The Net Benefit of Personalized Medicine: A Systematic Literature Review and Regression Analysis

Vellekoop, Heleen; Versteegh, Matthijs; Huygens, Simone; Ramos, Isaac Corro; Szilberhorn, László; Zelei, Tamás; Nagy, Balázs; Tsiachristas, Apostolos; Koleva-Kolarova, Rositsa; Wordsworth, Sarah; Mölken, Maureen Rutten-van

doi:10.1016/j.jval.2022.01.006

Cited by 18 publications

(18 citation statements)

References 32 publications

(44 reference statements)

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“…Using a different metric, the “net monetary benefit” (NMB) of precision medicine, similar outcomes were identified. 80 in the large heterogeneity across conditions in upper-middle- or high-income countries, with the greatest benefit in cancer, yet still at a high cost to improve health. As was illustrated in this and other analyses, there is difficulty in assessing cost-effectiveness thresholds in each country, in part due to limited data, difference in perspectives of what the threshold represents (society’s willingness to pay for increases in health versus the cost of health care spending), and how the threshold should be calculated.…”

Section: Cost Effectiveness Of Precision Medicinementioning

confidence: 99%

Precision Medicine in Type 1 Diabetes

et al. 2023

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Type 1 diabetes is a complex, chronic disease in which the insulin-producing beta cells in the pancreas are sufficiently altered or impaired to result in requirement of exogenous insulin for survival. The development of type 1 diabetes is thought to be an autoimmune process, in which an environmental (unknown) trigger initiates a T cell-mediated immune response in genetically susceptible individuals. The presence of islet autoantibodies in the blood are signs of type 1 diabetes development, and risk of progressing to clinical type 1 diabetes is correlated with the presence of multiple islet autoantibodies. Currently, a “staging” model of type 1 diabetes proposes discrete components consisting of normal blood glucose but at least two islet autoantibodies (Stage 1), abnormal blood glucose with at least two islet autoantibodies (Stage 2), and clinical diagnosis (Stage 3). While these stages may, in fact, not be discrete and vary by individual, the format suggests important applications of precision medicine to diagnosis, prevention, prognosis, treatment and monitoring. In this paper, applications of precision medicine in type 1 diabetes are discussed, with both opportunities and barriers to global implementation highlighted. Several groups have implemented components of precision medicine, yet the integration of the necessary steps to achieve both short- and long-term solutions will need to involve researchers, patients, families, and healthcare providers to fully impact and reduce the burden of type 1 diabetes.

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Section: Cost Effectiveness Of Precision Medicinementioning

confidence: 99%

Precision Medicine in Type 1 Diabetes

et al. 2023

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“…Cardiovascular stents have experienced remarkable development, because of technological advances in the field of biocompatible materials and different manufacturing methods and have been enhanced by artificial intelligence (Borhani et al , 2018; Hoare et al , 2019; Pan et al , 2021; Udriste et al , 2021; Fu et al , 2022; Solórzano-Requejo et al , 2023; Vellekoop et al , 2022; Wu et al , 2023).…”

Section: Introductionmentioning

confidence: 99%

3D printing of personalised stents using new advanced photopolymerizable resins and Ti-6Al-4V alloy

