Medicine of the future: personalized, stratified or precision? (literature review)

Abstract

“Personalized” medicine is based on the belief that each person has unique molecular, physiological, environmental and behavioral characteristics, and in case of development of the disease, each patient should be treated taking into account these unique characteristics. This belief was to some extent confirmed by the use of the latest technologies, such as DNA sequencing, proteomics, imaging protocols and the use of wireless devices for health monitoring, which revealed large inter-individual differences. 
 The purpose: to substantiate a personalized approach will be used in the medicine of the future. 
 Literary sources (scientific articles) were searched, including those published in peer-reviewed journals indexed in Pubmed, WoS, Scopus, Global Health, CyberLeninka, and the Russian Science Citation Index. Seventy two articles devoted to personalized medicine were analyzed, of which 51 are included in this review. The review included articles on personalized medicine, published mainly over the past 10 years on the topics of oncology, genetics, and articles considering the legal, demographic and social aspects of this problem. From the analysis were excluded articles devoted to the philosophical aspects of personalized medicine, the use of computer and wireless technologies for data processing and communication. Historical precedents, some legislative and policy aspects of its implementation in practice, new technologies that make it possible, some new experiences including successes and failures, ways of testing and using individualized drugs, and future directions, including potential ways of treating people with problems concerning fertility and infertility are considered. The existing limitations of “personalized” medicine are presented. Since aspects of “personalized” medicine are rooted in biological realities, individualization of medical practice in certain cases is probably inevitable. 
 Conclusion. With the development of technology and the accumulation of experience, an individual approach to the patient becomes more effective and cost-effective. In order for the various stakeholders to embrace “personalized” medicine and begin operating in this paradigm, it is necessary to develop and implement more effective strategies for the education and training of health professionals at all stages.