Precision medicine: From one-size-fits-all to personalized healthcare

Scientist pipetteAdvances in technology are essential if precision medicine is going to become reality.

Imagine a future in which, rather than using symptoms to identify a disease, your genes, metabolism, and gut microbiome inform how your individual health is managed. This is the vision of precision medicine.

Traditional medicine uses symptoms to diagnose diseases, and drugs to treat these symptoms. But precision medicine aims to turn this concept on its head.

By identifying the factors that predispose a person to a particular disease and the molecular mechanisms that cause the condition, treatment and prevention strategies can be tailored to each individual. 

So, how do we get from traditional to precision medicine? Advances in genetics and molecular analysis techniques have been a deciding factor, as has getting patients involved with managing their own health.

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Beyond privacy concerns: Interactive gadgets can pose threat to children’s psychology

Children, who are learning what’s appropriate social interaction, can be affected more than adults by the human-computer relationship that’s becoming more commonplace in homes. In other public health news: early menopause, the shingles vaccine, fatty liver disease, racism, and gun safety.

NPR: Parenting in the age of Alexa, are artificial intelligence devices safe for kids?
Earlier this month, the toy-giant Mattel announced it had pulled the plug on plans to sell an interactive gadget for children. The device, called Aristotle, looked similar to a baby monitor with a camera. Critics called it creepy. Powered by artificial intelligence, Aristotle could get to know your child — at least that was how the device was being pitched. (Doucleff and Aubrey, 10/30)

The New York Times: Underweight women at risk of early menopause
Underweight women are at increased risk for early menopause, a new study has found. This study, in Human Reproduction, followed 78,759 premenopausal women ages 25 to 42 beginning in 1989. Over the following 22 years, 2,804 of them reported natural menopause before age 45. (Bakalar, 10/26)

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Amazon is poised to enter Pharma landscape — so what will that look like?

Stat: Who wins and who loses if Amazon enters the prescription drug business

Will pharma be the next business Amazon disrupts?In industry after industry, the company has turned practices and expectations inside out — and the pharmaceutical world is the latest poised for change as speculation mounts that Amazon will soon start selling prescription medicines. Anticipation has been building for months, in fact, but it heightened last week on the news that Amazon (AMZN) obtained wholesale pharmacy licenses in at least a dozen states. (Silverman, 10/30)

Bloomberg: Amazon’s ambitious October spooks stocks standing in its path
The looming threat of Amazon.com Inc. siphoned billions in market cap from Under Armour Inc. to FedEx Corp. to Walgreens Boots Alliance Inc. — more than $30 billion combined — in October. Companies are gearing up to face Bezos’s behemoth heading into the holiday season, with some appearing ready to get creative as the state of their industries is shaken. (Smith, 10/31)

The New York Times: The more lavish the gifts to doctors, the costlier the drugs they prescribe
When drug companies give gifts to doctors, the doctors prescribe more — and more expensive — drugs. The more lavish the gifts, the greater the effect. Researchers used data from the Center for Medicaid and Medicare Services on the prescriptions written by doctors in Washington, and information from the D.C. Department of Health on gifts from pharmaceutical and medical device companies given to providers in 2013. (Bakalar, 10/25)

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app,Carnegie Mellon University,Magee-Womens Hospital,Medical Internet Research mHealth and uHealth,neonatal death,preterm birth

Novel app developed to combat preterm birth

Maternal-fetal medicine specialists at Magee-Womens Hospital of UPMC collaborated with decision scientists at Carnegie Mellon University (CMU) to develop and test a personalized smartphone application designed to combat preterm birth by engaging a typically hard-to-reach population of pregnant women. The findings, reported in the Journal of Medical Internet Research mHealth and uHealth, indicate that the app was successful in providing accessible and personalized obstetrical care, designed specifically to target preterm birth risk.

Preterm birth, the leading cause of neonatal death or long-term disability, is on the rise in the United States with approximately one of every 10 births occurring prior to 37 weeks of gestation. These rates are disproportionately high among some socioeconomic groups, including African Americans and families living in poverty. These patient groups often are the hardest to reach due to limited access to and attendance at routine prenatal care.

“Mobile phone apps are a great way to engage a vulnerable population in their health care because approximately 86 percent of American adults own a mobile phone, regardless of racial and ethnic groups,” explained Tamar Krishnamurti, Ph.D., lead author and assistant research professor of engineering and public policy at CMU. “Moreover, 20 percent of all smartphone owners downloaded a pregnancy app in 2015. Although hundreds of pregnancy-related apps exist, few have been developed through a scientific process that is patient-centered and grounded in behavioral decision research.”

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CRISPR,CRISPR-Cas9,Jian-Hua Luo,MAN2A1-FER,University of Pittsburgh School of Medicine

Novel gene editing approach to cancer treatment shows promise in mice

A novel gene therapy using CRISPR genome editing technology effectively targets cancer-causing “fusion genes” and improves survival in mouse models of aggressive liver and prostate cancers, University of Pittsburgh School of Medicine researchers report in a study published online in Nature Biotechnology.

“This is the first time that gene editing has been used to specifically target cancer fusion genes. It is really exciting because it lays the groundwork for what could become a totally new approach to treating cancer,” explained lead study author Jian-Hua Luo, M.D., Ph.D., professor of pathology at Pitt’s School of Medicine and director of its High Throughput Genome Center.

