Precision Medicine and ICU Care
Innovations in technology have made the world more personalized. Although much of this innovation is led by marketing endeavors, personalization is a rising trend in all industries – including healthcare.
Hospitals have always tried to provide personalized care by maintaining thorough records of their patients. However, patient records have been limited to the basic information provided by patients and any data collected from examinations and procedures. Furthermore, most of this data relies on identifying signs and symptoms after they’ve occurred. With modern technology at hand, healthcare practitioners are now looking for ways to gather data that anticipates problems before they show up in a routine physical.
The Importance of Individual Data
Western medicine has proven to be the most successful form of medicine for keeping large populations of people alive. It has cured diseases that wiped out thousands in the past and this has resulted in the longest life expectancy of all time.
However, the next step in improving healthcare is the application of individual data, such as genetic information from DNA testing. While we’ve done a tremendous job of figuring out what works for most people most of the time, the next step is figuring out what works best for each individual. In striving to do so, the next step is a shift towards Precision Medicine.
What is Precision Medicine?
Precision Medicine (PM) is a medical approach that customizes all aspects of healthcare to the specific traits and needs of the individual. Precision Medicine exists to treat individuals with the exact drug protocols and procedures for their ailments based on their genetic makeup, current symptoms, current test results and medical history.
Three Current Precision Medicine Programs:
- The Precision Medicine Initiative Cohort Program – This $130 million program seeks to enroll over 1 million Americans in the next three or four years to study their ongoing health records for individual responses to different types of drugs, monitor their risk for specific diseases, and assess general health factors.
- National Cancer Institute-Molecular Analysis for Therapy Choice (NCI-Match) Trial – This program will enroll about 1,000 people with tumors that are unresponsive to standard cancer treatments in an effort to match specific types of tumors with specific medicines. The goal is to identify medicines with better outcomes based on genetic markers.
- The Wisdom Study – By medical standards, mammogram screenings are slightly unreliable with about 5-10% of women receiving false positive readings. The Wisdom Study, led by UCSF, will study around 100,000 women 40 to 80 years old to find a more targeted approach to identifying breast cancer.
In addition to the programs listed above and the others underway, we expect to see a lot more Precision Medicine studies conducted over the next decade as healthcare improves the individualized approach to patient care and disease prevention.
Precision Medicine and Critical Care
Everything is amplified in the ICU because patients are often in a critical state and there’s far less room for medical errors – whether they are a result of human error or lack of information. The ICU stands to benefit greatly from Precision Medicine. With an improved ability to predict which treatment methods will work for specific patients and a better understanding of disease mechanisms and their prevention, ICU treatment can become more effective. A long term benefit for the entire field of medicine lies in precise registries that will contribute to a comprehensive database for treatment and future research.
For example, community-acquired pneumonia (CAP) remains one of the most common causes of death worldwide and mortality rates for CAP patients who end up in the ICU range from 19% to 50%. It is widely accepted that clinical judgment is insufficient to assess disease severity, making CAP especially challenging to treat. However, a genome-wide association study of survivors of sepsis due to pneumonia demonstrated that common variants in the FER gene are strongly associated with survival, which explains why certain patients with low bacterial burden are still susceptible to fatal outcomes.
Providing more accuracy to the treatment of just this one disease could save millions of lives and allow ICU doctors and nurses to provide the highest level of care possible.
In the same spirit as Precision Medicine, Elcam Safety aims to improve healthcare on an individual level by providing tools that are safer for patients and practitioners. Especially in the ICU where a lot is happening at once, nurses and doctors need tools that can be adapted to a variety of treatment protocols with minimal risk for air embolism, needle sticks, or disconnections.
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