Understanding Predictive Analytics

Predictive analytics is the use of data, statistical algorithms and machine learning techniques to identify the likelihood of future outcomes based on historical data. One of its major uses is in healthcare. It predicts the effectiveness of new producers, medical tests, and medications and improves services or outcomes by providing safe and effective patient care. It also helps in detecting and handling insurance claim frauds, identifying which patients are at most risk of having a chronic disease and know which interventions make the most medical and financial sense. Some examples of the above applications can be the executives of Taipei Medical University that analyse and monitor performance across all hospitals in its system or Express Scripts, one of the largest pharmacy benefits companies in the US which uses analytics to identify the patients not adhering to their prescribed treatment, resulting in a savings of $1500 to $9000 per patient.

We distinctly remember the moment that scientists claimed victory against all nature of future disease after the human genome had successfully been decoded. However, over the ensuing decade-plus, it has become clear that our health is not quite that deterministic. Clinicians must weigh not just a string of nucleotides when making decisions about our care but must also incorporate a growing set of health data that is generated and controlled by patients. Incorporating this data into health care to enable better decisions is at the heart of this report. The benefits of using predictive analytics are the same as many categories of digital health: better care and lower costs. The difference is that the path to realizing these benefits—through personalized care—is only possible by implementing these technologies. The concern that care will be reduced to a set of algorithmically-derived probabilities is important and real. But the promise is as well.

Vinnie Ramesh, chief technology officer and the Co-founder of Wellframe said, “Predictive analytics is not reinventing the wheel. It’s applying what doctors have been doing on a larger scale. What’s changed is our ability to better measure, aggregate, and make sense of previously hard-to-obtain or non-existent behavioral, psychosocial, and biometric data.Combining these new datasets with the existing sciences of epidemiology and clinical medicine allows us to accelerate progress in understanding the relationships between external factors and human biology—ultimately resulting in the enhanced re-engineering of clinical pathways and truly personalized care.”

Investors certainly believe in the promise, pouring $1.9 Billion into companies that purport to use predictive analytics. The most active investors being Khosla Ventures, Merck Global Health Innovation fund, Norwest Venture Partners, Sequoia Capital and Social + Capital Partnership. Funded companies claiming to use predictive analytics are highly focused on providers, practically ignoring patients.

The keystone of any successful predictive analytics model is the ability to improve the prediction based on a feedback loop.Within seconds, Google knows whether its search engine prediction is correct. But in health care, the feedback loop—which is often measured in terms of impact on biometric or cost outcomes—can take years.

Startup companies are attacking the key challenges in predictive analytics, advancing the space and making a difference.

The challenges that this method faces is the ability of accessing meaningful, historical data sets and normalize for inherent biases and validity concerns; Integrating with current clinical workflow to collect real-time, point of care patient data; Learning to manage and process new and existing forms of unstructured soiled data and in addressing HIPAA and privacy related concerns to guarantee patient anonymity.

“We are underestimating the potential impact of predictive analytics in process tools to help physicians make better decisions.Every week, at the airport, I get on an airplane, and I don’t worry about flying at all. There are so many tools deployed to assist the pilot. I was talking with a pilot about the new 787–and the pilot said he basically monitors the plane. We’re going to see more of that in health care.Physicians will be monitoring algorithms”, saidKevin Fickenscher, President AMC Health and Former President, AMIA.

References-

https://en.wikipedia.org/wiki/Predictive_analytics

http://www.sas.com/en_us/insights/analytics/predictive-analytics.html

http://www.webopedia.com/TERM/P/predictive_analytics.html

http://www.predictiveanalyticsworld.com/predictive_analytics.php

The Future of Personalized Healthcare: Predictive Analytics

 

Technology and Personalized Medicine

We do know by now that personalized medicine is the new “in” thing making waves in the world of Medical Biotechnology. Millions of people have been touched by the era of personalized medicine, but the field is still in its infancy.

Scientists are hard at work to learn more about how genes affect our health and how treatments and prevention strategies for various diseases could be customized for each individual based on the information these genes provide. As technological innovation continues to advance, we have discovered new ways to diagnose and monitor the condition of patients.

Today’s new technologies allow doctors to gather increasingly detailed information about the progression and treatment of disease and even offer personalized treatment based on a patient’s genes.

Personalized medicine is often defined as “the right treatment for the right person at the right time.” While already being considered in drug development strategies, it is still at an early stage with respect to clinical applications that support patient-specific therapy. As the push towards personalization and precision medicine continues to build, genetic testing will play a greater role in day-to-day interactions between physicians and patients.

