Talk:Personalized medicine

message: It seems to make sense to merge the Precision medicine article into this one as both articles make reference to the fact that the terms are used interchangeably, albeit with some groups arguing that there are slight nuances between the terms. Many key sources (see refs in intro to this article) point out how the two phrases overlap and are used to mean the same thing and as thinking develops in this area this shared use is growing.
If both articles need to explain this link and how the topics are connected, and point out that many people use the terms interchangably, it makes sense to have the content all in one place.
Thoughts welcome....
Jpmaytum (talk) 09:53, 7 January 2016 (UTC)
replies: text:  As there seems no consensus for the merge, I'm closing this now. Chiswick Chap (talk) 13:21, 7 January 2017 (UTC)
replies: text: , , , , , any change in thoughts? I was reading this article and saw: One of those tools is “precision medicine,” a term the National Research Council, which leads the Precision Medicine Initiative with the National Institutes of Health (NIH) and other research centers, prefers over the older term, “personalized medicine,” Smartt said. Haven't dug in enough to find out if this characterization is quite accurate. We should follow the sources. UPDATE: I see this a quote from the NRC clarifying is at Precision_medicine#Relationship_to_personalized_medicine and the lead to this article says the terms tend to be used interchangeably. I think a merge would make this more maintainable / less confusing, but I suppose it's not a big deal. II | (t - c) 06:18, 2 December 2018 (UTC)
replies: text: Although I have not been part of the discussion, I agree that, over time, the two topics will merge in the eyes of the reading public. "Precision medicine" is a new term to me, but it seems a practical choice to merge the articles sooner rather than later.--Quisqualis (talk) 08:25, 2 December 2018 (UTC)
replies: text:  We decided not to go ahead for lack of consensus. If you feel like starting a new merger discussion, go ahead (Proposing a merger) and see if you can obtain consensus. I have no view on the matter. Chiswick Chap (talk) 09:28, 2 December 2018 (UTC)
replies: text:  Thank you , ,   - it's clear that the world is moving towards these two terms being used so interchangably as to make no difference to most Wikipedia readers.   I was rather disappointed that we didn't manage to have a discussion in terms of the Wikipedia merger guidelines at WP:MERGE.  Chiswick Chap - if the  best way is to propose a new merge, then that probably makes sense.   Are there any guidelines about when you can repropose a merger? I'm guessing 3 years isn't unreasonable in such a fast-moving world.
Jpmaytum (talk) 11:11, 29 January 2019 (UTC)
thread_title: Merger proposal - Precision medicine

message: The above definition makes no sense. The term "theranostic" is more frequently used to denote linking of a diagnostic to therapeutic. The second half of the word "nostic" is supposed to represent diagnostic but sounds more like "gnostic", a word introduced into English from Greek and meaning "having a knowledge of". Theranostic could thus mean having knowledge of therapy. Moreover "theranostic" is confusing and not understood by most people and should be deleted from the vocabulary. There is no difficulty in describing this concept without using a special term. Diagnostics used to guide therapeutics are also called “companion diagnostics”. If one has to use a single word to describe a test linked to therapy, one can use "pharmacodiagnostic", which is more appropriate and easy to understand. 
Although using this term has been criticized as less than accurate, the above definition does seem to be in line with today's personalized approach to medicine, especially as it relates to cancer treatment.  The stakes have never been higher to know that the drug therapy is working in real time than with cancer.  Tumor responsiveness is critical to successful treatment and the term used to describe the process of making clinical treatment decisions mid-therapy in direct response to that precise therapy is theranostics.
 
