[MUSIC]
Welcome to this course on personalized medicine.
Personalized medicine is getting a lot of press, and people are very interested in
the idea that their medicine should be personalized.
But in fact the idea that
we take care of patients in a very highly individualized way is not something new.
Hippocrates, the father of modern and ancient medicine,
said it is more important to know what sort of
person has a disease than to know what sort of a disease a person has.
That's another way of saying that it's important to understand the patient and
then you'll understand the disease.
More recently, Sir William Osler, the father of modern medicine, a Canadian who
went to Johns Hopkins to found the famous department of medicine there and
ended at his career at Oxford, is widely quoted.
I'll just read you the bottom quote.
You can read the top one to yourself.
The good physician treats the disease.
The great physician treats the patient who has the disease.
That's another way of saying that the great physician understands
what it is about their patient that's special,
that's individual, that's unique, and tries to tailor the therapy for them.
So those ideas have been around for a long time.
So the question is what is so special about this vogue for
personalized medicine.
So we've known forever that occasional patients seem different from
the average somehow.
How long they live, how susceptible or resistant they are to disease,
how well they'll respond to drugs or how badly they'll respond to certain drugs.
The excitement in personalized medicine is that we now have new tools
with which to understand this variability and to exploit it.
So one of the new tools is an understanding of the DNA molecule, and
we'll talk about that in the next few modules.
But it's important to understand that without the advent of modern
computer technology, we would not be able to analyze the DNA sequences that we have,
and understand how it is that those should be applied to individual patients.
So, I think that the revolution in personalized medicine
Is taking advantage of these two developments.
One in the science of DNA, and
the other in the science of managing large data sets.
So large data sets are not just DNA, but other kinds of data sets.
What you surf at Google, what your X-rays look like, what your Shopping habits
are like it, and taken together, that is defining the new science of big data.
And big data is another way of looking at very, very large data sets and
trying to understand what it is about an individual person, a patient or
a shopper that makes them different.
We're all familiar with that from surfing the web, and you can imagine that you
could surf your DNA web and do the same kind of individualization.
Okay, so the promise of this personalized medicine,
big data intersection is that we will learn more about disease susceptibility or
response to drugs by looking at DNA patterns,
by looking at patterns in electronic medical records,
by looking at patterns of proteins that we can measure in blood samples,
by looking at other kinds of large data sets to understand what it is that makes
an individual special, and one of the things that we're going to use that for
is to engage patients in their own care and their individualization.
Now the problem there is that patients vary and
their level of excitement around the concepts of personalized medicine.
So people vary for many, many reasons that have very little to do with their