2023 Society for Academic Emergency Medicine Consensus Conference on Precision Emergency Medicine: Development of a policy-relevant, patient-centered research agenda.


Journal

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
ISSN: 1553-2712
Titre abrégé: Acad Emerg Med
Pays: United States
ID NLM: 9418450

Informations de publication

Date de publication:
23 May 2024
Historique:
revised: 04 04 2024
received: 13 11 2023
accepted: 11 04 2024
medline: 23 5 2024
pubmed: 23 5 2024
entrez: 23 5 2024
Statut: aheadofprint

Résumé

Precision medicine is data-driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency medicine (EM) has been peripheral to the precision medicine discourse, lacking both a unified definition of precision medicine and a clear research agenda. We convened a national consensus conference to build a shared mental model and develop a research agenda for precision EM. We held a conference to (1) define precision EM, (2) develop an evidence-based research agenda, and (3) identify educational gaps for current and future EM clinicians. Nine preconference workgroups (biomedical ethics, data science, health professions education, health care delivery and access, informatics, omics, population health, sex and gender, and technology and digital tools), comprising 84 individuals, garnered expert opinion, reviewed relevant literature, engaged with patients, and developed key research questions. During the conference, each workgroup shared how they defined precision EM within their domain, presented relevant conceptual frameworks, and engaged a broad set of stakeholders to refine precision EM research questions using a multistage consensus-building process. A total of 217 individuals participated in this initiative, of whom 115 were conference-day attendees. Consensus-building activities yielded a definition of precision EM and key research questions that comprised a new 10-year precision EM research agenda. The consensus process revealed three themes: (1) preeminence of data, (2) interconnectedness of research questions across domains, and (3) promises and pitfalls of advances in health technology and data science/artificial intelligence. The Health Professions Education Workgroup identified educational gaps in precision EM and discussed a training roadmap for the specialty. A research agenda for precision EM, developed with extensive stakeholder input, recognizes the potential and challenges of precision EM. Comprehensive clinician training in this field is essential to advance EM in this domain.

Identifiants

pubmed: 38779704
doi: 10.1111/acem.14932
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Society for Academic Emergency Medicine
Organisme : School of Medicine, Stanford University
Organisme : Agency for Healthcare Research and Quality
ID : R13HS029275

Informations de copyright

© 2024 The Author(s). Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.

