Prospective health care the second transformation of medicine 英文参考文献.docVIP

Opinion Prospective health care: the second transformation of medicine Ralph Snyderman* and Jason Langheier*?? Addresses: *Duke University Medical Center, DUMC 3059, Durham, NC 27710, USA. ?Proventys, Inc., 2200W. Main Street, Suite L110, Durham, NC 27705. ?Harvard School of Public Health, 35 Park Drive, Boston, MA 02215, USA. Correspondence: Ralph Snyderman. Email: ralph.snyderman@ Published: 27 March 2006 Genome Biology 2006, 7:104 (doi:10.1186/gb-2006-7-2-104) The electronic version of this article is the complete one and can be found online at /2005/7/2/104 ? 2006 BioMed Central Ltd Abstract Emerging scientific technologies provide rich sources of predictive biomarkers, which could transform health care. Identification of causal biomarkers will enable the development of tools to quantify risk and anticipate disease. Accurate health risk analysis is rapidly becoming feasible, so health care can become rational, preventive and personalized. Evolution of health care The reductionist focus on specific and single etiological causes of disease is a useful strategy to understanding patho- genesis, but is limited in truly explaining disease. Even for a microbial disease for which an etiological agent is known, the outcome of infection is highly dependent on the state of the host’s immune system and their general health status. In genetic diseases resulting from well understood molecular mechanisms, such as sickle-cell disease, there is a highly variable course: some individuals have severe unremitting crises leading to death by their early twenties, whereas others live well beyond their fifties. At the beginning of the 20th century, the emerging sciences of physiology, pathology, chemistry, biochemistry, microbi- ology and radiology had the potential to change medicine from a practice based on mythology and anecdotal observa- tions to one grounded in experimental science. Particularly powerful wa