Baila,

Sanfilippo,

Savu

et al. 2024

RPJ

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Purpose The development of new advanced materials, such as photopolymerizable resins for use in stereolithography (SLA) and Ti6Al4V manufacture via selective laser melting (SLM) processes, have gained significant attention in recent years. Their accuracy, multi-material capability and application in novel fields, such as implantology, biomedical, aviation and energy industries, underscore the growing importance of these materials. The purpose of this study is oriented toward the application of new advanced materials in stent manufacturing realized by 3D printing technologies. Design/methodology/approach The methodology for designing personalized medical devices, implies computed tomography (CT) or magnetic resonance (MR) techniques. By realizing segmentation, reverse engineering and deriving a 3D model of a blood vessel, a subsequent stent design is achieved. The tessellation process and 3D printing methods can then be used to produce these parts. In this context, the SLA technology, in close correlation with the new types of developed resins, has brought significant evolution, as demonstrated through the analyses that are realized in the research presented in this study. This study undertakes a comprehensive approach, establishing experimentally the characteristics of two new types of photopolymerizable resins (both undoped and doped with micro-ceramic powders), remarking their great accuracy for 3D modeling in die-casting techniques, especially in the production process of customized stents. Findings A series of analyses were conducted, including scanning electron microscopy, energy-dispersive X-ray spectroscopy, mapping and roughness tests. Additionally, the structural integrity and molecular bonding of these resins were assessed by Fourier-transform infrared spectroscopy–attenuated total reflectance analysis. The research also explored the possibilities of using metallic alloys for producing the stents, comparing the direct manufacturing methods of stents’ struts by SLM technology using Ti6Al4V with stent models made from photopolymerizable resins using SLA. Furthermore, computer-aided engineering (CAE) simulations for two different stent struts were carried out, providing insights into the potential of using these materials and methods for realizing the production of stents. Originality/value This study covers advancements in materials and additive manufacturing methods but also approaches the use of CAE analysis, introducing in this way novel elements to the domain of customized stent manufacturing. The emerging applications of these resins, along with metallic alloys and 3D printing technologies, have brought significant contributions to the biomedical domain, as emphasized in this study. This study concludes by highlighting the current challenges and future research directions in the use of photopolymerizable resins and biocompatible metallic alloys, while also emphasizing the integration of artificial intelligence in the design process of customized stents by taking into consideration the 3D printing technologies that are used for producing these stents.

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“…In parallel, evidence about long-term value-for-money to ensure the sustainable implementation of personalised oncology as part of standard of care is necessary and expected for payers. A number of examples exist in developed and developing countries where attempts are being made to scale adoption of personalised oncology into routine care (Delnord et al, 2022 ; Liu et al, 2022 ; Vellekoop et al, 2022 ; Fasola et al, 2023 ; Stark et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm

Lajmi,

Alves-Vasconcelos,

Tsiachristas

et al. 2024

Camb. prisms Precis. med.

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The personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outcomes across all cancer types, financial, technological and operational barriers need to be addressed. For example, complete integration and certification of the ‘molecular tumour board’ into ‘standard of care’ ensures a unified clinical decision pathway that both counteracts fragmentation and is the cornerstone of evidence-based delivery inside and outside of a research setting. Generally, integrated delivery has been restricted to specific (common) cancer types either within major cancer centres or small regional networks. Here, we focus on solutions in real-world integration of genomics, pathology, surgery, oncological treatments, data from clinical source systems and analysis of whole-body imaging as digital data that can facilitate cost-effectiveness analysis, clinical trial recruitment, and outcome assessment. This urgent imperative for cancer also extends across the early diagnosis and adjuvant treatment interventions, individualised cancer vaccines, immune cell therapies, personalised synthetic lethal therapeutics and cancer screening and prevention. Oncology care systems worldwide require proactive step-changes in solutions that include inter-operative digital working that can solve patient centred challenges to ensure inclusive, quality, sustainable, fair and cost-effective adoption and efficient delivery. Here we highlight workforce, technical, clinical, regulatory and economic challenges that prevent the implementation of precision oncology at scale, and offer a systematic roadmap of integrated solutions for standard of care based on minimal essential digital tools. These include unified decision support tools, quality control, data flows within an ethical and legal data framework, training and certification, monitoring and feedback. Bridging the technical, operational, regulatory and economic gaps demands the joint actions from public and industry stakeholders across national and global boundaries.

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The Net Benefit of Personalized Medicine: A Systematic Literature Review and Regression Analysis

Cited by 18 publications

References 32 publications

Precision Medicine in Type 1 Diabetes

Precision Medicine in Type 1 Diabetes

3D printing of personalised stents using new advanced photopolymerizable resins and Ti-6Al-4V alloy

Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm

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