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KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ

Year 2019, Volume: 22 Issue: 4, 843 - 862, 26.12.2019

Lütfiye Tekpınar , Ramazan Erdem

Abstract

Genel tıp anlayışında hastalıklar ve salgınlar üzerine odaklanılmış, tedavilerin bir sınırı olabileceği düşünülerek halkı hastalıktan korumak adına, “önce zarar verme” ilkesi benimsenmiştir. İlerleyen zamanlarda ise “hastalık yoktur hasta vardır” anlayışı benimsenmeye başlanmıştır. Günümüzde ise “hastalık yoktur, hasta vardır” anlayışında bilim ve teknolojinin gelişimiyle somut adımlar atılmış ve oldukça ilerleme kaydedilmiştir. 21. yy.’dan günümüze ivme kazanan bu anlayış mevcut tıp bilgisinde ve eğitiminde de gelişmeleri ve yeni kavramları beraberinde getirmiştir. Kişiselleştirilmiş tıp veya hassas tıp olarak geçen kavramlar bunlardan bazılarıdır. İnsan Genom Projesi öncülüğünde genom araştırmaları kişiselleştirilmiş tıbbın ön plana çıkmasında oldukça etkili olmuştur. Kişiselleştirilmiş tıp genel olarak bir kişinin sağlık risklerini etkileyen genetik, fenotipik ve çevresel faktörleri belirlemeye çalışmaktadır. Kişiselleştirilmiş tıp, daha etkin, yan etkilere daha az eğilimli ve mevcut tedavilerin çoğundan potansiyel olarak daha maliyet etkili, her bir hastanın kendine has özelliklerine uyarlanmış tedaviler sunmayı vaat etmektedir. Kişiselleştirilmiş tıbbın amaçları, insanlar sağlıklıyken veya hastalığın ilk aşamalarındayken önleyici sağlık stratejileri ve ilaç tedavilerini optimize etmek için hastalığın moleküler temelinden yararlanmaktır. Bu faktörler her insan için farklı olduğundan, hastalığın doğası, başlangıcı, seyri ve ilaca veya diğer müdahalelere nasıl tepki verebileceği bireyseldir. Kişiselleştirilmiş tıbbın sağlık hizmeti sağlayıcıları ve hastaları tarafından kullanılması için, bu bulguların hassas teşhis testlerine ve hedefli tedavilere çevrilmesi gerekmektedir. Genel hedef her bireyin tıbbi bakımını ve sonuçlarını optimize etmek olduğundan, tedaviler, ilaç tipleri ve dozajlar ve/veya önleme stratejileri kişiden kişiye farklılık gösterebilir, bu da sağlık hizmetlerinin benzersiz şekilde özelleştirilmesine neden olmuştur. Bu çalışmada günümüzde sıkça kullanılan fakat Türkçe kaynağın fazla bulunmadığı kişiselleştirilmiş tıp kavramı ve bileşenleri açıklanmıştır.

Keywords

Kişiselleştirilmiş tıp hassas tıp genom araştırmaları

References

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Year 2019, Volume: 22 Issue: 4, 843 - 862, 26.12.2019

