Your great-grandchildren will laugh when someone tells them that, not so long ago, all patients with the same diagnosis received the same treatment. They will say that would be similar to all people getting the same shoe regardless of the size of their feet.
The era of personalized medicine is emerging. Patients are beginning to receive different diagnostic tests and treatments based on their genetic makeup and metabolism. Expanding this to all patients will require the manipulation and study of big volumes of data, including genomic and proteomic mapping as well as the integration of near real time electronic medical information.
I celebrate that the National Institutes of Health are putting a fresh emphasis on health informatics. Biomedical computing will foster collaboration across medical disciplines, and there is little doubt that such efforts will bring forth unique insights and generate novel analytical tools. Truven Health Treatment Pathways is a first generation product of this movement. With it, we have the capability to conduct comparative effectiveness research in a real world setting using large populations in a matter of weeks instead of years.
As a treating physician, I have been struck by the nearly complete absence of information comparing treatment alternatives - most are approved against doing nothing rather than each other. By comparing treatment regimens and outcomes, not only will doctors and patients be better informed but health plans will be able to markedly advance the field of evidence based benefit design. For all of these reasons both public and private investment into medical big data should be endorsed and promoted.
Ray Fabius MD
Chief Medical Officer