04 July 2006

What is P4 Medicine?

P4 Medicine is a plan to radically improve the quality of human life via biotechnology.

P4 Medicine is a term coined by biologist Leroy Hood, and is short for "Predictive, Preventive, Personalized, and Participatory Medicine." The premise of P4 Medicine is that, over the next 20 years, medical practice will be revolutionized by biotechnology, to manage a person's health, instead of manage a patient's disease.

P4 Medicine is the subject of this blog. I can imagine few ideas as exciting, fulfilling, and worthy of attention as P4 Medicine. But this is not a simple subject either. The technological challenges are stupefying. Moreover, there are significant social and moral implications.

5 Comments:

Blogger Michael said...

Would you please share with me what are the moral and social implications as mentioned with P4 Med?

5:09 PM  
Blogger Erik Nilsson said...

"moral and social implications" Wow, that's a broad topic.

I suppose I could say "see every other entry in this blog for my thoughts on that subject", but maybe I can say something more pointed.

P4 medicine may lead to significant social changes, with moral implications. One often-cited example is, what are the social and moral implications of extending the average active life span (for those who can afford it) by 20 years?

Here's another area to consider: in P4 medicine, therapies will be much more targeted. Innovation in medicine often comes from doctors using their discretion to try new approaches. There are ethical and social issues with that process already. But, what if therapies were much more targeted? Will the current system of balancing risks and benefits to patients fail if we have more data (of still imperfect quality) about how patients are likely to respond to different therapies?

4:30 PM  
Anonymous Anonymous said...

Ethical, moral and social implications? , are you serious? I'm sick of all this meagering socialist, anti-propagander, leagilistic, anti- 'everything' mentality, to keep the status quo. The health system in almost all countries are SCREWED, there is no denying this. If a new revolutionary solution is proposed from several of the pre-eminent leaders in the medical field, then why don't people prick up their ears? listen and take interest, and support or tweak the solution. People have no idea, how hard it is for movements, or ideas to be developed into reality, and all it takes is a small micro % of a population to object, and the solution is trashed.
Let me put it to you this way, you may 'insist' that you object to use of your personal data, the sequencing of your dna, the use of 'chemicals' rather than herbs, the overprescribing, the expense.
But when you're crying in a bed alone, in agonizing pain for months and possibly years on end, and you want the doc to do more.
Guess what? they can't because you objected to all the above mentioned, and whats more everyone has to suffer the same treatment too.

7:42 AM  
Blogger Erik Nilsson said...

Hi Anonymous, thanks for posting.

I think you are making some unwarranted assumptions about my position on personalized medicine. Briefly, I think it's the way forward, but it isn't going to be easy, and lots of great-sounding ideas will turn out to just not work. So, we should not accept a claim of effectiveness without data, even if that claim is made by a very smart person with a lot of letters after their name.

To answer your questions and assertions:

- Yes, I'm serious.

- Yes, the health systems in most countries are a mess.

- Yes, the medical profession is very resistant to change. Partly, this a reasonable skepticism towards that which is not yet proven. Partly, it's just plain stick-in-the-mud.

So making medicine better requires structural changes, new technology, and new practices. Each of these will have to be evaluated, measured, and retained if they demonstrate their value.

You close with a quote that calls out for reply:

"But when you're crying in a bed alone, in agonizing pain for months and possibly years on end, and you want the doc to do more. Guess what? they can't…."

I've been there. And I've watched friends die, good people who suffered painful and terrifying diseases. That doesn't make me special, it just makes me human: all of us who've been here long enough have had to watch people suffer in ways that conceivably could be prevented.

One of the reasons I have stayed in the biomedical field is to find ways to make those bad ends less common.

6:11 PM  
Anonymous George said...

P4 is the marketing ploy drug companies have used to support the introduction of new drugs. It does not address how to reduce the disease burden, which is our real health crisis.

Thank you for giving me the opportunity to explain the need for a shift in focus from disease to maintaining wellness. I am a clinical test researcher and I have been involved with systemic change analysis methods and disease pattern recognition for over thirty years. For the last fifteen I have been looking at ways to use systemic biochemical monitoring to measure a persons shift to or from wellness. I have worked on developing testing that can answer this question in the shortest possible time: Is the intervention working?

Using new testing protocols that measure epigenetic biochemical changes, an individual can monitor if their intervention is working for management of their disease. These tests can also indicate to someone without disease if their actions are maintaining or improving their wellness. Wellness testing is not dependent on the intervention used. For example, you could have taken a drug, used an herb, practiced yoga, or used group prayer as the intervention.

Epigenetic biochemical monitoring can determine a return to wellness within days to weeks of starting an intervention. Epigenetic test monitoring can be done with a cellular phone photo or with clinical tests using a standard blood sample. Traditional Chinese Medicine uses observations of pulse, tongue, eyes, and hands to determine wellness. Due to a lack of trained healers we need to use technology to assist us.

One of my goals is not to just replace toxic medical interventions with less toxic alternatives; but to provide a path to maintaining wellness. I would like your help.

“Given the environment‘s enormous impact on disease, a substantial gap exists between the attention lavished on genetics and the comparatively scant attention given to how environmental factors interact with genes and human biology to cause outcomes.”

5:54 AM  

Post a Comment

<< Home