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Targeted therapy is not possible when diseases are defined by thresholds: Where the White House’s “Precision Medicine Initiative” needs help.

Article, Diagnositc relationalism, News, Sepsis |

President Obama’s latest State of the Union Address announced the launch of a new Precision Medicine Initiative (1), chartered by the NIH (2). The Initiative promises to lay a “scientific foundation” (3) for targeted treatment of disease based on individual human factors. The NIH’s model works well for diseases like cancer, where a simple biopsy reveals the exact sub-type or genotype of the cancer. Patients with breast and lung cancers routinely undergo genotyping.

But what about other conditions?

For other conditions—like sepsis—we can’t readily determine the genotype. There is no tumor to biopsy and test, but more importantly such conditions are often defined by broad traditional 20th century definitions (such as the “Sepsis Criteria”). In many cases these traditional definitions are simply a set of one-size-fits-all thresholds—the antithesis of precision medicine. This makes it impossible for the researchers to lay any solid “scientific foundation” for the targeted treatment of sepsis and other conditions so defined, regardless of how much “human data” the NIH amasses.

For precision medicine to deliver on its promise, it will need to be extended to conditions other than cancer (and the few other diseases for which the genotypes are known). This requires defining the “phenotype” of the condition, which is the combined clinical and biochemical manifestation of the condition in the patient (the dynamic pattern of symptoms and laboratory values). This is why all large sepsis trials have failed in the past 25 years. Just as 20th century one-size-fits-all chemotherapy for cancer failed, so too does one-size-fits-all treatment for sepsis.

This is where PatientStormTracker can help. PatientStormTracker is actually a disease phenotyper, which tracks the complexities in clinical data, showing the dynamic, relational patterns of the condition (the patterned, phenotypic expressions) as motion images moving across a screen. PatientStormTracker is a powerful tool that can give researchers insight into the actual phenotypes of a condition like sepsis, where it isn’t possible to biopsy a tumor.

Precision medicine has the power to improve care and save lives—but, first, we need to move away from the threshold science. To learn more about PatientStormTracker as a research and precision medicine tool, request a demo of the software, by visiting here.

1) Remarks by the President in State of the Union Address. The White House website, January 20, 2015. Accessed June 16, 2015.

2) Precision Medicine Initiative. National Institutes of Health website, Accessed June 16, 2015.

3) The Precision Medicine Initiative: Infographic. National Institutes of Health website Accessed June 16, 2015.