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Mastering Information for Personal Medicine

To make the most of new technologies, medicine must come to grips with the mountains of data it will produce

Mastering Information for Personal Medicine

Sometimes, mastery over the raging influx of information all around us has life and death consequences. Consider national security agencies charged with ensuring our safety by detecting the next big terrorist threat. Presented with worldwide email traffic, phone conversations, credit card purchase histories, video images from pervasive surveillance cameras and intelligence reports, the challenge for these agencies is to integrate all this abundant, disparate information and to present it to analysts in ways that help to identify significant threats more quickly.

Soon we will all be faced with a similar challenge that could have a dramatic impact on our well-being. In the not-too-distant future, average Americans will have access to detailed information about their genetic makeup, the molecular states of cells and tissues in their bodies, longitudinal collections of readings on their weight, blood pressure, glucose and insulin measurements, and myriad other clinical traits informative about disease, disease risk and drug response. Whereas classic molecular biology and clinical medicine offered only simple links between molecular entities and disease (for example, relating insulin levels and glucose levels to risks of diabetes), new technologies will provide comprehensive snapshots of living systems at a hierarchy of levels, enabling a more holistic view of human systems and the molecular states underlying disease physiologies. All this data—once appropriately integrated and presented—will allow us and our doctors to make the best possible informed decisions about our risks for disease; it will also help us to tailor treatment strategies to our particular disease subtypes and to our individual genetic and environmental backgrounds.

Powerful examples of how this new era of personalized medicine will change diagnosis and treatment are already available. A now-routine genetic test can indicate whether breast cancer patients will respond to treatment with the drug Herceptin, and testing for certain changes in DNA that affect blood-clotting can help doctors decide what dose of the anticoagulant warfarin would be safest for certain patients.

However, unlike the doctor of today, armed with a stethoscope and thermometer, tomorrow’s doctors will have access to a multitude of biosensor chips and imaging technologies capable of monitoring variations in our DNA and in the activities of genes and proteins that drive all cellular functions. They will be able to order scans with singlecell resolution for any organ in our bodies. How will such data be managed? How will it be analyzed and contrasted with similar types of data collected from populations so that the totality of these data help us to better understand our specific condition? How will the complex models derived from such data be interpreted and then applied to us as individuals by our doctors? Is the medical community prepared—and are individuals ready—for this revolution?

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