What is Systems Medicine?
To define or not define?
This is extensively discussed and many see a precise definition as impracticable. However, some definition is necessary because the different stakeholders CASyM wishes to address need to be clear what stands behind this concept. Therefore, a key outcome from future stakeholder events is to reach a working definition that is useful. A useful definition is not necessarily comprehensive, but it must effectively communicate the concepts underlying the approach.
The following working definition is supported by CASyM:
Systems Medicine is the implementation of Systems Biology approaches in medical concepts, research and practice. This involves iterative and reciprocal feedback between clinical investigations and practice with computational, statistical and mathematical multiscale analysis and modelling of pathogenetic mechanisms, disease progression and remission, disease spread and cure, treatment responses and adverse events as well as disease prevention both at the epidemiological and individual patient level. As an outcome Systems Medicine aims at a measurable improvement of patient health through systems-based approaches and practice.
A distinctive challenge of Systems Medicine is that it means different things for different people and that different societies and communities use different approaches and languages. Therefore, relevant communities and stakeholders need to develop a common understanding on the broadness and the goals of the roadmap for Systems Medicine. CASyM represents the overarching concept and the catalyzer for this process.
Clinical needs will be the driving force for CASyM and future Systems Medicine
The specificities brought about by Systems Medicine involve the use of dedicated mathematical, bioinformatic and statistical tools that are necessary to address properly the critical issues of integrating across multiple scales, the dynamics of disease processes and treatment efficacy, as well as their modulation by genetic, epigenetic, lifestyle determinants of the person, and environmental influences.
These tools further allow scaling up to population studies. In this sense, CASyM´s intention is not to create any of these tools but rather to bring specific concepts of Systems Medicine to the clinical community. Thus, clinical needs are the driving force of Systems Medicine, with the following main areas of impact:
- Personalized medicine (4P medicine*), especially with regard to approaches to disease prevention and personalized therapies
- Pharmaceutical drug/vaccine development, production, delivery and safety, especially with regard to the identification of proper patient subgroups where Systems Medicine-based develop mental therapeutics might best and quickly succeed
- Discovery of effective diagnostics and biomarkers, and their multidimensional combination to better define the prognostic of a given disease in a given patient, and to improve the prediction of the most effective treatment schedule
- Rational design of combinatorial therapies, with special considerations of dosing and chronobiological administration patterns
- Reduction of healthcare costs due to enhanced prevention, better patient stratification, and tailored therapies, as well as the applications of Systems Medicine concepts to the management of chronic disease patients at home, using telemedicine tools (e-health)
* A medicine that is predictive, preventive, personalized and participatory (Sobradillo et al., 2010; PMID: 21190770).