What’s in a Name? The Evolution of “P-Medicine”
The current paradigm of modern healthcare is a reactive response to patient symptoms, subsequent diagnosis and corresponding treatment of the specific disease(s). This approach is predicated on methodologies first espoused by the Cnidean School of Medicine ~2500 years ago. More recently a rapid improvement in OMIC analyses, bioinformatics and knowledge management tools, as well as the emergence of big data analytics, and systems biology has led to a better understanding of the profound, dynamic complexity and variability of individuals and human populations in their daily activities. These developments in conjunction with escalating healthcare costs and relatively poor disease treatment efficacies have fermented a rethink in how we carry out such medical practices. This has led to the emergence of “P-Medicine”. The initial wave was in the form of Personalized Medicine, which encompasses elements of preventive, predictive, and pharmacotherapeutic medicine and focuses on methodologies and data output tailored to a person’s unique molecular, biochemical, physiological and pathobiological profile. Personalized Medicine is still in a fledgling and evolutionary phase and there has been much debate over its current status and future prospects. A confounding factor has been the sudden development of Precision Medicine which has also joined the P-Medicine “revolution” and currently has captured the imagination of policymakers responsible for modern medical practice. There is some confusion over the terms Personalized versus Precision Medicine. Here we attempt to define the key components of P-Medicine and provide working definitions, as well as a practical relationship tree. The development and growth of P-Medicine and its impact on the healthcare system as well as the individual patient will be fueled by the informed and knowledgeable consumer as well as the thoughtful clinician armed with the right tools and technologies and approach to deal with the complexity of disease diagnosis, onset, progression, treatment, prognosis, and outcome.