Références

Wilson B, Nicholls SG. The Human Genome Project, and recent advances in personalized genomics. RMHP. 2015;8:9‐20.
National Research Council (US) Committee on A Framework for Developing a New Taxonomy of Disease. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. National Academies Press (US); 2011 http://www.ncbi.nlm.nih.gov/books/NBK91503/
Collins FS, Varmus H. A new initiative on precision medicine. N Engl J Med. 2015;372(9):793‐795.
Dzau VJ, Ginsburg GS. Realizing the full potential of precision medicine in health and health care. JAMA. 2016;316(16):1659‐1660.
Feero WG, Wicklund CA, Veenstra D. Precision medicine, genome sequencing, and improved population health. JAMA. 2018;319(19):1979‐1980.
Kass‐Hout TA, Stevens LM, Hall JL. American Heart Association precision medicine platform. Circulation. 2018;137(7):647‐649.
Gilard V, Derrey S, Marret S, Bekri S, Tebani A. Precision neurosurgery: a path forward. JPM. 2021;11(10):1019.
Introduction—precision surgery. Eur J Surg Oncol. 2017;43(5):iii.
Minor L. Discovering Precision Health: Predict, Prevent and Cure to Advance Health and Wellbeing. 1st ed. Wiley‐Blackwell; 2020.
Kikano S. Precision medicine in pediatric cardiology. Pediatr Ann. 2022;51(10):e390‐e395.
Weldy CS, Ashley EA. Towards precision medicine in heart failure. Nat Rev Cardiol. 2021;18(11):745‐762.
Tsimberidou AM, Fountzilas E, Nikanjam M, Kurzrock R. Review of precision cancer medicine: evolution of the treatment paradigm. Cancer Treat Rev. 2020;86:102019.
Mateo J, Steuten L, Aftimos P, et al. Delivering precision oncology to patients with cancer. Nat Med. 2022;28(4):658‐665.
Lee S‐H. Role of genetics in preventive cardiology: focused on dyslipidemia. Korean Circ J. 2021;51(11):899‐907.
Ashina M, Terwindt GM, Al‐Karagholi MA‐M, et al. Migraine: disease characterisation, biomarkers, and precision medicine. Lancet. 2021;397(10283):1496‐1504.
Keshavan MS, Clementz BA. Precision medicine for psychosis: a revolution at the interface of psychiatry and neurology. Nat Rev Neurol. 2023;19(4):193‐194. https://www.nature.com/articles/s41582‐023‐00788‐0
Hampel H, Gao P, Cummings J, et al. The foundation and architecture of precision medicine in neurology and psychiatry. Trends Neurosci. 2023;46(3):176‐198.
Williams LM, Hack LM. A precision medicine–based, ‘fast‐fail’ approach for psychiatry. Nat Med. 2020;26(5):653‐654.
Limkakeng AT, Monte AA, Kabrhel C, et al. Systematic molecular phenotyping: a path toward precision emergency medicine? Acad Emerg Med. 2016;23(10):1097‐1106.
Schultebraucks K, Shalev AY, Michopoulos V, et al. A validated predictive algorithm of post‐traumatic stress course following emergency department admission after a traumatic stressor. Nat Med. 2020;26(7):1084‐1088.
Taylor RA, Pare JR, Venkatesh AK, et al. Prediction of in‐hospital mortality in emergency department patients with sepsis: a local big data–driven, machine learning approach. Acad Emerg Med. 2016;23(3):269‐278.
Stopyra JP, Riley RF, Hiestand BC, et al. The HEART pathway randomized controlled trial one‐year outcomes. Acad Emerg Med. 2019;26(1):41‐50.
Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM. Prospective validation of wells criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med. 2004;44(5):503‐510.
Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: a Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke [Internet]. 2019;50(12):e344‐e418. doi:10.1161/STR.0000000000000211
Ahmed L, Constantinidou A, Chatzittofis A. Patients’ perspectives related to ethical issues and risks in precision medicine: a systematic review. Front Med. 2023;10:1215663.
Chan T, Thoma B, Finnell J, et al. Precision medicine within health professions education: defining a research agenda for emergency medicine using a foresight and strategy technique (FaST) review. AEM Educ Train. 2024;8:s5‐s16. 10.1002/aet2.10983
Jamison DT, Gelband H, Horton S, et al. Disease Control Priorities, Third Edition (Volume 9): Improving Health and Reducing Poverty. World Bank; 2017 http://hdl.handle.net/10986/28877
Tadesse Gebremedhin L, Nsanzimana S, Lamin Samateh A, et al. A call to invest in emergency, critical and operative care for universal health coverage. Nat Med. 2023;29(7):1591‐1592.
Zink BJ. Anyone, Anything, Anytime: A History of Emergency Medicine. 2nd ed. American College of Emergency Physicians; 2018.
Vigilante K, Escaravage S, McConnell M. Big data and the intelligence community—lessons for health care. N Engl J Med. 2019;380(20):1888‐1890.
Davenport T, Kalakota R. The potential for artificial intelligence in healthcare. Future Healthc J. 2019;6(2):94‐98.
Rose C, Barber R, Preiksaitis C, et al. A conference (missingness in action) to address missingness in data and AI in health care: qualitative thematic analysis. J Med Internet Res. 2023;25:e49314.

Auteurs

Matthew Strehlow (M)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Michael A Gisondi (MA)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Holly Caretta-Weyer (H)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Felix Ankel (F)

Department of Emergency Medicine, Regions Hospital, St. Paul, Minnesota, USA.

Alexandria Brackett (A)

Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, USA.

Pawan Brar (P)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Teresa M Chan (TM)

School of Medicine, Toronto Metropolitan University, Toronto, Ontario, Canada.
Department of Medicine, Division of Emergency Medicine, McMaster University, Toronto, Ontario, Canada.

Adrene Garabedian (A)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Bridget Gunn (B)

Health Sciences Library, Baystate Health, Springfield, Massachusetts, USA.

Eric Isaacs (E)

Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA.

Megan von Isenburg (M)

School of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.

Angela Jarman (A)

Department of Emergency Medicine, University of California, Davis, Sacramento, California, USA.

Damon Kuehl (D)

Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.

Alexander T Limkakeng (AT)

School of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.

Melis Lydston (M)

Treadwell Library, Massachusetts General Hospital, Boston, Massachusetts, USA.

Alyson McGregor (A)

Prisma Health, University of South Carolina School of Medicine, Greenville, South Carolina, USA.

Ava Pierce (A)

Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.

Maria C Raven (MC)

Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA.

Rama A Salhi (RA)

Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Christopher Stave (C)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Josephine Tan (J)

Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA.

Richard Andrew Taylor (RA)

Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

Hong-Nei Wong (HN)

Lane Medical Library, Stanford University, Stanford, California, USA.

Maame Yaa A B Yiadom (MYAB)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Kori S Zachrison (KS)

Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Jody Vogel (J)

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

Classifications MeSH