title: Multilevel, Dynamic Chronic Obstructive Pulmonary Disease Heterogeneity. A Challenge for Personalized Medicine.
abstract: This article summarizes how the multilevel (clinical, functional, structural, and biological) and dynamic (i.e., subjected to changes with time) heterogeneity of chronic obstructive pulmonary disease challenges a personalized approach for these patients. In particular, the following issues are discussed: (1) the conceptual differences between personalized and precision medicine, (2) how to frame the complexity and heterogeneity of chronic obstructive pulmonary disease by considering the precise meaning of the terms personalized medicine and precision medicine, and (3) how to translate all these novel concepts into clinical practice and move the field forward.
authors.affiliation: 1 Centro de Investigacíon Biomédica en Red, Respiratory Diseases (CIBERES), Madrid, Spain.|2 Fundació Clinic per a la Recerca Biomèdica, Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Faner
authors.affiliation: 1 Centro de Investigacíon Biomédica en Red, Respiratory Diseases (CIBERES), Madrid, Spain.|2 Fundació Clinic per a la Recerca Biomèdica, Barcelona, Spain.|3 Institut Respiratori, Hospital Clinic, Barcelona, Spain.|4 Institut d'Investigació Biomedica August Pi i Sunyer (IDIBAPS), Barcelona, Spain; and.|5 Universitat de Barcelona, Barcelona, Spain.
authors.forename: Álvar
authors.initials: Á
authors.lastname: Agustí
mesh_terms: D029481:Bronchitis, Chronic / Q000503:physiopathology; D006801:Humans; D057285:Precision Medicine; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011656:Pulmonary Emphysema / Q000503:physiopathology
keywords: biomarkers; bronchitis; emphysema; lung function; network analysis