Precision medicine offers individualized health care instead of “one-size-fits-all”
Dr. Mark Haigney discusses his views on precision medicine to researchers at the MHS Research Symposium on Aug. 17, 2016.
WOuld someone buy shoes from a “one-size-fits-all” bin? Probably—not.
Would a family look for a home that meets their needs—size, cost, location? Probably—yes.
So, why should patients settle for health care designed for everyone when they can get care that’s uniquely tailored for them?
Like foot size, a person’s genes determine their unique physical features. Now, it’s also known that genes—or rather mutations in the genes—can indicate if someone may be at risk for certain medical conditions. By integrating genomic information with a patient’s family history, lifestyle and environmental factors, doctors can better predict a person’s risk for disease or response to prescription drugs and can tailor treatment plans for each individual patient.
This innovative approach that may revolutionize health care is known as precision medicine. Medical researchers from across the Military Health System (MHS) discussed precision medicine at the MHS Research Symposium on Aug. 17, 2016. They talked about active studies that are exploring the human genome to find new ways to improve clinical-decision making and predict outcomes in the operating room and on the battlefield.
According to Dr. Mark C. Haigney, professor of medicine and pharmacology at the Hebert School of Medicine at the Uniformed Services University of the Health Sciences, “Precision medicine is all about identifying vulnerabilities in people who don’t know they have those vulnerabilities in order to prevent catastrophic outcomes.” He went on to discuss a tool he believes will fulfill the promise of precision medicine, the induced pluripotent stem cell, or iPSC, especially in the advancement of cardiovascular research and medicine.
Another study discussed in depth was the Air Force Medical Service Personalized Medicine Clinical Utility Study. The study began in 2010 in collaboration with the Coriell Personalized Medicine Collaborative Research Study. One of the objectives is to discover if study participants will change their behaviors—and make healthier decisions—if they know about medical conditions they might be at a higher risk of incurring. Participants in the study get individualized risk reports based on their genome map. To date, the study has identified 39 actionable medical conditions—for each of which the risk can be reduced if the patient changes something in their environment or lifestyle.
Between 2011 and 2013, 2100 participants were enrolled and 28,000 risk reports were generated. According to Air Force Lt. Col. David Watson, the risk reports did drive behavior change. For example, study participants with an increased genetic risk of melanoma took precautions in the sun where they didn’t before the study.
In 2014, the study expanded to more than 3,000 participants. Another goal was to find out if participants are sharing their risk reports with their providers. According to Watson, 17 percent of participants have already shared this information with their providers and 48 percent are planning to share it.
The study is now available to Air Force service members, retirees and family members age 18 and older using.
Precision Medicine Initiative
In his 2015 State of the Union address, President Obama announced that he was launching the Precision Medicine Initiative. Agencies across the Federal government, including the MHS, are supporting the President’s vision. Currently, the Department of Defense (DoD) is partnering with the Department of Veterans Affairs (VA) to facilitate the enrollment of active duty men and women into the Military Veteran Program, national, voluntary research program funded entirely by VA Office of Research & Development. This collaboration will enhance the quality of data available to both VA and DoD, as well as the natural progression from active duty military to veteran status.