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Both at the Same Time

Both population-scale and personalized medicine are needed, argue researchers from Brigham and Women's Hospital and Harvard Medical School in the Journal of the American Medical Association this week.

In the past, Harvard's Elliott Antman and his colleagues write that medical studies focused on small groups of patients that they then extrapolated to whole populations. But with better and more data collection, researchers can both study broad populations as well as individuals.

"If rigorous methodologic approaches that have emerged from epidemiology studies and clinical trials are applied in these settings, then the promise of delivering on population and personalized medicine could be realized," the authors say.

Population and personalized approaches will both have their uses, Antman and his colleagues add. For instance, they say that treatment of people over the age of 55 with a so-called 'polypill' that addresses risk factors like hypertension, hypercholesterolemia, and platelet reactivity for cardiovascular disease could reduce disease incidence. At the same time, they note that vitamin B12 treatment is helpful for some, but not all patients, with anemia, and targeted therapy in that and similar situations would make sense.

"There are times when the data will suggest that broadly treating a population uniformly will be optimal, particularly when the disease state is prevalent, the risk of adverse outcomes is high, and serious adverse effects of the intervention are infrequent," they say. "However, personalizing therapies will be better in other scenarios to optimize benefit and reduce risk."