Predictive precision medicine will shape the future of health care

We face an invisible adversary that undermines public health: Non-communicable Diseases (NCDs), which claim 41 million lives each year, accounting for 74% of all deaths worldwide. The impact is particularly severe in low- and middle-income countries where 77% of NCD deaths occur, underscoring the need for an urgent and unified response to this growing crisis.

Cardiovascular diseases, which account for most NCD deaths globally, cause 25-27% fatalities in India. A notable number of these deaths occur in individuals under 50. This represents not only a significant loss of life but also a substantial economic and emotional burden on families and communities. These numbers are a clarion call for pre-emptive action against a threat that spares no one, highlighting the critical role of preventive medicine.
Predictive precision medicine promises to go beyond reacting to diseases as they appear, and anticipate and prevent them. It helps tailor health care to each individual’s unique genetic makeup, lifestyle, and risk factors, representing a shift towards a health care system that is not only effective but deeply empathetic. It recognises the individuality of each person’s health journey.
Predictive precision rests on the principle of the “five rights” — the right patient receiving the right treatment at the right time, in the right dose, and via the right route. This concept might seem straightforward, but it’s a radical departure from traditional one-size-fits-all medicine. It hinges on understanding each person’s unique health blueprint, incorporating their genetic data, lifestyle choices, and even their living environment into their care plan.
Many confuse precision medicine with the older concept of personalised medicine, but the former brings accuracy and effectiveness to personal medicine by bringing population-specific data and cutting-edge technology.
One of the most exciting elements of precision medicine is its reliance on -omics — such as genomics, proteomics, metabolomics and others — that offer a window into the complex machinery of the human body at a molecular level. This not only helps understand what’s wrong but also why, leading to highly specific and effective steps for treatment, should the need arise.
The traditional preventative measures for heart disease — monitoring blood pressure, blood glucose, and cholesterol or advocating for a healthy lifestyle — often don’t resonate until it’s too late. This is particularly true for heart attacks as they can precipitate rapidly and silently due to plaque rupture, leading to sudden and severe consequences.
Historically, risk assessment for heart disease has been a broad stroke, categorising individuals into “high” or “low” risk. This method, while helpful, is imprecise. Sample this. Out of 100 people deemed “high risk”, 20 might face a heart event; in the “low risk” group also, five may suffer a heart attack. All are advised preventive medicine, but few heed it with the consequence of disease onset in the majority. But, for those at high risk, poor compliance may become fatal.
Predictive precision medicine refines this approach. By harnessing detailed analytics, it identifies within high-risk groups, individuals who truly stand at the precipice of heart attacks.
Artificial Intelligence (AI) and machine learning are at the heart of this revolution. These technologies delve into health data, discerning risk patterns with a precision unattainable by traditional methods.
AI’s capability to analyse complex data — from ECG abnormalities to environmental factors — and compare them against large data sets enables a highly personalised risk assessment and projection of disease progression, helping doctors select the most precise and efficient medical intervention that is meaningful for the patient.
Though a decade old, the story of Angelina Jolie vividly illustrates this. By identifying a genomic variant in the BRCA1 gene, her doctors could estimate her heightened risk for breast and ovarian cancer at 87% and 50%, respectively — significantly above the average lifetime risk of under 15% for these cancers among women. This critical insight led Jolie to opt for preventive surgery, dramatically reducing her risk to that of the average woman her age. Her proactive decision highlights predictive precision medicine’s potential to empower individuals with actionable, life-saving information.
The application of predictive precision medicine extends beyond heart disease and cancer to various other illnesses including neurological conditions, mental health disorders, and even infectious diseases, wherein persons at risk of developing severe complications can be identified.
As we embrace the wide-reaching impact of precision medicine across health domains, its pivotal role in reshaping public health on a global scale comes into focus. In a rapidly ageing world, facing the vagaries of the climate crisis, the demand for a health care system that can dynamically meet new needs is undeniable. This need is further accentuated by a looming deficit of health care professionals, anticipated to reach 18 million by 2030.
Predictive precision medicine, leveraging advanced data analytics, technology, and AI, together, can help create a formidable strategy to meet these challenges.
It can pinpoint populations at heightened risk for specific conditions, enabling focused, large-scale interventions to reduce disease incidence and severity across communities. Furthermore, this approach minimises the inherent risks of medical treatments — ranging from adverse reactions to surgical complications and economic burdens — by shifting the point of intervention from disease onset to its nascent stages. This approach also reduces out-of-pocket spending, contributing to the overall sustainability of health systems globally.
Predictive precision embodies the promise of a health care system where disease prevention, personalised management, and efficiency are at the forefront. It advocates for a future where every individual has the right and means to tailor their health strategy, resonating with the ethos of “My Health, My Right”.
Naresh Trehan is CMD, Medanta. The views expressed are personal