Jain KK. Textbook of Personalized Medicine, Springer, 2009.  — Preceding unsigned comment added by Ettuquoque (talk • contribs) 03:18, 13 January 2012 (UTC)
thread_title: copied from [[Theranostics]] article

message: I disagree that use of imatinib mesylate (the real name of Gleevec) constitutes "personalised medicine". This is targeted therapy, but that is not the same as the loaded and horrible term "personalised medicine". It would be if every CML patient had his bcr/abl checked for particular resistance mutations and assigned imatinib, nilotinib or dasatinib as per the findings. That is not the case. JFW | T@lk 16:32, 27 September 2006 (UTC)
replies: text: I agree with JFW.  Gleevec seems a lot closer to targeted therapy than to personalized medicine.  I feel the same about Herceptin's inclusion.  Under SARM's rather expansive definition of personalized medicine, you'd have to include HAART protocol changes based on viral resistance tests, and antibiotic selection based on what the bacteria seemed resistant to in culture.  I don't think that anything which isn't one-size-fits-all should be lumped into "personalized medicine." WhatamIdoing (talk) 16:25, 7 December 2007 (UTC)
replies: text: I definitely agree with JFW and WhatamIdoing.  "Personalized medicine" is more of a buzz word and marketing tool than an actual medical reality. Medical geneticist (talk) 11:43, 10 August 2008 (UTC)
thread_title: Gleevec

message: Parts of this section feel to me like they're kinda choppy in terms of language and syntax. Also, the 'Patients' and 'Genetic Discrimination' headings seemingly disagree on whether the public seems to support genetic testing or not. Needs some clarification.
I didn't wanna edit it myself without saying something first. :-)
70.119.253.214 06:52, 3 November 2007 (UTC)
thread_title: 'Stakeholder response'

message: This whole article seems biased to me.  To say that one can make predictive statements about an individual based on what is learned about genetic variants in large populations is a fallacy.  What was learned from the sequencing of Watson and Venter?  That they had risks (on the basis of genetic variants) for medical conditions they already knew they had risks for (on the basis of family history).  Proponents of "Personalized medicine" -- in the context of performing predictive DNA testing in healthy individuals to determine risk -- fail to recognize that unless you know which variants are actually responsible for disease and resistance to disease within a family it is extremely problematic to assign an adjusted risk based on an individual's molecular profile.  
:For example, imagine that your father had high cholesterol and a heart attack.  You are at increased risk for high cholesterol and heart disease, simply on the basis of your family history.  So, you go to your neighborhood SNP sequencing company, fork over a pile of money, and they tell you: you have SNPs A, B, and C, so your risk of heart disease is X%.  What if your father had SNPs D and E?  The more useful information would be to know whether you had inherited SNPs D and E, which are the variants that are most likely to be associated with disease in your family.  What if your mother actually has a protective SNP?  Again, it is more useful to know the variants in your own biological context.  If these private variants aren't tested for in the commercial "personalized medicine" SNP profiles, then you gain no useful information.
Also, it is completely untested whether adding "predictive" genetic information will actually change an individual's likelihood of participating in preventive measures that are already proven to improve health outcomes.  In fact, it is conceivable that a result on a "predictive" genetic test could worsen compliance with interventions such as diet, exercise, and moderation with regard to alcohol/tobacco/drugs.  If a person is given a "predictive" genetic test result that suggests decreased risk for high cholesterol, might they subconsciously or consciously take this as license to splurge a little, thereby worsening their health with regard to other conditions (obesity, diabetes, cancer)?  If a person is given an increased risk, might they take a fatalistic attitude that nothing can be done about it?  
The point is that the research hasn't been done to know whether "predictive" testing is any better than taking a good family history and recommending uniform, simple interventions -- eat better, exercise better, sleep more, drink less, smoke less(or not at all), practice safe sex, etc.  It's just that "personalized medicine" is a much sexier buzz word than "family practice" or "medical genetics".Medical geneticist (talk) 12:12, 10 August 2008 (UTC)
thread_title:  Limitations of "Personalized Medicine" 

message: I got too peeved about the lack of NPOV in the previous version and have started a re-write.  I'm happy to incorporate any suggestions/recommendations.  Medical geneticist (talk) 15:39, 20 August 2008 (UTC)
thread_title: Starting a major revision

