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Author: Walter Fierz Presented by Xiaomin Xu For Journal Club on Sep.13,2005

Challenge of personalized health care: To what extent is medicine already individualized and what are the future trends?. Author: Walter Fierz Presented by Xiaomin Xu For Journal Club on Sep.13,2005. Backgound. Before the advent of scientific medicine Lack of standardization

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Author: Walter Fierz Presented by Xiaomin Xu For Journal Club on Sep.13,2005

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  1. Challenge of personalized health care: To what extent is medicine already individualized and what are the future trends? Author: Walter Fierz Presented by Xiaomin Xu For Journal Club on Sep.13,2005

  2. Backgound • Before the advent of scientific medicine • Lack of standardization • Individualize medical care • Introduction of the scientific medicine • Personal aspects of treatment were endangered • Challenge: regain individualism on a scientific basis

  3. Personalized medicine • Occurred at post-genomic era • Individualized medicine is not new • New are: Molecular diagnostics based on comprehensive and high-throughput genetic testing & pharmacogenomics • Focus of this article: infectious diseases and clinical immunological disorders

  4. Six dimensions of PM • Disease: disease evolution • Environment: the infecting microbe • Genes: the molecular traits and mechanisms underlying the individual characteristics of both the patient and the microbe

  5. Six dimensions of PM (Cont.) • Medication: drug development • Health care: health-care process • Information management: patient-specific and knowledge-based • Properties along these six dimensions are not independent from each other

  6. Individual character of infectious diseases • Interaction between host and microbes is very individual • Individuality: based on many factors • Molecular technology has been introduced into the third dimension

  7. Individual character of immune responses • Innate immune system and adaptive immune system both show high degree of polymorphism • Overwhelming complexity of the immune system make personalizing prevention and treatment difficult

  8. Within health care process • Personalized medicine and patient-centered care are mutually supportive. • Put emphasis on the integration of disparate personalized medical approaches and on the integration of fragmented personal records. • Personalized information management • Clinical laboratory should provide electronic links between personal lab data and electronic information from digital libraries and databases.

  9. Social and ethical risks • Personal values are at stake: privacy, protection of minorities, prevention of discrimination • Regulation: • Inform consent in the diagnostic process • Clinical lab as trusted intermediaries • Legal protection • Protect genetic minorities • Rational and irrational discrimination

  10. Conclusions • Personalized medicine is promising • Challenge is to adapt the health-care process to the needs of personalized medicine and to cope with its social risks

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