未来医学:个性化、分层还是精准?(文献综述)

Q4 Medicine
Igor S. Dоlgopolov, M. Rykov
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引用次数: 0

摘要

“个性化”医学是基于这样一种信念,即每个人都有独特的分子、生理、环境和行为特征,在疾病发展的情况下,每个病人的治疗都应该考虑到这些独特的特征。这一信念在一定程度上得到了最新技术的证实,例如DNA测序、蛋白质组学、成像协议和使用无线设备进行健康监测,这些技术揭示了巨大的个体间差异。目的:证实个性化的方法将在未来的医学中使用。文献来源(科学文章)进行了搜索,包括发表在Pubmed、WoS、Scopus、Global Health、CyberLeninka和Russian Science Citation Index等同行评议期刊上的文献。我们分析了72篇关于个性化医疗的文章,其中51篇纳入了本综述。这篇综述包括了关于个性化医疗的文章,这些文章主要是在过去10年里发表的,主题是肿瘤学、遗传学,以及考虑这一问题的法律、人口和社会方面的文章。从分析中排除了致力于个性化医疗的哲学方面,使用计算机和无线技术进行数据处理和通信的文章。讨论了历史先例、在实践中实施的一些立法和政策方面、使其成为可能的新技术、一些新的经验(包括成功和失败)、测试和使用个体化药物的方法以及未来的方向,包括治疗有生育和不孕症问题的人的潜在方法。提出了“个性化”医疗存在的局限性。由于“个性化”医疗的各个方面根植于生物学现实,在某些情况下,医疗实践的个性化可能是不可避免的。结论。随着技术的发展和经验的积累,个体化治疗变得更加有效和经济。为了使各利益攸关方接受"个性化"医疗并开始按这种模式运作,有必要制定和实施更有效的战略,在各个阶段对保健专业人员进行教育和培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medicine of the future: personalized, stratified or precision? (literature review)
“Personalized” medicine is based on the belief that each person has unique molecular, physiological, environmental and behavioral characteristics, and in case of development of the disease, each patient should be treated taking into account these unique characteristics. This belief was to some extent confirmed by the use of the latest technologies, such as DNA sequencing, proteomics, imaging protocols and the use of wireless devices for health monitoring, which revealed large inter-individual differences. The purpose: to substantiate a personalized approach will be used in the medicine of the future. Literary sources (scientific articles) were searched, including those published in peer-reviewed journals indexed in Pubmed, WoS, Scopus, Global Health, CyberLeninka, and the Russian Science Citation Index. Seventy two articles devoted to personalized medicine were analyzed, of which 51 are included in this review. The review included articles on personalized medicine, published mainly over the past 10 years on the topics of oncology, genetics, and articles considering the legal, demographic and social aspects of this problem. From the analysis were excluded articles devoted to the philosophical aspects of personalized medicine, the use of computer and wireless technologies for data processing and communication. Historical precedents, some legislative and policy aspects of its implementation in practice, new technologies that make it possible, some new experiences including successes and failures, ways of testing and using individualized drugs, and future directions, including potential ways of treating people with problems concerning fertility and infertility are considered. The existing limitations of “personalized” medicine are presented. Since aspects of “personalized” medicine are rooted in biological realities, individualization of medical practice in certain cases is probably inevitable. Conclusion. With the development of technology and the accumulation of experience, an individual approach to the patient becomes more effective and cost-effective. In order for the various stakeholders to embrace “personalized” medicine and begin operating in this paradigm, it is necessary to develop and implement more effective strategies for the education and training of health professionals at all stages.
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