message: Modify the statement into this "However, large cohort studies do not take into account the genetic and epigenetic variability of individuals within a population". 
In response to your statements above: I don't think this (personalized medicine) is silly- if we are after an excellent individual biological in toto care for anyone personalized medicine is the best approach.. what else?  —Preceding unsigned comment added by 216.66.59.41 (talk) 03:53, 14 May 2010 (UTC)
thread_title:  Epigenetics has to be included- this is  revolutionizing biology at present 

message: At a minimum, a review of the current scandal involving Dr. Anil Potti and associates should be included.
The Potti papers cited as "Further Reading" and associated work are currently under review.  
# Potti et al. (2006), Genomic Signatures to Guide the Use of Chemotherapeutics, Nature Medicine 12: 1294.
# Potti et al. (2006), A genomic strategy to refine prognosis in early-stage non-small-cell lung cancer, New England Journal of Medicine 355: 570
A review of the problems uncovered in the analysis reported in these Potti papers can be found in
Deriving chemosensitivity from cell lines: Forensic bioinformatics and reproducible research in high-throughput biology
Keith A. Baggerly and Kevin R. Coombes
Source: Ann. Appl. Stat. Volume 3, Number 4 (2009), 1309-1334. 
A summary of the issues can be found in the journal "Science"
Science 6 August 2010:
Vol. 329. no. 5992, pp. 614 - 615
DOI: 10.1126/science.329.5992.614
News of the Week
Cancer Research:
As Questions Grow, Duke Halts Trials, Launches Investigation
Jennifer Couzin-Frankel  
An "Expression of Concern" was issued by Lancet Editor Dr. David Collingridge, see
Expression of concern—validation of gene signatures that predict the response of breast cancer to neoadjuvant chemotherapy: a substudy of the EORTC 10994/BIG 00-01 clinical trial
David Collingridge
The Lancet Oncology - 1 September 2010 ( Vol. 11, Issue 9, Pages 813-814 )
DOI: 10.1016/S1470-2045(10)70185-6 
Three clinical trials funded and started under the guise of such personalized medicine have been suspended, and the trials and associated methodology are now being reviewed by the National Academy of Sciences Institute of Medicine.
http://dukechronicle.com/print/153336
The Chronicle
News » Health & Science
IOM to review Potti research, clinical trials
By Sonia Havele
October 21, 2010
142.103.207.10 (talk) 02:31, 26 October 2010 (UTC)
thread_title:  Personalized Medicine Scandal 

message: Are you writing the history of personalized medicine and comparing it with "aristotle"? It seems that there is nothing new about personalized medicine. You are not including the new publications that talks about let us say the importance of environment to personalized medicine (2010) and other new findings. What are you talking here are the 2001 publication , the 2007 alternative name.. what is this? I think only .00001% of the editors here know what  PM is all about. Browse Medical News Today and look for the current references....  —Preceding unsigned comment added by 69.22.174.172 (talk) 16:46, 29 April 2011 (UTC)
thread_title:  This article is antiquated 

message: It is impossible to group people having singular/common need for one treatment(in this case breast cancer for a common blah blah) because they have other genes that may interact unfavorably/ differently to this similar treatment. Even applying SM to siblings/or to a family because their genes are more or less having a high percentage of similarities I can still see that SM will fail because even in families as well as among siblings there are genes/ epigenes that will not allow a similar cure of having a similar intensity (of curing) with that of the other siblings-- in other words there is still the difference-- so I would suggest not to use SM or BlockM - for each one needs a PM type of cure- an individualized medical care not a group care like SM or BM... these 2 are impossible and are even deviating from PM... misleading PM  —Preceding unsigned comment added by 69.22.174.172 (talk) 17:11, 29 April 2011 (UTC)
thread_title:  A comment on stratified medicine 

message: To the editor(s?) using IP addresses 72.66.223.40, 72.66.199.136, and 128.173.102.238:
Please provide adequate sources for your edits of 11/2011.  Your initial additions were sourced entirely using external links to an entity promoting certain aspects of personalized medicine.  These could be considered biased contributions aimed primarily at increasing web traffic, which is not an appropriate use for Wikipedia.  Please see our guidelines on external links and reliable sources.  Also, if you have any direct affiliation with the organization to whom you are providing external links (as I suspect due to one of your IP address mapping to the Virginia Polytechnic Institute, which coincidentally is the location of the organization to which you are linking), this could be considered a conflict of interest. --- Medical geneticist (talk) 00:37, 18 November 2011 (UTC)
thread_title:  External promotional links are not appropriate sources 

