title: Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients.
abstract: Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation.
authors.affiliation: Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland; Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland; Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy. Electronic address: fabrizio.montecucco@unige.ch.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
authors.affiliation: Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland; Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Carbone
authors.affiliation: Cardiac, Thoracic and Vascular Department, University of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, 56124 Pisa, Italy.
authors.forename: Frank Lloyd
authors.initials: FL
authors.lastname: Dini
authors.affiliation: Serviço de Cardiologia 1, Hospital de Santa Maria (CHLN), Lisboa, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Fiuza
authors.affiliation: Serviço de Cardiologia 1, Hospital de Santa Maria (CHLN), Lisboa, Portugal.
authors.forename: Fausto J
authors.initials: FJ
authors.lastname: Pinto
authors.affiliation: Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Martelli
authors.affiliation: Vascular and Endovascular Surgery Unit, Department of Surgery, San Martino Hospital, 10 Largo Rosanna Benzi, 16132 Genoa, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Palombo
authors.affiliation: Department of Nuclear Medicine Unit, IRCCS San Martino-IST, University of Genoa, L.go R. Benzi 10, 16132 Genoa, Italy.
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
authors.affiliation: Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Mach
authors.affiliation: Institute of Cardiology and Center of Excellence on Aging, G. d'Annunzio University - Chieti-Pescara, Italy; G. Monasterio Foundation, Pisa, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
mesh_terms: D035843:Biomedical Research / Q000379:methods / Q000458:organization & administration / Q000592:standards; D002318:Cardiovascular Diseases / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D013597:Systems Analysis; D057170:Translational Research, Biomedical
keywords: Cardiovascular research; Clinical trials; Home-care; Systems Medicine