Fusion genes, which often are associated with cancer, form when two previously separate genes become joined together and produce an abnormal protein that can cause or promote cancer.

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Congressional Budget Office,Harvard Medical School,RAND Corporation,telemedicine

Use of telemedicine for mental health in rural areas on the rise but uneven

Newly published research by Harvard Medical School and the RAND Corporation reveals a dramatic growth in the use of telemedicine for the diagnosis and treatment of mental health disorders in rural areas, but strikingly uneven distribution of services across states.

The results, published in Health Affairs, stem from analysis of telemedicine use among Medicare beneficiaries nationwide over10 years.

The study shows an average 45 percent jump per year in telemedicine visits between 2004 and 2014, among rural patients, with striking variation across states. Four states had no such visits in 2014, while in nine states, there were more than 25 telemedicine visits per 100 patients with serious mental illness.

The reasons for the dramatically uneven distribution remain unclear, but the study investigators say state laws that regulate the provision and reimbursement of telemedicine services for mental health appear to play some role.

“Our results highlight the growing importance of telemedicine in the treatment of mental health disorders in rural settings where access to mental health care is often problematic,” said study lead investigator Ateev Mehrotra, associate professor in the Department of Health Care Policy at Harvard Medical School.

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Modern Healthcare,Stat,The New York Times,Vanderbilt University Medical Center

This technology may allow computers to sniff out diseases

Patients give off a unique odor that can hold clues to any medical problems going on in their bodies, but it can’t be detected easily by humans. Also in technology news, doctors ponder the future of artificial intelligence and the role it has to play in medicine, and a look at Vanderbilt University Medical Center’s roll out of its new electronic health record system.

The New York Times: One day, a machine will smell whether you’re sick
Blindfolded, would you know the smell of your mom, a lover or a co-worker? Not the smells of their colognes or perfumes, not of the laundry detergents they use — the smells of them? Each of us has a unique “odorprint” made up of thousands of organic compounds. These molecules offer a whiff of who we are, revealing age, genetics, lifestyle, hometown — even metabolic processes that underlie our health. (Murphy, 5/1)

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"chemical imaging" system,'Volumetric' imaging method,Purdue University's Weldon School of Biomedical Engineering,stimulated Raman projection microscopy and tomography

‘Volumetric’ imaging method reveals chemical content, might lead to systems that eliminate need to draw blood for lab tests

A “chemical imaging” system that uses a special type of laser beam to penetrate deep into tissue might lead to technologies that eliminate the need to draw blood for analyses including drug testing and early detection of diseases such as cancer and diabetes.

The system, called stimulated Raman projection microscopy and tomography, makes possible “volumetric imaging” without using fluorescent dyes that might affect biological functions and hinder accuracy, said Ji-Xin Cheng, a professor in Purdue University’s Weldon School of Biomedical Engineering, Department of Chemistry and Birck Nanotechnology Center.

“Volumetric chemical imaging allows a better understanding of the chemical composition of three-dimensional complex biological systems such as cells,” he said.

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cerebral palsy,multiple sclerosis,Rady Children's Hospital,Sensor-filled glove,stroke,University of California San Diego

Sensor-filled glove could help doctors take guesswork out of physical exams

Everyone experiences stiff muscles from time to time, whether after a rigorous workout, in cold weather, or after falling asleep in an unusual position. People with cerebral palsy, stroke and multiple sclerosis, however, live with stiff muscles every single day, making everyday tasks such as extending an arm extremely difficult and painful for them. And since there isn’t a foolproof way to objectively rate muscle stiffness, these patients often receive doses of medication that are too low or too high.

Now, an interdisciplinary team of researchers at the University of California San Diego and Rady Children’s Hospital has developed new wearable sensors and robotics technology that could be used to accurately measure muscle stiffness during physical exams. “Our goal is to create a system that could augment existing medical procedures by providing a consistent, objective rating,” said Harinath Garudadri, a research scientist at the university’s Qualcomm Institute and the project’s lead investigator.

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cancer,computer-assisted music,Music therapy,personalized diagnostics,Sync Project,Wearable gadgets

Will these three innovations change your clinical practice?

Wearable gadgets, personalized diagnostics, and computer-assisted music: the world of healthcare technology aims to improve the patient experience, contribute to long-term health outcomes and, ultimately, make it easier for physicians to deliver care. What’s new and in the pipeline in 2017? Medical News Today report from the recent WIRED Health conference in London, United Kingdom.
[Physician with medical technology]
How can healthcare professionals harness the latest technological advancements to help their patients?

One of the recurring themes woven into the speakers’ sessions was placing the patient at the center of care.

Despite the rapidly advancing pace of technological innovation, many of the health problems faced by the wider population persist. In light of this, how can innovative technology be harnessed to help each patient and their individual needs?

Microlevel focus is key in fighting sickness and disease, and this means finding a way to look at the individual.

Whether you are looking for new ways to address your type 2 diabetes patients’ care, are interested in the world of personalized molecular diagnostics for cancer, or just want to recommend some soothing music for your patients’ anxiety and pain, Medical News Today report on some of the technological innovations that could change patient care.

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