message: Hi,
I'm coming across quite a few relevant things during my work on Molecular diagnostics. The two overlap in that all the real world examples of PM are either tests or therapies; and all the tests are also examples of Molecular diagnostics. So more cross-linking?
I've come across some general articles on PM, should they be of use:
This article is a useful primer, and reaction to the first ten years of full genome sequencing:
* http://www.futuremedicine.com/doi/pdf/10.2217/pme.10.30
The Path to Personalized Medicine, 2010
* http://www.nejm.org/doi/full/10.1056/nejmp1006304
Cheers,
Ian McDonald (talk) 19:16, 18 October 2013 (UTC)
thread_title:  Useful references for anyone working on this 

message: Creators of the exposome article and some related pages have added the following, which I deleted with the stated reason "revet addition that promotes one lab's publications. exposome is currently not medicine, but rather a research paradigm. is not "background""   The original poster  restored it without an edit note.  I reverted and re-deleted, citing WP:BRD, and just now User:So26 undeleted,  again without an edit note.  Not good wikipedia communication.  Since the OP refused to start a discussion, I am doing it.  Here is the new content.
Beyond germline genetics, molecular pathology is a much wider open area for therapeutic and preventive applications. Inter-personal difference of molecular pathology is diverse, so as inter-personal difference in the exposome, which influence disease processes through the interactome within the tissue microenvironment, differentially from person to person. As the theoretical basis of personalized medicine, the "unique disease principle"(ref)Ogino S, Lochhead P, Chan AT, Nishihara R, Cho E, Wolpin BM, Meyerhardt AJ, Meissner A, Schernhammer ES, Fuchs CS, Giovannucci E. Molecular pathological epidemiology of epigenetics: emerging integrative science to analyze environment, host, and disease. Mod Pathol 2013;26:465-484.(ref/) (which was first described in neoplastic diseases as the unique tumor principle(ref)Ogino S, Fuchs CS, Giovannucci E. How many molecular subtypes? Implications of the unique tumor principle in personalized medicine. Expert Rev Mol Diagn 2012; 12: 621-628.(ref/)) emerged to embrace the ubiquitous phenomenon of heterogeneity of disease etiology and pathogenesis. As the exposome is a common concept of epidemiology, personalized medicine is intertwined with molecular pathological epidemiology (MPE). MPE research is capable of identifying potential biomarkers for personalized precision medicine.(ref)Ogino S, Lochhead P, Giovannucci E, Meyerhardt JA, Fuchs CS, Chan AT. Discovery of colorectal cancer PIK3CA mutation as potential predictive biomarker: power and promise of molecular pathological epidemiology. Oncogene advance online publication 24 June 2013; doi: 10.1038/onc.2013.244(/ref) 
This is pretty clear self-promotion by Ogino et al.  Also it is not "background" for personalized medicine. The paradigm described above is an emerging one;  pioneers in the field are building the basic science and infrastructure.  If anything it is "forward looking research" or the like.  but mostly, the fact that all the papers cited are from one group calls into question whether this is really notable enough for inclusion at all.  if it stays it needs to be copyedited for better english and the claims toned down (it is not the theoretical basis for personalized medicine)  and the over-wikilinking cut down. Jytdog (talk) 15:20, 17 February 2014 (UTC)
thread_title:  new content about "expsome" etc 

