches.

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The current understanding of precision medicine and personalised medicine in selected research disciplines: study protocol of a systematic concept analysis

Cited by 6 publications

References 23 publications

Population Pharmacokinetic Analysis of Perampanel in Portuguese Patients Diagnosed with Refractory Epilepsy

Population Pharmacokinetic Analysis of Perampanel in Portuguese Patients Diagnosed with Refractory Epilepsy

Individualisation, personalisation and person-centredness in mental healthcare: a scoping review of concepts and linguistic network visualisation

Personalized assessment and management of non‐specific low back pain

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