The Problem With Personalized Medicine

Arguably, targeting things like lifestyle factors is also "personalized medicine", in the sense that treating patient X specially because a defect in their homozygous foo allele predisposes them to cardiac disease isn't all that different from treating patient X specially because getting no exercise predisposes them to cardiac disease.(and, in uncomfortably-many-but-not-all cases, the "personal" element is just the most visible factor in a stew that includes environmental and social influences, like diesel soot and cube farms...)

I'd be inclined to say that Emanuel is neither a dinosaur(he isn't rejecting the new-and-shiny out of hand, just pointing out that much of it offers questionable bang-for-buck compared to the low hanging fruit offered by seriously boring lifestyle stuff), nor a pragmatist(y'know why people like to ignore lifestyle factors and focus on genetic whiz-bangs and hypothetical personalized super-pills? Because lifestyle intervention lies dead at the center of the intersection of "really boring", "really hard", and "lousy patient compliance".

We already have plenty of good advice to go around(by no means perfect knowledge; but we know much better than we do), largely unheeded and often coexisting with social conditions that actively work against heeding it. We don't actually have personalized genetic-super-pills(with limited but important exceptions: oncology, for instance, has a number of genetic markers that have proved tractable to test for and highly useful to know. Some rare hereditary disorders have also been well worked up. Much of the rest of it remains in the "yeah, it sure does appear to run in families; and we made this mouse model by tweaking the genes like so; but that doesn't help you very much...); but we could probably get people to take them fairly regularly if we did...

Source: http://rss.slashdot.org/~r/Slashdot/slashdotScience/~3/Fr9Dj7ymP1U/the-problem-with-personalized-medicine

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