Lütfiye Tekpınar , Ramazan Erdem

Abstract

References

  • 1. An G. and Vodovotz Y. (2015) What is “Precision Medicine”- And Can it Work? https://www.elsevier.com/connect/what-is-precision-medicine-and-can-it-work (Erişim Tarihi: 10.05.2019).
  • 2. Bashyam M.D. and Hasnain S.E. (2003) The Human Genome Sequence: Impact on Health Care. Indian Journal of Medical Research 117: 43-65.
  • 3. Buchman T.G., Billiar T.R., Elster E., Kirk A.D., Rimawi R.H., Vodovotz Y. and Zehnbauer B.A. (2016). Precision Medicine for Critical Illness and Injury. Critical Care Medicine 44(9): 1635-1638.
  • 4. Carlsten C., Barauer M., Brinkman F., Brook J., Daley D., McNagny K., Pui M., Royce D., Takaro T. and Judah D. (2014) Genes, the Environment and Personalized Medicine: We Need to Harness Both Environmental and Genetic Data to Maximize Personal and Population Health. EMBO Reports 15(7): 736-739.
  • 5. Christensen C.M., Grossman J.H. and Hwang J. (2009) The Innovator’s Prescription: A Disruptive Solution for Health Care. McGraw-Hill, New York.
  • 6. Collins F.S. (2005) Personalized Medicine: A New Approach to Staying Well. July 17. The Boston Globe. (Erişim Tarihi: 12.05.2019).
  • 7. enabiz.gov.tr. https://enabiz.gov.tr/. (Erişim Tarihi: 03.12.2019).
  • 8. Appelboom G., Camacho E., Abraham M. E., Bruce S.S., Dumont E.L.P. Zacharia B. E. D'Amico R., Slomian J., Reginster J. Y. Bruyère O. and Connolly E. S. (2014) Smart Wearable Body Sensors for Patient Self-Assessment and Monitoring. Archives of Public Health 72(28): 1-9.
  • 9. FDA News Release (2017) FDA Permits Marketing of Mobile Medical Application for Substance Use Disorder. https://www.fda.gov/newsevents/newsroom/ pressannouncements/ucm57 6087.htm. (Erişim Tarihi: 04.05.2019).
  • 10. Ginsburg G.S. and Willard F.H. (2009) Genomic and Personalized Medicine: Foundations and Applications. Translational Research 154(6): 277-87.
  • 11. Goetz L.H. and Schork N.J. (2018) Personalized Medicine: Motivation, Challenges, and Progress. Fertility and Sterility 109(6): 952-63.
  • 12. Green R.C. Berg J.S., Grody W.W., Kalia S.S., Korf B.R., Martin C.L., McGuire A.L., Nussbaum R.L., O'Daniel J.M., Ormond K.E. Rehm H.L., Watson M.S., Williams M.S. and Biesecker L.G. (2013) ACMG Recommendations for Reporting of Incidental Findings in Clinical Exome and Genome Sequencing. Genetics in Medicine 15(7): 565-74.
  • 13. Gronowicz G. (2016) Personalized Medicine Promises and Pitfalls. CRC Press, London.
  • 14. Hehir-Kwa J.Y., Claustres M., Hastings R.J., Van Ravenswaaij-Arts C., Christenhusz G., Genuardi M., Melegh B., Cambon-Thomsen A., Patsalis P., Vermeesch J., Cornel M.C., Searle B., Palotie A., Capoluongo E., Peterlin B. and Estivill X. (2015) Towards a European Consensus for Reporting Incidental Findings during Clinical NGS Testing. In European Journal of Human Genetics 23(12): 1601-1606.
  • 15. Hood L. and Flores M. (2012) A Personal View on Systems Medicine and the Emergence of Proactive P4 Medicine: Predictive, Preventive, Personalized and Participatory. New Biotechnology 29(6): 613-24.
  • 16. Institute of Medicine. (2013) The Economics of Genomic Medicine: Workshop Summary. National Academies Press, Washington, DC.
  • 17. Institute for Precision Medicine. (2015) http://ipm.weill. cornell.edu/about/definition (Erişim Tarihi: 05.06.2019)
  • 18. International Bioethics Committee. (2001) The Use of Embryonic Stem Cells in Therapeutic Research: Report of the IBC on the Ethıcal Aspects of Human Embryonıc Stem Cell Research. United Nations Educational, Scientific and Cultural Organization, 6 April Paris.
  • 19. İleri Y.Y. (2018) Sağlık Yönetim Bilişim Sistemleri. Çizgi Kitabevi, Konya.
  • 20. İleri Y.Y. ve Uludağ A. (2017) E- Nabız Uygulamasının Yönetim Bı̇lı̇şı̇m Sı̇stemlerı̇ ve Hasta Mahremı̇yetı̇ Açısından Değerlendı̇rı̇lmesı̇. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi 3(3): 318-25.
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  • 22. Kasztura M., Richard A., Bempong N.E., Loncar D. and Flahault A. (2019) Cost-Effectiveness of Precision Medicine: A Scoping Review. International Journal of Public Health 64(9): 1261-1271.
  • 23. Katsnelson A. (2013) Momentum Grows to Make ‘Personalized’ Medicine More ‘Precise.’ Nature Medicine 19(3): 249-249.
  • 24. Khoury M. (2016) The Shift From Personalized Medicine to Precision Medicine and Precision Public Health: Words Matter! April 21. Center for Disease Control and Prevention. https://blogs.cdc.gov/genomics/2016/04/21/shift/ (Erişim Tarihi: 20.05.2019)
  • 25. Kushner J. (2014) The Ethics of Personalized Medicine. Personalized Medicine Universe 3: 42-45.
  • 26. Lee M.T.M. and Klein T.E. (2013) Pharmacogenetics of Warfarin: Challenges and Opportunities. Journal of Human Genetics 58(6): 334-338.
