Precision Medicine for Clinicians: The Future Begins Now
Authors: Lee Goldman, Jill S. Goldman
Journal: Annals of Internal Medicine (2019)

Editorials7 May 2019Precision Medicine for Clinicians: The Future Begins NowCorrection(s) for this article:CorrectionsJun 2019Correction: Precision Medicine for CliniciansFREELee Goldman, MD, MPH and Jill S. Goldman, MS, MPhilLee Goldman, MD, MPHVagelos College of Physicians and Surgeons, Columbia University, New York, New York (L.G.) and Jill S. Goldman, MS, MPhilTaub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York (J.S.G.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-1034 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This article has been corrected. The original version (PDF) is appended to this article as a Supplement.Until late in the 20th century, medical practice was largely based on case reports and a physician's personal experience, hopefully guided by the underlying pathophysiology. Practice patterns were heavily influenced by the logic and biases of a respected local "guru," whose therapeutic theology, though admired at the home institution, might be heresy to another institution's competing guru.Practice patterns began to change with the advent of randomized trials and evidence-based medicine. Although initially denigrated as "cookbook" medicine, guidelines based on such data elevated ...References1. Mensah GA, Wei GS, Sorlie PD, Fine LJ, Rosenberg Y, Kaufmann PG, et al. Decline in cardiovascular mortality: possible causes and implications. Circ Res. 2017;120:366-80. [PMID: 28104770] doi:10.1161/CIRCRESAHA.116.309115 CrossrefMedlineGoogle Scholar2. Goldman L. Too Much of a Good Thing: How Four Key Survival Traits Are Now Killing Us. New York: Little, Brown; 2015. Google Scholar3. Artin MG, Stiles D, Kiryluk K, Chung WK. Cases in precision medicine: when patients present with direct-to-consumer genetic test results. Ann Intern Med. 2019;170:643-50. doi:10.7326/M18-2356 LinkGoogle Scholar4. Kiryluk K, Goldstein DB, Rowe JW, Gharavi AG, Wapner R, Chung WK. Precision medicine in internal medicine. Ann Intern Med. 2019;170:635-42. doi:10.7326/M18-0425 LinkGoogle Scholar5. National Society of Genetic Counselors. 2018 Professional Status Survey Reports. Chicago: National Society of Genetic Counselors; 2019. Accessed at www.nsgc.org/p/cm/ld/fid=68 on 1 April 2019. Google Scholar6. Mahlangu J, Oldenburg J, Paz-Priel I, Negrier C, Niggli M, Mancuso ME, et al. Emicizumab prophylaxis in patients who have hemophilia A without inhibitors. N Engl J Med. 2018;379:811-22. [PMID: 30157389] doi:10.1056/NEJMoa1803550 CrossrefMedlineGoogle Scholar7. Al-Zaidy S, Pickard AS, Kotha K, Alfano LN, Lowes L, Paul G, et al. Health outcomes in spinal muscular atrophy type 1 following AVXS-101 gene replacement therapy. Pediatr Pulmonol. 2019;54:179-85. [PMID: 30548438] doi:10.1002/ppul.24203 CrossrefMedlineGoogle Scholar8. Personalized Medicine Coalition. Personalized Medicine at FDA: A Progress & Outlook Report. Accessed at www.personalizedmedicinecoalition.org/Userfiles/PMC-Corporate/file/PM_at_FDA_A_Progress_and_Outlook_Report.pdf on 1 April 2019. Google Scholar9. Davis R, Gurumurthy A, Hossain MA, Gunn EM, Bungert J. Engineering globin gene expression. Mol Ther Methods Clin Dev. 2019;12:102-10. [PMID: 30603654] doi:10.1016/j.omtm.2018.12.004 CrossrefMedlineGoogle Scholar10. Ray KK, Landmesser U, Leiter LA, Kallend D, Dufour R, Karakas M, et al. Inclisiran in patients at high cardiovascular risk with elevated LDL cholesterol. N Engl J Med. 2017;376:1430-40. [PMID: 28306389] doi:10.1056/NEJMoa1615758 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Vagelos College of Physicians and Surgeons, Columbia University, New York, New York (L.G.)Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York (J.S.G.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1034.Corresponding Author: Lee Goldman, MD, MPH, Harold and Margaret Hatch Professor, Dean of the Faculties of Health Sciences and Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, Suite 2-401, New York, NY 10032; e-mail, [email protected]edu.Current Author Addresses: Dr. Lee Goldman: Harold and Margaret Hatch Professor, Dean of the Faculties of Health Sciences and Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, Suite 2-401, New York, NY 10032.Ms. Jill Goldman: Columbia University Irving Medical Center, 630 West 168th Street, Box 16, New York, NY 10032.This article was published at Annals.org on 30 April 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCases in Precision Medicine: When Patients Present With Direct-to-Consumer Genetic Test Results Michael G. Artin , Deborah Stiles , Krzysztof Kiryluk , and Wendy K. Chung Precision Medicine in Internal Medicine Krzysztof Kiryluk , David B. Goldstein , John W. Rowe , Ali G. Gharavi , Ronald Wapner , and Wendy K. Chung Correction: Precision Medicine for Clinicians Metrics Cited byEthical Considerations in Precision Medicine and Genetic Testing in Internal Medicine Practice: A Position Paper From the American College of PhysiciansLisa Soleymani Lehmann, MD, PhD, Lois Snyder Sulmasy, JD, and Wylie Burke, MD, PhD, for the ACP Ethics, Professionalism and Human Rights Committee A systematic review of miRNAs as biomarkers in osteoporosis diseaseAcceptability, Usability, and Quality of a Personalized Daily Meal Plan Recommender System: The Case of Virtual DietitianIndividual risk management strategy for SARS-CoV-2 infection: A step toward personalized healthcareCorrection: Precision Medicine for Clinicians 7 May 2019Volume 170, Issue 9Page: 660-661KeywordsCholesterolDrugsEvidence based medicineForecastingGenetic counselingGenetic diseasesGenetic testingGenomicsPrecision medicineSurgeons ePublished: 30 April 2019 Issue Published: 7 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. 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