Few drugs now available as personalised medicine

Here are few links

https://www.astrazeneca.com/what-science-can-do/phc.html

Some article related with personalised medicine:

http://www.nature.com/news/personalized-medicine-time-for-one-person-trials-1.17411

http://www.futuremedicine.com/loi/pme

http://www.fda.gov/downloads/scienceresearch/specialtopics/personalizedmedicine/ucm372421.pdf

http://www.cancerresearchuk.org/support-us/donate/become-a-major-donor/how-you-can-give/the-catalyst-club/personalised-medicine

https://www.england.nhs.uk/wp-content/uploads/2016/09/improving-outcomes-personalised-medicine.pdf

Thanks

Regards

If research has at it's core generalizability, how does individualized personalized medicine interact with generalizability?

If it is personalized, does that mean every gold standard study has an n of 1?

If it is based on generalizability, is it really personalized to you or just the entire population to which you are assigned? 

I think personalized medicine is probably a marketable way to say population or evidenced based medicine and we are far from recognizing the uniqueness of "one".

Thanks for your nuanced answer (@KentBream).

You said "science has generalizability at its core".  That is inductive reasoning: from the specific to the general.  On the other end of the spectrum is deductive reasoning: from the general to the specific.  So perhaps we might want to modify our paradigm as "science (medicine in particular here) should have both generalizability and individualizability at its core?"   IOW might it be worthwhile to approach science (medicine) from both the inductive and the deductive points of view?  

Thanks again. 

I remain unconvinced that health science can do deductive reasoning, from the macro to the individual. (Bronfenbrenner)  While 50% of the population may have A trait, each individual does not have 50% of a trait. A frequency count in population sciences doesn't always create a probability. Each individual either has A trait or doesn't have A trait. So we cannot deduce the status of an individual within the population as A or not A (unless it is a cat in a steel chamber a la Schrödinger). Flipping a coin that actually can result in two outcomes makes for a good probability function. But our personalized medicine patients are not at risk for both states, they are one or the other. Our knowledge of their risk is the only thing that is subject to a probability.

For population data driven personalized medicine, translating a frequency into a probability and acting on that will over treat or over worry the unaffected or the outliers. 

When viewed under the lens of population genetics, I agree with you @KentBream that deductive process would seem too unwieldy to reasonably work in the health/life sciences. But remember we now have the technological capability to determine the sequence of a patient's entire genome quickly and relatively cheaply (or it is getting closer and closer to that). As a person's genome sequence carries all the information that make that person unique, this capability has, in effect, enabled (or will enable) medicine to be "personalized" or "individualized". Would that not qualify as deduction? My impression is that it does.

Gentlemen, thank you for this exchange. I come down, so far, on Dr. Bream's side. The relationship of personalized/precision medicine and person-centered medicine, is becoming the focus of considerable study. In fact, in early May I am sitting down with a range of senior colleagues to plan a major conference and publication on this specific area of interest. For too long now, certainly for a century, medicine has regarded patients as subjects, objects or complex biological machines, employing a scientistic reductionism that has been promoted by EBM, but resisted by movements such as the patient-centered care movement originating in North America in the late 1970s. The tensions, philosophical, scientific, clinical, political, have been with us every since, but newer concepts such as person-centered medicine are helping us to work towards a resolution of the tension, productively in my view, as we move forward in this post-EBM period and in the current environment of patient education, advocacy and empowerment. Scientific evidence-based medicine has shifted to the idea of a scientific evidence-informed healthcare, as part of the acknowledgement that science, however powerful, has its place and that there are other forms of clinical knowledge of importance in making good clinical decisions with the patient, not just one form. Indeed, many have argued that in order to respond to the current epidemic of long term chronic co and multi-morbid, socially complex illness, we need an entirely new approach to how we do things, so that the vertically ordered hierarchy of classical EBM is collapsing into a horizontally ordered library of clinical knowledge sources from which the wise clinician can select according to the unique clinical circumstances of the individual clinical case. Within this library, the particular knowledge that is generated and utilized by precision medicine has its place - alongside and not on top of all the others. Precision medicine is not medicine!  It is a science of use within a more broadly conceived person-centered framework, which is to say, good clinical medicine. The ultimate reason for clinical science and the ultimate destination of clinical science is the patient and the patient is a person first and a patient second, so that the use of the term person-centered vs patient-centered is not semantic or symptomatic of linguistic preference, but rather deeply rooted within the history and philosophy of medicine since Hippocrates. Person-centered care therefore subsumes precision medicine, it does not and cannot result from it. So, in my view, when we talk about precision medicine and ask how long before its dreams are realized, then we must keep firmly in mind what it is there for in the first place and this is easily forgotten in our superspecialized medical school and teaching hospital departments where the patient is seen as part of the disease and not the disease part of the patient. I attach a paper which talks briefly about such things, to be followed next month by a paper following up and expanding on these themes.  

If adopted the Chinese medicine, it is a customized medicine. Even for a same person's different time period couch, we can treat him differently due to the cause could be different and the accompanying symptoms with a cough could be changed.

No, this was would be disastrous. While the biomedical paradigm has considerable limitations, Chinese Medicine, if you mean TCM, is way, way outside such a paradigm and is rightly viewed with substantial suspicion. Nobody is arguing against giving patients more face-to-face time and human understanding, but we need to rehumanise allopathic medicine, not seek solace or understanding in largely discredited alternative systems such as TCM. Of course, such comments will be seen as symptomatic of Western medical imperialism, but it really is nothing of the sort. Person-centered medicine may not be based, in a fgundational sense (episetemiically speaking) on scientific evidence, but it is most certainly well informed by it. There's little room in rational 21st Century Medicine for alternative paradigms.

Ok. Let time prove who is right. If you can visit http://www.icmart.org/ to read, you might change your mind.

If the question refers to - when should personalized medicine be implemented in  the day by day practice then we are probably far. As for why it is  "far ", this is because although we already have a considerable number of tools for this purpose the practical conditions are still not developed meaning  : physicians should be trained , computer systems of HMO's should be adapted and enough time for each patient should be accorded. This is a time requiring and money requiring issue and is probably not close at all.

According to my experience, many patients sick is due to many unhealthy lifestyle styles, wrong dates, medical knowledge, these can use software to solve it. However, if the patient has belongings or discontents or limited beliefs, or shortage of love, caring, then, individual care is really needed. However, in some practical practice, when a doctor needs to treat 120 to 200 patients as I heard, the individual care needs are hard to be discovered by the doctor.  Except for the doctor hires enough assistants to help him monitor patients and find out.

On the other hand, medical wise, in Chinese medicine view is needed due to even the same symptoms can have different causes. One for all pill does not work. That leaves many businesses to the acupuncturists.

This Ayurvedic concept of Predictive, Preventive and Personalized Medicine may be informative:

Article Predictive, Preventive and Personalized Medicine: Leads From...

Ayurveda has descibed treatment based on PRAKRITI which is nothing but practice of personalised medicine. Ayugenomics is a new development based on PRAKRITI. Article Prakriti and its associations with metabolism, chronic disea...

According to Acharya Charak "Purusham Purusham Vikshaya" is said for individualized approach for treatment. Ayurveda suggest treatment and life style based on Prakruti of a person. Ayurgenomics is the concept will address personalized treatment

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