Personalized or precision medicine maintains that medical care and public health will be radically transformed by prevention and treatment programs more closely targeted to the individual patient. These interventions will be developed by sequencing more genomes, creating bigger biobanks, and linking biological information to health data in electronic medical records (EMRs) or obtained by monitoring technologies. Yet the assumptions underpinning personalized medicine have largely escaped questioning. In this Viewpoint, we seek to stimulate a more balanced debate by posing 7 questions for the advocates of personalized medicine.
DOES THE HUMAN GENOME CONTRIBUTE TO DISEASE RISK PREDICTION?
Personalized medicine builds on the Human Genome Project, which was forecasted to revolutionize disease risk prediction, with projected relative risks as high as 6 for gene variants linked to specific diseases. However, the relative risks for the vast majority of gene variants rarely exceed 1.5, and these variants have added little useful predictive power to traditional risk prediction algorithms. Moreover, improved adherence with lifestyle interventions expected to result from the provision of genomic risk information to patients has not materialized.1