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With the advances being made in molecular imaging, radiology and pathology departments will work hand-in-hand to provide presymptomatic diagnoses to patients and create the backbone of personalized health care. This was the basic theme during a conference held in Philadelphia that brought together experts in both fields to espouse the new technology's value, urge attendees to embrace it and describe the effects the technology will have in the medical industry.
Approximately 200 guests gathered Feb. 4 at the Sheraton Society Hill for the Molecular Summit, presented by the Dark Intelligence Group and organized by Siemens. The two-day event featured presentations and seminars that explained how in vivo and in vitro diagnostic systems can be combined for more detailed data.
"We want to create an early health model [EHM] that will help make a diagnosis, a prognosis and prescribe treatment for a preclinical disease," said Bruce Friedman, MD, professor emeritus of pathology at the University of Michigan Medical Center, during his conference-opening remarks.
Dr. Friedman laid out the clinical, financial and political ramifications that should be considered in order to promote widespread adoption of an EHM. By showing the technology's effectiveness with low-level projects, Dr. Friedman believes that high-level decision makers will come on board and spread the word. While the new technology may be expensive, he said that hospitals will ultimately reduce costs by treating diseases at an early stage through the help of early diagnostics and collaboration between the lab and imaging departments.
The diagnoses will come from combining laboratory information systems, radiology information systems and picture archiving and communication systems into one department, Dr. Friedman said, called diagnostic information systems. The integration will establish a panel of biomarkers that will be used to analyze and match genomes taken from patients.
"This will be superior to the typical physical exam," he said.
This new philosophy for diagnosis and treatment will prove to be superior to the current trial and error method, according to Jared Schwartz, MD, director of pathology and lab medicine at Presbyterian Healthcare in Charlotte, N.C. During his presentation, he considered the reigning approach of analyzing symptoms, coming up with the most likely diagnosis, prescribing the medication and then revising treatment if the outcome is too costly and unsatisfactory for patients.
"Patients want high-quality medical care at a reasonable cost from a doctor they can trust," he said.
By analyzing biomarkers early, doctors will be able to create more personalized treatments. When a patient is diagnosed now, the treatment is based primarily on previous studies and the high probability that the patient will react the same way. However, as several speakers pointed out, even if two patients have the same disease, their bodies are completely different, with unique factors that will affect the standard treatments.
By analyzing the biomarkers during routine, annual checkups, doctors would be able to study the biomarkers and prescribe treatment for the genetics of a particular disease in a particular patient, with all of his/her underlying conditions taken into consideration, said Dr. Schwartz.
The conference also included a series of breakout sessions categorized along three tracks: radiology, pathology and informatics. The afternoon seminars included a case study by Elliot Fishman, MD, professor of radiological science and oncology radiology at Johns Hopkins University School of Medicine in Baltimore, and a presentation by Michael Becich, MD, PhD, chairman of the department of biomedical informatics, on integrating oncology, molecular diagnostics and informatics. The day ended with a panel discussion featuring Dr. Friedman, Dr. Schwartz, Dr. Fishman and Richard Friedberg, MD, PhD, chairman of the department of pathology at Baystate Health in Massachusetts. The next day's events followed the same agenda, a morning of presentations followed by an afternoon of breakout sessions.
Dr. Friedman said events such as the Molecular Summit will help bring cautious clinicians on board. He recognized the resistance many have to change, but encouraged the audience to become early adopters and demonstrate the value of molecular diagnostics.
--Jim Boyle, ADVANCE staff
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