Empowered by genetic information, Vanderbilt aims to reinvent health care. by Bill Snyder and Dagny Stuart

The iconic Norman Rockwell painting of a family doctor checking the heart of a young patients doll may seem quaint, but its far from old-fashioned. On the contrary, personalized medicine is bringing the family doctor back and the family nurse, and the family pharmacist, and a whole team of family health care providers. Only this time, they will be empowered by 21st-century tools like genomics, informatics and high-tech imaging.

Ailments will be diagnosed more quickly and accuratelyor prevented before they can occur. By selecting drugs that match each patients unique genetic readout or by tweaking molecular pathways instead of blasting away like a shotgun, treatments will be more effective and will have fewer side effects.

After having gone through a period where blockbuster drugs and massive screening were the norm, we are actually moving back to a place where were trying to tailor care to the individual, says Dr. Jeff Balser, Vanderbilt Universitys vice chancellor for health affairs and dean of the School of Medicine.

I try to think of this as not getting more high-tech and therefore more distant from the patient, Balser says. But through technology were becoming more familiar with our patients as individuals and, along with that, always remembering to be personableNorman Rockwell with a DNA sequencer.

In 2010 Vanderbilt University Medical Center launched two major personalized medicine initiatives to advance cancer treatment and to individualize and improve drug therapy. Already this approach is showing promise.

Patients scheduled for cardiac or orthopedic procedures are being tested in advance for genetic variations that can affect their response to common blood thinners. Based on the test results, their doctors may adjust the dose or order a different drug entirely.

Similarly, by reading the genetic fingerprints of tumors removed from patients with certain forms of cancer, doctors can choose targeted drugs that are most likely to work.

Using genetic information to guide drug therapy is just the beginning. In the near future, genomicsthe science of reading and interpreting the DNA sequencewill help Vanderbilt physicians select the best tests and procedures for their patients. Eventually, genetics will help guide efforts to prevent disease and maintain good health.

Personalized medicine is more than genetics, of course. Social, family and behavioral factors, as well as environmental and economic circumstances, also have a profound impact on health. Those things are just as important in tailoring care to the individual as their genetic background, says Balser. Its almost like genomic medicine is what were using to learn how to individualize medicine, but then we can apply it to a broader set of data and circumstances.

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The Promise of Personalized Medicine - Vanderbilt Magazine

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