title: Essential elements of personalized medicine.
abstract: OBJECTIVE
  Genomic information has been promoted as the basis for "personalized" health care. We considered the benefits provided by genomic testing in context of the concept of personalized medicine.
  
  
  METHODS
  We evaluated current and potential uses of genomic testing in health care, using prostate cancer as an example, and considered their implications for individualizing or otherwise improving health care.
  
  
  CONCLUSIONS
  Personalized medicine is most accurately seen as a comprehensive effort to tailor health care to the individual, spanning multiple dimensions. While genomic tests will offer many potential opportunities to improve the delivery of care, including the potential for genomic research to offer opportunities to improve prostate cancer screening and treatment, such advances do not in themselves constitute a paradigm shift in the delivery of health care. Rather, personalized medicine is based on a partnership between clinician and patient that utilizes shared decision making to determine the best health care options among the available choices, weighing the patient's personal values and preferences together with clinical findings. This approach is particularly important for difficult clinical decisions involving uncertainty and trade-offs, such as those involved in prostate cancer screening and management. The delivery of personalized medicine also requires adequate health care access and assurance that basic health needs have been met. Substantial research investment will be needed to identify how genomic tests can contribute to this effort.
authors: Department of Bioethics and Humanities, University of Washington, Seattle, WA. Electronic address: wburke@uw.edu.
authors: Wylie
authors: W
authors: Burke
authors: Department of Bioethics and Humanities, University of Washington, Seattle, WA.
authors: Susan
authors: S
authors: Brown Trinidad
authors: Department of Public Health & Preventive Medicine, Oregon Health & Science University School of Medicine, Portland, OR; School of Nursing, Oregon Health & Science University, Portland, OR.
authors: Nancy A
authors: NA
authors: Press
mesh_terms: D003657:Decision Making; D003695:Delivery of Health Care / Q000941:ethics / Q000379:methods; D005820:Genetic Testing / Q000941:ethics* / Q000379:methods; D023281:Genomics / Q000941:ethics* / Q000379:methods; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D057285:Precision Medicine / Q000941:ethics* / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy
keywords: Genetics; Genomics; Health technology assessment; Personalized medicine; Pharmacogenomics; Prostate cancer