  • 27. Lonie I.M. (1978) Cos versus Cnidus and the Historians: Part 2. History of Science 16(2): 77-92.
  • 28. Luzzatto L. and Seneca E. (2014) G6PD Deficiency: A Classic Example of Pharmacogenetics with on-Going Clinical Implications. British Journal of Hematology 164(4): 469-80.
  • 29. Mancinelli L., Cronin M. and Sadee W. (2000) Pharmacogenomics: The Promise of Personalized Medicine. AAPS PharmSci 2(1): 1-13.
  • 30. Mayo Clinic (2018) Precision Medicine and Pharmacogenomics. September 26. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/personalized-medicine/art-20044300 (Erişim Tarihi: 05.05.2019)
  • 31. Nan H., Hutter C.M., Lin Y., Jacobs E.J., Ulrich C.M., White E. …. and Chan A.T. (2015) Association of Aspirin and NSAID Use with Risk of Colorectal Cancer According to Genetic Variants. Journal of the American Medical Association 313(11): 1133-42.
  • 32. U.S. National Research Council. (2011) Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. The National Academies Press, Washington, DC.
  • 33. U.S. Food and Drug Administration (FDA). (2018) Precision Medicine. September 27. https://www.fda.gov/medical-devices/vitro-diagnostics/precision-medicine (Erişim Tarihi: 05.05.2019).
  • 34. National Cancer Institute (2019) https://www.cancer.gov/publications/dictionaries/ cancer-terms/def/personalized-medicine (Erişim Tarihi: 15.02.2019).
  • 35. Naylor S. (2015) What’s in a Name? The Evolution of ‘P-Medicine.’ The Journal of Precision Medicine 2: 15-29.
  • 36. Naylor S. and Chen J. Y. (2011) Unraveling Human Complexity and Disease with Systems Biology and Personalized Medicine. Personalized Medicine 7(3): 275-89.
  • 37. Patel C.J. Sivadas A., Tabassum R., Preeprem T., Zhao J., Arafat D., Chen R., Morgan A.A., Martin G.S., Brigham K.L., Butte A.J. and Gibson G. (2013) Whole Genome Sequencing in Support of Wellness and Health Maintenance. Genome Medicine 5(58): 1-13.
  • 38. Personalized Medicine Coalition (PMC). (2015) The Case for Personalized Medicine. http://www.personalizedmedicinecoalition.org (Erişim Tarihi: 06.06.2019).
  • 39. Priorities for Personalized Medicine. (2008) President’s Council of Advisors on Science and Technology. September.
  • 40. Redekop W.K. and Mladsi D. (2013) The Faces of Personalized Medicine: A Framework for Understanding Its Meaning and Scope. Value in Health 16(6): 4-9.
  • 41. Shurkin J.N. (2012) Genome Sequencing Raises Jewish Ethical Concerns. November 25. https://www.jpost.com/Health-and-Science/Genome-sequencing-raises-Jewish-ethical-concerns (Erişim Tarihi: 05.10.2019).
  • 42. Singer P. (2015) Pratik Etik. Çeviren: Çatlı N. İthaki Yayınları, İstanbul.
  • 43. Sterling R.L. (2011) Genetic Research among the Havasupai: A Cautionary Tale. Virtual Mentor 13(2): 113-17.
  • 44. Sugeir S. and Naylor S. (2018) Critical Care and Personalized or Precision Medicine: Who Needs Whom? Journal of Critical Care 43: 1-17.
  • 45. Sverdlov O., Dam J.V., Hannesdottir K. and Thornton-Wells T. (2018) Digital Therapeutics: An Integral Component of Digital Innovation in Drug Development. Clinical Pharmacology and Therapeutics 104(1): 72-80.
  • 46. Swan M. (2013) The Quantified Self: Fundamental Disruption in Big Data Science and Biological Discovery. Big Data 1(2): 85-99.
  • 47. Tripp S. and Grueber M. (2011) Economic Impact of the Human Genome Project. Battelle Memorial Institute, Ohio.
  • 48. Veatch R.M. (2003) The Basic of Bioethics (2nd ed.). Routledge, Londra.
  • 49. Vogenberg F.R., Carol I.B. and Michael P. (2010) Personalized Medicine: Part 1: Evolution and Development into Theranostics. Pharmacy and Therapeutics 35(10): 560-576.
  • 50. Waring S.C. and Naylor S. (2016) The Silent Epidemic of of Alzheimer’s Disease: Can Precision Medicine Provide Effective Drug Therapies? Journal of Precision Medicine 4: 41-54.
  • 51. National Institutes of Health (2018). What is the difference between precision medicine and personalized medi- cine? What about pharmacogenomics? U.S. National Library of Medicine (Erişim Tarihi: 05.05.2019).
  • 52. https://en.wikipedia.org/wiki/Personalized_medicine (Erişim Tarihi: 02.12.2019).
  • 53. Yensen J. and Naylor S. (2016) The Complementary Iceberg Tips of Diabetes and Precision Medicine. Journal of Precision Medicine 3: 39-57.
  • 54. Zhang X.D. (2015) Precision Medicine, Personalized Medicine, Omics and Big Data: Concepts and Relationships. Journal of Pharmacogenomics & Pharmacoproteomics 6(2): 1-2.
  • 55. Health and Science https://www.jpost.com/Health-and-Science/Genome-sequencing-raises-Jewish-ethical-concerns (Erişim Tarihi: 25.06.2019).
  • 56. FDA (2019) https://www.fda.gov/ (Erişim Tarihi: 10.05.2019).
There are 56 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Makaleler
Authors

