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Model-guided therapy for hepatocellular carcinoma: a role for information technology in predictive, preventive and personalized medicine.

Berliner L, Lemke HU, vanSonnenberg E, Ashamalla H, Mattes MD, Dosik D, Hazin H, Shah S, Mohanty S, Verma S, Esposito G, Bargellini I, Battaglia V, Caramella D, Bartolozzi C, Morrison P - EPMA J (2014)

Bottom Line: We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient.An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists.The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

View Article: PubMed Central - HTML - PubMed

Affiliation: New York Methodist Hospital, Brooklyn, NY 11215, USA ; Weill Medical College of Cornell University, New York, NY 10021, USA.

ABSTRACT
Predictive, preventive and personalized medicine (PPPM) may have the potential to eventually improve the nature of health care delivery. However, the tools required for a practical and comprehensive form of PPPM that is capable of handling the vast amounts of medical information that is currently available are currently lacking. This article reviews a rationale and method for combining and integrating diagnostic and therapeutic management with information technology (IT), in a manner that supports patients through their continuum of care. It is imperative that any program devised to explore and develop personalized health care delivery must be firmly rooted in clinically confirmed and accepted principles and technologies. Therefore, a use case, relating to hepatocellular carcinoma (HCC), was developed. The approach to the management of medical information we have taken is based on model theory and seeks to implement a form of model-guided therapy (MGT) that can be used as a decision support system in the treatment of patients with HCC. The IT structures to be utilized in MGT include a therapy imaging and model management system (TIMMS) and a digital patient model (DPM). The system that we propose will utilize patient modeling techniques to generate valid DPMs (which factor in age, physiologic condition, disease and co-morbidities, genetics, biomarkers and responses to previous treatments). We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient. An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists. The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

No MeSH data available.


Related in: MedlinePlus

It may be possible to build on the BCLC staging system platform with an IT system for personalized medicine (ITS-PM). The first goal will be, through enhanced screening, to have patients seek medical attention earlier in the course of their disease, so that they may enter the algorithm at a more favorable stage; i.e. a ‘shift to the left’. The second goal will be to improve outcomes through a better understanding of treatment subcategories, combined treatments and the effects of down-staging.
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Figure 8: It may be possible to build on the BCLC staging system platform with an IT system for personalized medicine (ITS-PM). The first goal will be, through enhanced screening, to have patients seek medical attention earlier in the course of their disease, so that they may enter the algorithm at a more favorable stage; i.e. a ‘shift to the left’. The second goal will be to improve outcomes through a better understanding of treatment subcategories, combined treatments and the effects of down-staging.

Mentions: The BCLC staging system algorithm is an important advancement in the application of the principles of PPPM in cancer treatment. The IEs identified in ‘Identification of information entities relating to hepatocellular cancer’ section may be used to expand and reinforce the algorithm in several ways. Extensions may be added to the algorithm (Figure 8) that (1) facilitate enhanced screening for HCC, (2) explore ways in which targeted therapies may be used to improve outcomes and (3) provide statistically validated evidence regarding the selection of the best treatment from the many options available for palliative, down-staging and bridging therapies.


Model-guided therapy for hepatocellular carcinoma: a role for information technology in predictive, preventive and personalized medicine.

Berliner L, Lemke HU, vanSonnenberg E, Ashamalla H, Mattes MD, Dosik D, Hazin H, Shah S, Mohanty S, Verma S, Esposito G, Bargellini I, Battaglia V, Caramella D, Bartolozzi C, Morrison P - EPMA J (2014)

It may be possible to build on the BCLC staging system platform with an IT system for personalized medicine (ITS-PM). The first goal will be, through enhanced screening, to have patients seek medical attention earlier in the course of their disease, so that they may enter the algorithm at a more favorable stage; i.e. a ‘shift to the left’. The second goal will be to improve outcomes through a better understanding of treatment subcategories, combined treatments and the effects of down-staging.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4274760&req=5

Figure 8: It may be possible to build on the BCLC staging system platform with an IT system for personalized medicine (ITS-PM). The first goal will be, through enhanced screening, to have patients seek medical attention earlier in the course of their disease, so that they may enter the algorithm at a more favorable stage; i.e. a ‘shift to the left’. The second goal will be to improve outcomes through a better understanding of treatment subcategories, combined treatments and the effects of down-staging.
Mentions: The BCLC staging system algorithm is an important advancement in the application of the principles of PPPM in cancer treatment. The IEs identified in ‘Identification of information entities relating to hepatocellular cancer’ section may be used to expand and reinforce the algorithm in several ways. Extensions may be added to the algorithm (Figure 8) that (1) facilitate enhanced screening for HCC, (2) explore ways in which targeted therapies may be used to improve outcomes and (3) provide statistically validated evidence regarding the selection of the best treatment from the many options available for palliative, down-staging and bridging therapies.

Bottom Line: We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient.An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists.The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

View Article: PubMed Central - HTML - PubMed

Affiliation: New York Methodist Hospital, Brooklyn, NY 11215, USA ; Weill Medical College of Cornell University, New York, NY 10021, USA.

ABSTRACT
Predictive, preventive and personalized medicine (PPPM) may have the potential to eventually improve the nature of health care delivery. However, the tools required for a practical and comprehensive form of PPPM that is capable of handling the vast amounts of medical information that is currently available are currently lacking. This article reviews a rationale and method for combining and integrating diagnostic and therapeutic management with information technology (IT), in a manner that supports patients through their continuum of care. It is imperative that any program devised to explore and develop personalized health care delivery must be firmly rooted in clinically confirmed and accepted principles and technologies. Therefore, a use case, relating to hepatocellular carcinoma (HCC), was developed. The approach to the management of medical information we have taken is based on model theory and seeks to implement a form of model-guided therapy (MGT) that can be used as a decision support system in the treatment of patients with HCC. The IT structures to be utilized in MGT include a therapy imaging and model management system (TIMMS) and a digital patient model (DPM). The system that we propose will utilize patient modeling techniques to generate valid DPMs (which factor in age, physiologic condition, disease and co-morbidities, genetics, biomarkers and responses to previous treatments). We may, then, be able to develop a statistically valid methodology, on an individual basis, to predict certain diseases or conditions, to predict certain treatment outcomes, to prevent certain diseases or complications and to develop treatment regimens that are personalized for that particular patient. An IT system for predictive, preventive and personalized medicine (ITS-PM) for HCC is presented to provide a comprehensive system to provide unified access to general medical and patient-specific information for medical researchers and health care providers from different disciplines including hepatologists, gastroenterologists, medical and surgical oncologists, liver transplant teams, interventional radiologists and radiation oncologists. The article concludes with a review providing an outlook and recommendations for the application of MGT to enhance the medical management of HCC through PPPM.

No MeSH data available.


Related in: MedlinePlus