Genetic
Biological Physical
Political Social
Behavioural
Genetic Endowment
Natural Environment
Structural Environment
Indi...
GENES ENVIRONMENT
•
•
•
•
•
•
Complex diseases
Diabetes
Cardiovascular
Cancer
Alzheimer’s
Hypertension
Schizophrenia
Rheum...
A
A
B
B1
B2
The relationship between populations and individuals will need to be better understood
What Matters –Genes or Environment?
p
p
q q
q
q
Disease
Risk
Disease
RiskE1
E1
E2
E2
A better understanding of disease mechanisms
A new
categorisation
of disease
based on
genotype
Novel
therapeutic
intervent...
Economics
Genomics
Patient
Autonomy
Better
Prevention
Better
Diagnosis
Better
Treatment
Better
Prognosis
Organisational
Ch...
Super
Convergence
New Medicine
Old Medicine
Mobile
Connectivity
& Bandwidth
Internet
Social
Networking
Increased
Computing...
Pre-test
Probability
Postnegative-test
Probability
Post-positive-test
Probability
D+ D-
D+ D-
T+
T+
T-
T-
P(D)=8%
P(D)=0.1...
Hot Topics Our Genomic Future: Dr Ron Zimmern
Hot Topics Our Genomic Future: Dr Ron Zimmern
Hot Topics Our Genomic Future: Dr Ron Zimmern
Hot Topics Our Genomic Future: Dr Ron Zimmern
Upcoming SlideShare
Loading in …5
×

Hot Topics Our Genomic Future: Dr Ron Zimmern

1,949 views

Published on

This presentation was delivered at a Nesta Hot Topics event – Our Genomic Future – where we discussed what would happen if we all had our genome sequenced. For more on the event visit http://www.nesta.org.uk/event/our-genomic-future

Published in: Health & Medicine, Education
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,949
On SlideShare
0
From Embeds
0
Number of Embeds
1,009
Actions
Shares
0
Downloads
12
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Hot Topics Our Genomic Future: Dr Ron Zimmern

  1. 1. Genetic Biological Physical Political Social Behavioural Genetic Endowment Natural Environment Structural Environment Individual Behaviour INDIVIDUALS POPULATIONS Genetic factors are important determinants of health and disease and it will be as important to understand these as the external environmental factors with which we are all familiar
  2. 2. GENES ENVIRONMENT • • • • • • Complex diseases Diabetes Cardiovascular Cancer Alzheimer’s Hypertension Schizophrenia Rheumatoid arthritis Learning disability Genes and environment work together and are jointly responsible for all physiological traits and disease risk
  3. 3. A A B B1 B2 The relationship between populations and individuals will need to be better understood
  4. 4. What Matters –Genes or Environment? p p q q q q Disease Risk Disease RiskE1 E1 E2 E2
  5. 5. A better understanding of disease mechanisms A new categorisation of disease based on genotype Novel therapeutic interventions Opportunities for the prediction and prevention of disease Greater diagnostic potential through genetic testing Its implications for clinical care will need to be established
  6. 6. Economics Genomics Patient Autonomy Better Prevention Better Diagnosis Better Treatment Better Prognosis Organisational Change In the NHS Personalised Health Care Individual The individual citizen and patient will play a much greater part in health care and have a better understanding of their own disease risk
  7. 7. Super Convergence New Medicine Old Medicine Mobile Connectivity & Bandwidth Internet Social Networking Increased Computing Power & Data Universe Wireless Sensors Genomics Imaging Information Systems Adapted from Fig 1: The transformation of medicine today to new individualised medicine enabled by digitising humans. Eric Topol (2012) The Creative Destruction of Medicine Physician driven Technology as aid Objective values assessed professionally Medical profession as trusted intermediaries Patient defers to physician Community values predominate Consumer driven Technology driven Subjective values predominate Decline of trusted intermediaries Patient as partner Individualism reigns Achieving the right balance Information and telecommunication technologies will work with genomic technologies to result in a new paradigm of care
  8. 8. Pre-test Probability Postnegative-test Probability Post-positive-test Probability D+ D- D+ D- T+ T+ T- T- P(D)=8% P(D)=0.1% 10,000 100,000 800 9,200 1,032 8,968 664 136 368 8,832 Sensitivity=83% Specificity=96% 100 99,900 4,079 95,921 83 17 3,996 95,904 From Hunink & Glasziou: Decision Making in Health & Medicine PPV=64.3% NPV=98.5% PPV= 2.03% NPV=99.98% Use of FOBT in Colorectal Cancer The value of genomic(and indeed all clinical) tests will always be greater when applied to the ill patient than to the worried well

×