message: "Genotyping is the process of obtaining an individual’s DNA sequence by using biological assays.[10]"
I am just pointing this out, but this definition of genotyping is not quite right/misrepresentative. Genotyping is not quite the same as DNA sequencing. Genotyping is the process of confirming small snippets of DNA sequence (most commonly only one nucleotide, as in SNP genotyping, which is by far the most common type of genotyping and the most relevant to Personalized Medicine) to a known reference.
DNA sequencing is a method that can be used to perform genotyping, but today it is currently the least common method used to perform genotyping. From my experience in the industry, PCR-based and probe-based methods currently dominate the market (which is not sequencing). The notion that 23andme sequences the genome of its clients is a misleading, because their technology is probe-based. There is quite a substantial difference between DNA sequencing all 6 billion basepairs of the human genome versus genotyping 100,000 SNP sites throughout the genome.
I'm sorry if I'm being particularly technical, but as a scientist who deals in this field quite frequently, this particular section seemed to be the most glaring error in this article. Also the citation that was placed on this particular line is irrelevant/does not support the claim made. 98.110.225.95 (talk) 16:09, 5 July 2015 (UTC)
thread_title:  Genotyping Definition 

message: I am a Norwegian medical doctor, specialist in neurology, currently preparing a lecture on Personalized medicine as part of my PhD thesis defence. I came to this article to gain a quick overview. As it stands now, I deem it hopelessly biased and substandard. I'm sorry, but I don't think "editing" it would be of any help. There are too many issues with this article. I once faced the same situation on another topic, one that had not been worked on by professionals before me, and the only solution I could find was to scrap the entire article and start anew. I'm not sufficiently competent on the topic of personalized medicine to do this myself, but I would appeal to geneticists to take upon themselves this effort.
Contributors to this page should be aware that "personalized medicine" is a very complex issue. Firstly, the branding of PM may create the faulty impression that this is something radically new. It is not, rather, it is an age-old feature of "good medical practice". What's new about PM is the heavy involvement of genomics and other high-tec (but also high-cost, and highly commercial) investigations that are supposed to guide treatment. In some (even many) cases they do. But generally, there is still a gap between what one could wish (and even realistically hope) that PM can achieve, and what has actually been achieved so far. By reading truly scientific articles regarding PM in the field of neurology, there is mostly depictions of what can feasibly be foreseen - very few descriptions of what has actually been achieved. However, I acknowledge that in the field of oncology, genomic-based PM is probably far more established, and plays a major role even now. 
As for the field of pharmacogenomics, this Wiki article states, without any caution, that knowing your genotype may help guide the treatment most effective for you. That assertion lacks a solid foundation in research - it's a hope, surely, but so far with rather little clinical value. Even though this may change (even soon), this is part of what makes this article look like an advertisment. 
Given the very strong commercial interests involved in PM, and the pressure upon lay persons to have their genes checked with commercial firms, I do think that the Wiki moderators ought to be very critical towards articles like this one. Lay people may come here in order to "check out" whether PM is useful for them. They ought to be informed that the usefulness of genomic PM - in particular the direct-to-customor version of it - is strongly disputed, and by many professionals regarded as pure marketing. 
I realize that there may be different opinions on this issue - strong opinions going against mine. That is all right - but this article should then reflect that there is such a controversy. Usually, that means that the article should be very narrowed down, omitting strong assertions either way. The discussion on the usefulness of PM should not take place through Wiki-battles with endless textual changes and re-changes. 
Please erase this article, and please, someone take the time to make a more neutral version. Morten Horn (talk) 19:13, 7 January 2016 (UTC)
thread_title:  This article should be started anew 

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thread_title:  External links modified 

message: Should personalized medicine be more than genetics? It should also include other measures such as imaging techniques and proteomics. The article should move its focus from genomics but look at a broader field. Kairui jiang (talk) 18:26, 30 July 2020 (UTC)
thread_title:  Not broad enough 

message: Support the July proposal to merge Precision medicine with Personalized medicine on the grounds that these are synonyms, often used interchangeably. The evidence for distinct use is weak, and seems to reflect only speculation about potential misinterpretation. So, I suggest that Personalized medicine is the better target as the more establish term, older article and more developed article. Any differences in use of the term can be discussed on the page. Klbrain (talk) 18:48, 11 December 2021 (UTC)
replies: text: Klbrain (talk) 12:15, 23 September 2022 (UTC)
thread_title:  Merge proposal