Lütfiye Tekpınar

Ramazan Erdem

Publication Date December 26, 2019
Published in Issue Year 2019 Volume: 22 Issue: 4

Cite

APA Tekpınar, L., & Erdem, R. (2019). KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ. Hacettepe Sağlık İdaresi Dergisi, 22(4), 843-862.
AMA Tekpınar L, Erdem R. KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ. HSİD. December 2019;22(4):843-862.
Chicago Tekpınar, Lütfiye, and Ramazan Erdem. “KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ”. Hacettepe Sağlık İdaresi Dergisi 22, no. 4 (December 2019): 843-62.
EndNote Tekpınar L, Erdem R (December 1, 2019) KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ. Hacettepe Sağlık İdaresi Dergisi 22 4 843–862.
IEEE L. Tekpınar and R. Erdem, “KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ”, HSİD, vol. 22, no. 4, pp. 843–862, 2019.
ISNAD Tekpınar, Lütfiye - Erdem, Ramazan. “KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ”. Hacettepe Sağlık İdaresi Dergisi 22/4 (December 2019), 843-862.
JAMA Tekpınar L, Erdem R. KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ. HSİD. 2019;22:843–862.
MLA Tekpınar, Lütfiye and Ramazan Erdem. “KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ”. Hacettepe Sağlık İdaresi Dergisi, vol. 22, no. 4, 2019, pp. 843-62.
Vancouver Tekpınar L, Erdem R. KİŞİSELLEŞTİRİLMİŞ TIP VE GENOM ARAŞTIRMALARININ SAĞLIK ÇIKTILARI BAĞLAMINDA DEĞERLENDİRİLMESİ. HSİD. 2019;22(4):843-62.
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