The Evolution and Clinical Impact of Diagnostic Testing - Episode 2
Is there a distinction between the 1-size-fits-all approach and personalized medicine? David C. Collymore, MD, MBA, is certain there is.
“Medicine in general has evolved over time and 1-size-fits-all is an evidence-based approach that affects the population in general. While there has been a tremendous benefit to that over time, we have realized now that no 2 people are the same—this is not just with respect to expression of specific genes, but even differences based on ethnicities—realizing that certain medications may be more effective in specific populations.”
Dr Collymore explained that personalized medicine is definitely the next step and there have been enough scientific advances to prove the utility and cost effectiveness of the approach. “One-size-fits-all is the initial step and to get to the next step of quality of care and to ensure that we are providing the most effective treatment, for that individual, at that time, is what really makes sense,” said Dr Collymore.
While population health will remain a major focus of healthcare to treat disease processes and to improve overall outcomes, Dr Collymore thinks that personalized medicine will lead us to a more advanced stage of healthcare. “The biggest concern for everyone is ‘Am I at risk for a certain type of cancer?’ Personalized medicine—maybe not today—can get to a point where it can answer that question for a large percentage of our population,” he said.
Citing the example of a study that identified a reduced risk of colon cancer in individuals who took daily aspirin, Dr Collymore hypothesized that a personalized approach could help avoid gastrointestinal side effects of aspirin while reducing the risk of developing cancer. “The personalized approach to medicine and healthcare is in development. Despite great strides there is a lot more work to do to show effectiveness at the screening level as well as the treatment level,” he added.
The 1-size-fits-all approach is quickly becoming an antiquated model of thinking, and without the personalized approach, we would be decades behind in terms of treatment. According to Dr Collymore, if we get to a point in breast cancer care, for example, where the incidence of breast cancer or the incidence of treatment of breast cancer is significantly reduced because of personalized medicine, over time we’ll be able to see the impact on our entire healthcare landscape.