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The case for precis...
The case for precision medicine in the prevention, diagnosis, and treatment of cardiometabolic diseases in low-income and middle-income countries
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- Misra, Shivani (author)
- St Mary's University, Twickenham,Imperial College London
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- Aguilar-Salinas, Carlos A. (author)
- Salvador Zubirán National Institute of Health Sciences and Nutrition
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- Chikowore, Tinashe (author)
- University of the Witwatersrand
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- Konradsen, Flemming (author)
- Novo Nordisk A/S,University of Copenhagen
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- Ma, Ronald C.W. (author)
- Prince of Wales Hospital Hong Kong,Chinese University of Hong Kong
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- Mbau, Lilian (author)
- Kenya Cardiac Society
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- Mohan, Viswanathan (author)
- Madras Diabetes Research Foundation
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- Morton, Robert W. (author)
- Novo Nordisk A/S
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- Nyirenda, Moffat J. (author)
- London School of Hygiene and Tropical Medicine
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Tapela, Neo (author)
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- Franks, Paul W. (author)
- Lund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups,University of Oxford,Harvard University
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(creator_code:org_t)
- 2023
- 2023
- English 12 s.
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In: The Lancet Diabetes and Endocrinology. - 2213-8587. ; 11:11, s. 836-847
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Abstract
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- Cardiometabolic diseases are the leading preventable causes of death in most geographies. The causes, clinical presentations, and pathogenesis of cardiometabolic diseases vary greatly worldwide, as do the resources and strategies needed to prevent and treat them. Therefore, there is no single solution and health care should be optimised, if not to the individual (ie, personalised health care), then at least to population subgroups (ie, precision medicine). This optimisation should involve tailoring health care to individual disease characteristics according to ethnicity, biology, behaviour, environment, and subjective person-level characteristics. The capacity and availability of local resources and infrastructures should also be considered. Evidence needed for equitable precision medicine cannot be generated without adequate data from all target populations, and the idea that research done in high-income countries will transfer adequately to low-income and middle-income countries (LMICs) is problematic, as many migration studies and transethnic comparisons have shown. However, most data for precision medicine research are derived from people of European ancestry living in high-income countries. In this Series paper, we discuss the case for precision medicine for cardiometabolic diseases in LMICs, the barriers and enablers, and key considerations for implementation. We focus on three propositions: first, failure to explore and implement precision medicine for cardiometabolic disease in LMICs will enhance global health disparities. Second, some LMICs might already be placed to implement cardiometabolic precision medicine under appropriate circumstances, owing to progress made in treating infectious diseases. Third, improvements in population health from precision medicine are most probably asymptotic; the greatest gains are more likely to be obtained in countries where health-care systems are less developed. We outline key recommendations for implementation of precision medicine approaches in LMICs.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
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Misra, Shivani
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Aguilar-Salinas, ...
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Chikowore, Tinas ...
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Konradsen, Flemm ...
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Ma, Ronald C.W.
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Mbau, Lilian
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Mohan, Viswanath ...
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Morton, Robert W ...
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Nyirenda, Moffat ...
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Tapela, Neo
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Franks, Paul W.
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