In the world of diagnostic healthcare, a changing of the guard seems to be underway as the focus of medicine is shifting to a totally different perspective. The time for making this shift is long overdue and the implications are far reaching as it will impact nearly all facets of medicine.
The primary focus for a diagnostic technology has long been described as being a technology that serves to identify or characterize in a manner that delivers a precise indication. The key element is the notion of identifying and providing information with precision.
Accurately identifying the condition with precision has been the hallmark of an effective blueprint for the clinician to then develop a roadmap for treating the condition at hand. Fairly simple: Identify what the patient has with as much precision as possible, and then use that information develop a treatment regimen that offers the greatest possibility for a cure or a remedy.
Seems as though this has been the basic process since the beginning of time. While it seems to make sense, and it has served mankind well over generations, a closer analysis shows a significant flaw with this approach. It is based entirely on waiting until after the patient has developed an ailment, disease, or malady. It then looks to cure or correct the defect that is already in place.
The wave that is coming is a seismic shift away from diagnostic testing and is trending towards prognostic testing. While there are many similarities, it is the approach and the focus that makes all the difference. A prognostic approach also looks to identify a condition with precision, however, (and this is a big however), it looks to precisely identify the potential for a condition before the patient acquires it. It is completely predictive in nature as opposed to after the fact.
Shifting to a prognostic approach has the potential for preventing the patient from acquiring a disease, or at the very least mitigating the effects of a disease if and when it develops. All of us have certain and unique predispositions. The effective use of a prognostic approach to medicine allows the clinician to proactively personalize a regimen, with a precision specifically designed to meet a patient’s particular situation. The life changing component is that it does this in a predictive manner. It has the potential to identify a specific disease state that the patient is predisposed to, and it can offer a preventive roadmap to avoid the ailment.
Treatments may involve the use of medicines specifically designed for the individual patient, changes in lifestyle and or nutrition. The essence is that by knowing what the patient has been clinically identified as being predisposed for, action can me taken in a proactive and preventive manner.
The areas of medicine where this approach has strong applications are limitless. Conditions such as endometriosis, esophageal cancer, osteoporosis, and diabetes to name just a few.
The first element in the process is for science and technology to further improve on the ability to accurately identify biomarkers for specific diseases. Much progress has been made in using simple bloodwork to identify biomarkers that provide the link to such predictive capabilities.
Let’s look at one example: There is a subset of diabetic patients who are predisposed to having significant kidney issues later in life. These issues are serious, can often be life threatening and can ultimately expose the patient to long term dialysis. A biomarker has been identified that is a precursor to having these kidney issues. That biomarker can be used to identify a patient’s risk factor, and this information can be used in a proactive manner to eliminate or mitigate the impact later in life. Again, it is all about being proactive in treatment as opposed to treating things retroactively.
Certainly, there will also be a huge need for educating the masses as to how this works. It will be necessary to fully explain why an individual is very likely predisposed (usually due to a pre-existing condition) to a particular malady. The patient must fully understand the value of this approach and the heartache and pain it has the potential to avoid on the patient’s behalf.
The shift from a diagnostic to a prognostic approach offers to change the entire landscape of who, when, and why we treat patients. The potential for savings in time, money and pain are well worth the effort to fully develop this new approach to treating patients.