Personalized Medicine

Personalized medicine—the idea that genetic testing can reveal a person’s unique risks for various illnesses, as well as the most effective treatments—has attracted a huge amount of attention over the past few years.

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June 22, 2017 – Free MCAT CARS Practice

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Personalized medicine—the idea that genetic testing can reveal a person’s unique risks for various illnesses, as well as the most effective treatments—has attracted a huge amount of attention over the past few years. While the concept includes promising approaches to things like cancer treatment, much of the focus has been on using genetic risk information to motivate healthy lifestyles. In his 2015 State of the Union address, President Obama suggested that future advances in biomedicine would provide the “personalized information we need to keep ourselves and our families healthier.” Francis Collins, the director of the National Institutes of Health, has suggested that personalized medicine “means taking better care of ourselves.”

In the context both men are describing—living healthier lifestyles to prevent chronic disease—the promise of personalized medicine lies in its ability to inspire behavior change. Having this genetic information isn’t inherently helpful; it’s what people do with the information that matters. But new research suggests that knowing one’s genetic risk isn’t enough to get people to quit smoking, eat better, or otherwise take actions to improve their health.

In a study published on Tuesday in BMJ, researchers from Cambridge University’s Health and Behavior Research Unit analyzed 18 past papers on the link between knowledge of genetic risk and health-behavior change. Their takeaway from the review: “Expectations that communicating DNA-based risk estimates changes behavior are not supported by existing evidence.”

“These results do not support use of genetic testing or the search for risk-conferring gene variants for common complex diseases on the basis that they motivate risk-reducing behavior,” they wrote.

This isn’t the first time researchers have arrived at that conclusion—many past studies, for example, have suggested that knowing one’s genetic-risk information doesn’t have a significant impact on smoking behavior, weight loss, or adherence to lifestyle advice, even when the genetic information is accompanied by counseling.

But given the momentum around personalized medicine and the continued growth of the direct-to-consumer genetic-testing industry, it remains to be seen how much of an impact these findings will have on the direction of future research.

In certain situations, the institutional reverence for personalized medicine may be misguided or even detrimental: It distracts people from more evidence-based approaches to improving population health. It feeds into the myth that living a healthy lifestyle requires complicated solutions, which may, paradoxically, hurt efforts to sustain behavior change or discourage individuals from even trying. And it helps to legitimize the marketing of unproven genetic-testing services.

In addition, a focus on personalized approaches to health may subtly shift responsibility away from social institutions and toward individuals. There is at least some evidence that this kind of framing may hurt public support for population-based public-health interventions. Diet, exercise, substance use—all those are driven by structural factors as much as, or more than, personal choice. Genetic testing won’t change that.

Adapted from theatlantic.

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28 Comments


  1. Personalized medicine may offer effective treatment, but it will not change behavior of a person. While effective treatment options are important, the author is trying to say that healthy lifestyle and personal attitude towards ones health plays a bigger underlying role.

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  2. Personalized medicine does not necessarily led to better health.

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  3. Author gives some examples on how genetic testing isn’t conferring behavior changes of people with high risk of chronic diseases.
    Personalized medicine can even be detrimental to individuals.

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  4. MIP: Past studies show that knowledge of health does not necessarily lead to behavior change, so why would personalized medicine? PM may be detrimental to health.

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  5. Personalized medicine have some positive qualities but it doesn’t not necessarily leads to better health unless the person is willing to make the change.

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  6. There is recent excitement and drive toward personalized medicine. The main benefit seems to be awareness of risk factors and therefore motivation to live a better lifestyle in order to mitigate risks. However, behavioral research does not find a correlation between awareness of risk factors and changes in behavior. The effects of a dvancement of personalized genetic testing may be less compelling than thought. It may even be detrimental in that it may deter the responsibilities of social institutions to impact public lifestyle and behaviors, putting the sole responsibility to individuals.

