Preventive , predictive and perzonalized medicine Current status amd perspectives of education in the Czech Republic

1. Preventive, predictiveandperzonalizedmedicineCurrent status amdperspectivesofeducationin theCzechRepublic O.Topolčan, Š. Svobodová, H.Rosolová Medical Faculty nad Faculty Hospital Pilsen Czech Republic

2. Preventive medicine education in the Czech Republic • Pre-gradual • Medical faculties • 3 faculties – obligatory subject • 4 faculties - elective subject • Other universities • Bachelor studies • Master studies • Post-gradual • Medical faculties • Courses for PGS students • Czech Medical Society • Preventive medicine society • Other medical societies • Special events • Ministry of Health • Doctoral studies in individual study programs • Grant projects policy • Special events

3. Background for education • Prevention • Epidemiology data • Population studies of risk factors • Data based on diseases dispensarization • Prevention based on biomarkers missing !! • For research only ! • Prediction • No distinction between prediction and prognosis • Prognosis well established • Prediction with limitation, particularly in: • Cardiology • Oncology

4. Background for education ofpersonalized medicine • Research only • Universities • Research institutes • Czech Academy of Science • Missing interdisciplinary cooperation with: • Individual sujects • Routine health care practice • Health care insurance company • Methods launched • Proteomic • Genomics • Biomarkers Methods training is performed in: • Special courses • Cooperation with diagnostic or pharmaceutical company

5. Existující preventivní postupy v ČR – využívající biomarkery • Primární a sekundární prevence kardiovaskularních chorob - koncensus 11 odborných společností • Sreening Downova syndromu a vrozených vývojových vad – společné doporučení biochemické společnosti, imunoanalytické, genetické a gynekologické • Diagnostika poruch funkce štítné žlázy v těhotenství- společné doporučení biochemické, endokrinologické, imunoanalytické, gynekologické a všeobecné zdravotní pojišťovny • Časná diagnostika karcinomu prostaty pomocí PSA – doporučený postup imunoanalytické, biochemické, urologické, sekce praktických lékařů a všeobecné zdravotní pojišťovny – sponzorováno fy Abbott

6. Perspectives of education • Information sources • Network organization between national and international institutes • Optimal method overview • List and characteristic of biomarkers • Recommended guidelines proposal

7. Education qualification • National educational program – at least 1 faculty per one state • Links between research and education • Specialization of faculties in individual states • Lectures and books exchange between the states • Uniform web site for education at www.epma.net • Links between universities - pharmaceutical companies – health care insurance companies

8. Education and research on biomarkers • Re-evaluation of current biomarkers relevance for multidisciplinary connection • E.g. Inflammatory markers are related to atherosclerosis, cancer, autoimmunity, degenerative factors • Re-evaluate the relevance of biomarkers, based on the latest knowledge • E.g. osteoptegrinwas used as a marker of bone metabolism, currently it is a trigger marker of angiogenesis • Evaluate biomarkers not individually, but complexly, i.e. Not a typical marker for disease, but for disequilibrium- multifactorial analysis evaluation