Personalized medicine uses a patient’s genetic information to help determine the best type of treatment for them. This sounds promising, however in many cases environmental factors dominate genetic factors. For example, traditional cardiovascular disease risk factors are better predictors of disease than genetic factors. In a recent issue of Science, Horwitz et al, argue that it is essential to integrate clinical, social, and environmental data with the individualized genomic and molecular information when treating a patient in order to provide the best care.
The implications of a genomics-based to “personalized” medical treatment are considerable. For example, treatment of native American Pima Indians (who are at high genetic risk of diabetes but have a low indicence of disease) would result in exaggerated risk assessment and overtreatment. The authors suggest that personalized treatment would be “equally inappropriate” for present day Pima Indians consuming a Western diet, due to the importance of “gene-environment interactions.”
What are your thoughts?
Horwitz, R.I., et al., Medicine. (De)personalized medicine. Science, 2013. 339(6124): p. 1155-6.