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  7. PM =/= better health outcomes. Tone: neutral

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  8. Personalized medicine utilizing genetic info has no significant impact. Author’s tone is neutral.

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  9. pm = help –> change behavior = untrue, already known, not enough
    pm praise = misguided + institution –> individual

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  10. MP: genetic testing and personalized medicine will probably not do much to help make people healthier. in fact it might be detrimental and take away from more population health targets.

    diet,etc also reliant on structural factors as much as or even more than personal choice

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  11. Personalized medicine does not necessarily lead to better health, can actually be detrimental sometimes.

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  12. Lots of hype about personalized medicine has come up but recent research says it does not change population health effectively and efforts toward it may be fruitless

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  13. MI: Personalized medicine will not help individuals be healthy- in fact, as genetic testing improves, it may even negatively impact people. Studies do not support that when people know they are predisposed genetically to certain risk factors that they will modify their behavior. Further, genetic testing may put more of the responsibility of health on individuals rather than institutions. Author tone: critical of those (like Obama) who see it will be useful

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  14. Personalized healthcare does not necessarily lead to better health.

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  15. personalized medicine does not necessarily translate into behavioral change to healthy lifestyle; it can be distracting or even detrimental to one’s self-care, and responsibility will fall on individuals rather than social institutions

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  16. Personalized medicine will not improve public health

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  17. MP: people think that personalized medicine can be good in motivating people to live healthier, but the evidence shows otherwise

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  18. MP: While PM Is popular, it does not change behaviors. PM could be also detrimental due to the shift from social to individual responsibility for health, which will decrease the need for population health.

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  19. personalized medicine has the potential to positively benefit the health of many; however, many problems arise: genetic testing is often not enough to motivate people to change their existing behaviors, and many other lifestyle choices – such as diet – have other influences besides the individual himself (thus, making it difficult to successfully implement).

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  20. genetics doesn’t change behavior

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  21. MIP: Genetic risk → not enough to change b , P.M. = Bad , Tone = negative

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  22. Genetic testing is a novel filed of medicine that may help indicate personal risk factors of disease, but they may have the potential to demotivate individuals to change behaviour in order to prevent the risk of disease

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  23. Personalized medicine is not so much about gene-targeted therapy here but more of genetic testing to identify genes that predispose one to certain illness and diseases. The information is used instead to promote healthy lifestyle changes. Author mentions that having genetic information is not that helpful (does not lead to positive outcomes like behavioral changes to better health) and states that having this information is not enough to take actions to improve health based on research literature.

    Author doesn’t provide explanation to this finding in the papers. Despite this scientific evidence, genetic testing is still receiving a lot of hype. Author is definitely not an advocate for genetic testing as he is concerned that such information may not be used properly to benefit the patients. He feels that if we attribute everything to genetics, we might find it hard to make substantial lifestyle changes (get paranoid) and he feels that genetic-testing services ought to be legitimize to prevent people from developing paranoia.

    He is concerned that the government will make less effort to provide interventions and improve healthcare for the people (hurt public support for population-based public health interventions) since people are already aware of their condition (thanks to genetic testing) and the onus on maintaining good health lies in their hands. Simply put, it is now the people’s responsibility to take care of their health rather than the government in maintaining a healthy populace. Author does not support genetic testing and he feels that it does not serve its purpose of improving health outcomes in the population.

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  24. MIP
    (1) PM = genetic risks + treatment –> change behaviour
    (2) Knowledge =/= action, therefore PM =/= change behaviour

    Tone
    Negative. PM is misguided and places too much focus on individuals, rather than institutions.

    Reply

  25. Though individuals believe that genetic testing will improve the health of individuals, research has shown it has failed to do so thus far. Behavior change after knowledge gained from testing has not been shown to be significant and may actually be harmful by placing blame on individuals for not adhering to counseling advice.

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  26. personalized medicine is seen as beneficial because one can see the possible risks but author has a slight doubt about its advantage because knowing the risk does not mean healthy behaviors are adapted

    Reply

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