Personalized Medicine

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Abstract


Evidence-based medicine at the end of the 20th century saved many lives, allowing us to reliably screen out pseudoscientific and dangerous methods. The medical community has gained access to weighted “standards” for treating common diseases. Unfortunately, this algorithmic approach pays for the breadth of coverage with low specificity of recommendations. In this article, the necessity and timeliness of the next step - the transition from broad clinical generalizations to working with the individual characteristics of the patient - are substantiated. The discussion opens with a forced criticism of the current state of clinical medicine, which suffers from economic inefficiency and low accuracy of pharmacotherapy. According to the FDA reference agency, up to 75% of patients do not respond to medications, which is very alarming and requires a change in the dominant paradigm in medicine. Next, we turn to the scientific and technological prerequisites of personalized healing, focusing on the achievements of molecular genetics and the value of genetic counseling. We also deal with issues of genome-wide sequencing and rapidly developing post-genomic methods. Taking into account international experience, we consider organizational and methodological difficulties, as well as ways to overcome them on the way to personalization of medicine. Key points of the article are illustrated by case reports from the clinical practice of the Endocrinology research centre (Moscow).


Ivan I. Dedov

Endocrinology Research Centre; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: dedov@endocrincentr.ru
ORCID iD: 0000-0002-8175-7886

Russian Federation

MD, PhD, Professor

11 Dm.Ulyanova street, Moscow, 117036

SPIN-cod: 5873-2280

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