GenomicEnterprise.com Science Blog

The term “P4 Medicine” was first introduced more than 5 years ago by the researcher Leroy Hood in an attempt to change medicine from a reactive to a proactive perspective. The ultimate goal of this “futuristic medicine” is to maximize wellness for each individual rather than just treat the disease. P4 stands for the letter “P” in four words: Predictive, Preventive, Personalized and Participatory (for more information see “Predictive, personalized, preventive, participatory (P4) cancer medicine” by Hood and Friend). Emerging from debates related to health care system reform and translational research, this new way of thinking about medicine has put the focus on the patients, other than the physicians. P4 medicine utilizes four interconnected aspects to improve both the effectiveness and efficiency of health management at the individual level. The first “P” that stands for Predictive medicine studies the risk factors, predispositions, and genetic susceptibilities that exist before issues arise by the use of genetic testing and genome sequencing, technologies that have evolved in the last decade. This gives the patient and their health care team warning signs long before a disease is diagnosed. It also gives information that can influence changes in the diet and lifestyle of individuals. The second “P” for Preventive medicine uses the knowledge of the risk factors learned from predictive medicine to change a person’s behavior. It also helps in pre-disease treatments and early screening helping cut off the development of more serious conditions. The third “P” is for Personalized medicine in which each individual will respond differently to treatments. This helps the physician understand what works and what does not work. Personalized or individualized medicine studies and treats each individual as a unity and the current system of health care attempts to treat patients in a universal fashion, which is wrong. The knowledge and access to multiple treatment options as well as better predictions on what works more effectively will help patients and their health care team in selecting the treatment to best meet the patient needs, thus personalizing the medical experience. The fourth and last “P” is for Participatory medicine in which the patient and doctor relationship will become more interactive, helping in better diagnosis and effective treatments. Participation in health care decisions empowers the patient and can encourage innovation among the health care team. Importantly, the emergence of the Web 2.0 and social media websites is facilitating these interactions. Social Media is also empowering individuals to share their data with others that may have the same conditions. This new era in medicine has been shaped by technology breakthroughs such as increasing computer storage capacities and speed, the emergence of the cloud and systems biology generating tons of patient data points. This concept of enabling data and models to be shared by communities as maps of disease built in an open-source manner that includes researchers and physicians around the world will change the style and speed of discovery and development of new therapies. This revolution in medicine will also facilitate clinical trials that need to recruit a very large number of patients. It will be possible by the use of crowd-sourced recruitment bringing several centers and groups together with the use of next generation Electronic Medical Records (Next-Gen EMRs) empowered by social media tools. I truly believe that “P4 medicine”, with patients being more in charge of their own health data, will change the way we approach and treat diseases. That is indeed a medical revolution!

In this blog post today, I will share some experiences in my day-to-day life doing (or trying hard to do…) translational research. Just to be clear there are two main types of research: 1) basic, which tries to understand the fundamental principles and phenomena that drive cells, organisms, systems and the world we live in; and 2) translational, which is the application of the basic research to solve specific problems, aid in diseases and help the society at different levels. In health sciences, translational research has its focus on removing barriers to multidisciplinary collaboration between scientists and physicians helping to “translate” basic discoveries in new drugs to treat diseases and/or the identification of better ways to manage chronic diseases such as cancer, diabetes, etc. Importantly, translational research has the potential to drive the advancement of applied science. It is also an attempt to bridge the medical and scientific domains to move discoveries “from bench to bedside” or from laboratory experiments through clinical trials to actual point-of-care patient applications. Well, it is pretty and fancy to say that you are doing translational research, since the chances that your research will help improve patient care are always higher. I can tell using my personal experience that this is a very complicated and entropic process. As in any field, communication is key to success. For example, in project management, business, finance, and etc, communication has to be the most important feature in the path to success. The same applies to multidisciplinary projects involving scientists, project managers and physicians. The problem is that it is not like this. Physicians have different expectations compared to scientists and I have a feeling that I am always “lost in translation” and vice-versa. The success of any project depends not just in commitment from the personal involved but also good communication skills between the people that are involved. It is like in the cartoon above, there is a “valley of death” between both parts mainly because the exchange of information is faulty. Well, we are in need for better ways to facilitate the communication between professionals with different backgrounds, especially when doing translational research. The physician needs to understand and be interested in the scientific side of the project (read more, study more, be curious about science which sometimes is not the case…) and the scientist has to understand the physician’s needs and the problems he or she wants to find answers in order to increase the rates of success. My feeling is that none of this happens and the environment between both sides is indeed entropic with constant miscommunication. Improvements in both sides for a better information exchange are crucial to develop multidisciplinary projects with impacts for patients suffering from diseases. New discoveries doesn’t depend just on working hard towards a goal, there might be a synchrony between researchers and doctors so the rate of success will increase extraordinarily. Finally, I believe that both parts need to learn more about Project and Finance Management, especially in though times with shortage of money for research. I think this is not an isolated case and this may happen in a lot of institutions around the world. So, let’s step back for a while and think on how to maximize our chances of better communication and, consequently, of success in translational research.