The Relation between Precision Medicine and Evidence-based Medicine and Its Application to Cerebrovascular Disease_Chinese Journal of Evidence-Based Medicine

Authors：

 HAOZi-long ^# ,  LIDan ^# ,  LIUMing

Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUMing, Email: wyplmh@hotmail.com

Keywords：

Precision medicine; Evidence-based medicine; Cerebrovascular disease

DOI：

10.7507/1672-2531.20160058

Video：

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Abstract Precision medicine is an ideal medical paradigm which combines modern scientific methods with traditional medical methods to diagnose, treat and evaluate the physical function and nature of diseases more precisely, and to maximize health benefits and minimize the risk of individuals and society with the most effective, safest, and the most economical medical service. Evidence-based medicine is necessary to verify the precision of diagnosis and treatment. In this review, we clarified the conception of precision medicine and the relation between precision medicine and evidence-based medicine. Moreover, we reviewed the application of precision medicine in the field of cerebrovascular disease. We pointed out that such new technologies as genetics, bioinformatics, molecular imaging and management provided tools to realize the idea of precision medicine, and high-quality evidence-based studies provided a guarantee for the clinical practice of precision medicine. In summary, precision medicine is an individualized medical mode that based on the context of a patient's genetic information, living environment and clinical data, etc. to provide precise treatment strategies for the prevention and treatment of disease, but still the promotion of precision medicine should be based on clinical validation under the guidance of evidence-based medicine. Thus, long-term exploration and unremitting efforts are required to achieve the idea of precision medicine.

Citation： HAOZi-long, LIDan, LIUMing. The Relation between Precision Medicine and Evidence-based Medicine and Its Application to Cerebrovascular Disease. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 373-377. doi: 10.7507/1672-2531.20160058 Copy

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1. Collins FS, Varmus H. A new initiative on precision medicine. N Engl J Med, 2015, 372(9):793-795.
2. Watson JD, Crick FH. Molecular structure of nucleic acids; a structure for deoxyribose nucleic acid. Nature, 1953, 171(4356):737-738.
3. Nancy B, 高健. 美国国会探究绘制人类基因组图谱的问题. 生物科学信息, 1989, 1(05):30-31.
4. McPherson JD, Marra M, Hillier L, et al. A physical map of the human genome. Nature, 2001, 409(6822):934-941.
5. International Human Genome Sequencing Consortium. Finishing the euchromatic sequence of the human genome. Nature, 2004, 431(7011):931-945.
6. National Research Council (US) Committee on A Framework for Developing a New Taxonomy of Disease. Toward Precision Medicine:Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. Washington (DC):National Academies Press (US); 2011. Available at:http://www.ncbi.nlm.nih.gov/books/NBK91503.
7. McCarthy M. Obama seeks $213m to fund "precision medicine". BMJ, 2015, 350:h587.
8. Porche DJ. Precision Medicine Initiative. Am J Mens Health, 2015, 9(3):177.
9. Goldberger JJ, Buxton AE. Personalized medicine vs guideline-based medicine. JAMA, 2013, 309(24):2559-2560.
10. CAST (Chinese Acute Stroke Trial) Collaborative Group. CAST:randomised placebo-controlled trial of early aspirin use in 20000 patients with acute ischaemic stroke. Lancet, 1997, 349(9066):1641-1649.
11. International Stroke Trial Collaborative Group. The International Stroke Trial (IST):a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet, 1997, 349(9065):1569-1581.
12. 临床个体化处理应尽可能循证决策. 中国循证医学杂志, 2007, 7(02):83-84.
13. 脑血管病循证医学与个体化处理不相对立. 中华神经科杂志, 2006, 39(09):577-579.
14. Yang J, Lin S, Zhou J, et al. Genetic variations of MMP9 gene and intracerebral hemorrhage outcome:a cohort study in Chinese Han population. J Neurol Sci, 2014, 343(1-2):56-59.
15. Yang J, Wu B, Lin S, et al. Genetic variations of MMP9 gene and intracerebral hemorrhage susceptibility:a case-control study in Chinese Han population. J Neurol Sci, 2014, 341(1-2):55-57.
16. International Stroke Genetics Consortium, Wellcome Trust Case Control Consortium 2, Bellenguez C, et al. Genome-wide association study identifies a variant in HDAC9 associated with large vessel ischemic stroke. Nat Genet, 2012, 44(3):328-333.
17. Little J, Higgins JP, Ioannidis JP, et al. STrengthening the REporting of Genetic Association Studies (STREGA):an extension of the STROBE statement. PLoS Med, 2009, 6(2):e22.
18. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack:a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2014, 45(7):2160-2236.
19. Jickling GC, Sharp FR. Biomarker panels in ischemic stroke. Stroke, 2015, 46(3):915-920.
20. Gnanapavan S, Hegen H. Guidelines for uniform reporting of body fluid biomarker studies in neurologic disorders. Neurology, 2014, 83(13):1210-1216.
21. Collins GS, Reitsma JB, Altman DG, et al. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD):the TRIPOD statement. BMJ, 2015, 350:g7594.
22. Moons KG, Altman DG, Reitsma JB, et al. Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD):explanation and elaboration. Ann Intern Med, 2015, 162(1):W1-73.
23. Galvin R, Atanassova PA, Motterlini N, et al. Long-term risk of stroke after transient ischaemic attack:a hospital-based validation of the ABCD(2) rule. BMC Res Notes, 2014, 7:281.
24. European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, Camm AJ, et al. Guidelines for the management of atrial fibrillation:the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J, 2010, 31(19):2369-2429.
25. Camm, AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation:an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J, 2012, 33(21):2719-2747.
26. January CT, Wann LS, Alpert JS, et al. 2014 AHA ACC HRS Guideline for the Management of Patients With Atrial Fibrillation. J Am Coll Cardiol, 2014, 64(21):e1-76.
27. Menon BK, Campbell BC, Levi C, et al. Role of imaging in current acute ischemic stroke workflow for endovascular therapy. Stroke, 2015, 46(6):1453-1461.
28. Powers WJ, Derdeyn CP, Biller J, et al. 2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment:A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2015, 46(10):3020-3035.
29. Sgaier SK, Jha P, Mony P, et al. Public health. Biobanks in developing countries:needs and feasibility. Science, 2007, 318(5853):1074-1075.
30. Smith GD, Ebrahim S, Lewis S, et al. Genetic epidemiology and public health:hope, hype, and future prospects. Lancet, 2005, 366(9495):1484-1498.
31. 孙孪孪, 谭云龙, 等. 中国慢性病前瞻性研究的标准化生物银行建设. 转化医学杂志, 2014, 3(6):321-326.

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