To achieve this goal of propagating precision medicine, we need to overcome current limitations like clinical use, cost, and understanding of the value of genotyping.  Scientific and technological advancements in human genetics will pave the way for this personal knowledge and consequential lifestyle changes to happen for the broader population.

Some of the changes brought about by technology that can be envisioned for the near future are-

  • Researchers Nigam Shaw and Russ Altman have been able to use data mining to identify the potential rare side effects of specific treatments and divide the population into those at risk of experiencing those side effects and those safe from said side effects. By understanding how a person will react to a particular therapy, researchers will be able to develop better targeted and effective treatment options and physicians will be able to prescribe those treatments more accurately. 
  •  Obtaining sequencing data has gotten faster and less expensive, but hold-ups exist not just in regulatory processes but also in correlating the DNA sequence with clinical outcomes.  Major companies involved in sequencing technologies are offering data analysis and data storage cloud services in addition to just the instrumentation. New technologies to break this glass ceiling in analysis and to drive clinical utility of additional genes will be crucial in overcoming this problem.
  •  Personalized medicine would require devices and sensors for physicians to monitor the conditions of their patients and modify the treatment as needed. Today’s sensors have managed to be functional at a considerably small size but advances in nanotechnology could shrink sensors enough to make them suitable for implantation in the body. Imagine a day in which levels of specific compounds in blood could be measured effortlessly; biomarkers of response to the prescribed treatments could be continuously monitored via minuscule sensors which would alert physicians if specified border levels were reached.
  •  3D printing in the field of medicine! While initially 3-D tissue prints will be used as models for drug action and safety, many believe that in 10-15 years it may enable tissue and organ (re-)construction from cells harvested from the patient, thus providing custom and personalized organs on demand with no issues of compatibility.
  • It would be ideal if doctors could just tap into a single, large database filled with anonymous genetic information — biomarkers tied to patient statistics tied to specific drugs and treatments — to help them make more informed, accurate decisions about each individual’s medical path. Getting there is going to be a long and bumpy ride, with plenty of wrong turns and backtracking along the way.

The progress in technology over the last few decades has been phenomenal. Its applications in various fields have been multiple dreams come true. It would not then, be too outrageous to believe that the predictable future of healthcare- personalized medicine, would arrive soon assisted by rapidly developing technology.

References-

http://www.dddmag.com/articles/2015/09/how-technology-transforming-personalized-medicine

https://www.nih.gov/about-nih/what-we-do/nih-turning-discovery-into-health/personalized-medicine-new-technologies

http://www.bio-itworld.com/2013/10/18/5-ways-technology-is-changing-personalized-medicine.html

http://www.omicsonline.org/emerging-new-technology-to-advance-personalized-medicine-2153-0645.1000e113.php?aid=3986

What Is Personalized Medicine?

 

Understanding Personalized Medicine: Drug Development and Usage

Every day, millions of people are taking medications that will not help them. The drugs currently being prescribed are optimally beneficial to as few as 4% of the population consuming them. The realization that physicians need to take individual variability into account is driving huge interest in ‘precision’ medicine or Personalized medicine. In this time of technological advancements and unprecedented scientific breakthroughs, personalized health care has the ability to look at a patient on an individual basis so as to detect the onset of disease at its earliest stages, and at the same time increase the efficiency of the health care system by improving quality, accessibility, and affordability.

Every person has a unique genome and personalized medicine relies on technologies that confirm a patient’s biology at the molecular level with DNARNA, or protein, which ultimately leads to the diagnosis of the disease. Having an individual’s genomic information can be significantly useful for developing drugs. These days, it’s common for physicians to use a trial and error strategy until they find the treatment that is most effective for their patient, whereas with personalized medicine, we can:

  • Specifically, formulate a treatment for an individual and have insight into how their body will respond to the drug.
  • Use detailed information of the person  genotype to decide the treatment prescriptions, which will be more cost-effective and accurate.
  • Shift the emphasis in medicine from reaction to prevention.
  • Direct the selection of optimal therapy and reduce trial-and-error prescribing.
  • Help avoid adverse drug reactions.
  • Improve the quality of life.
  • Reveal additional or alternative uses for medicines and drug candidates.
  • The decrease in the overall cost of health care due to small and fast trials.

Studies that focus on a single person are known as N-of-1 trials, where enough genomic data of an individual is collected. This data provides the blueprint for the production of various proteins in the body that may have an important role in drug development for one of the several reasons, including the following:

  • The protein plays a role in breaking down the drug.
  • It helps with the absorption or transportation of the drug.
  • The protein that is the actual target of the drug.
  • It has some role in a series of molecular events triggered by the drug.

 

When researchers compare the genomes of individuals taking the same drug, they may discover that a set of people who share a certain genetic variation also share a common treatment response, such as:

  • A greater risk of side effects
  • Severe side effects at relatively low doses
  • The need for a higher dose to achieve a therapeutic effect
  • No benefit from the treatment
  • A greater or more likely benefit from the treatment
  • The optimal duration of treatment

In N-of-1 trials, the appropriate crossover designs, in which different interventions are administered to the same person alternately (possibly with ‘wash-out’ periods in between to allow the drugs’ effects to wear off) would also enable experimenters to compare the effect of different drugs in the same person.

Well-designed N-of-1 trials could be useful in the early stages of clinical drug development and for studies investigating the safety and appropriate dosages of drugs. Currently, phase I and II clinical trials usually involve giving different amounts of an FDA-approved drug to a small group of healthy volunteers.

FDA’s (U.S. Food and Drug Administration) role is to ensure the accuracy of genetic tests, many of which are acquired from the next generation sequencing (NGS), that poses novel regulatory issues for FDA. Recognizing these challenges, FDA is working out an optimum regulatory platform, by issuing discussion papers and holding workshops that will encourage innovation while ensuring accuracy. In addition, FDA has created precisionFDA, a community research and development portal that allows testing, piloting, and validating existing and new bioinformatics approaches to NGS process.

There are still various barriers to bringing N-of-1 trials mainstream, such as:

  • Regulatory agencies, researchers, and physicians are wary of moving away from classical clinical trials.
  • Pharmaceutical companies tend to focus on drugs that are likely to be used by thousands or millions of people.
  • Tailoring treatments to patients is costly as there is a lot of work to be done on biomarkers, monitoring devices, study designs and data analysis methods.

The fact remains still that these well-designed trials could save the millions of dollars that are spent on inappropriate interventions, the management and treatment of persistent or recurring diseases, and on conventional phase III trials. And the best part is that the researchers, as well as doctors, are interested in exposing people’s unique characteristics at the molecular level to deduce better alternatives to the already existing treatment procedures.  Also, cheap and efficient devices that collect health data are becoming available along with the increasing support of the governments and life-sciences funding bodies worldwide. All we require is a team effort by innovators, entrepreneurs, regulators, payers, and policymakers to overcome the barriers and move personalized medicine forward.

References-

http://www.personalizedmedicinecoalition.org/Userfiles/PMC-Corporate/file/pmc_the_case_for_personalized_medicine.pdf

 

https://en.wikipedia.org/wiki/Personalized_medicine

 

http://www.fda.gov/ScienceResearch/SpecialTopics/PrecisionMedicine/default.htm

 

http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/personalized-medicine/art-20044300

 

http://www.nature.com/news/personalized-medicine-time-for-one-person-trials-1.17411

 

Personalized vs. Mainstream Medicine.

Have you ever noticed how different people react differently to any drug?

How a person A may be fit as a fiddle upon popping a single pill but person B goes through the whole bottle and still be the same? What about person C, who might just be allergic and for whom the pill would do more bad than good? On average, any given prescription drug on the market nowadays only works for half of those who take it.

The underlying concept behind this different responsiveness to drugs is a combination of each person’s genetic make-up and the influence of environmental factors.

Conventional healthcare is based on the evidence-based practice of diagnosing and treating diseases. The drugs and treatments thus devised are tested on broad populations and prescribed using statistical averages. While these may work perfectly on some, others aren’t that lucky and for some, they may even prove fatal. In fact, there have been more than a million deaths due to ‘adverse drug reactions’ in the last 10 years!

Advancements in technology and drug discovery have led to the inception of a previously-deemed-science-fiction concept- Customized Health Care using personalized medicine. Yes, you read that right, customized treatment plans designed for every individual. Though still far from being commonly practiced, the roots of this new practice have begun to take hold.

Personalized medicine uses predictive tools to evaluate health risks and to design personalized health plans to help patients mitigate risks, prevent disease and to treat it with precision when it occurs. Techniques such as genome sequencing can reveal mutations in DNA that influence diseases ranging from cystic fibrosis to cancer.  This emerging science has the potential to truly customize healthcare to the patient, enabling providers to match drugs to patients based on their genetic profiles, to identify which health conditions an individual is susceptible to, and to determine how a given patient will respond to a particular therapy.

Although there have been quite a few encouraging signs of change, not many health systems apart from a few pioneers have yet embraced this practice. This concept seems like a boon for all those who are included in the minority percentage of people dealing with adverse effects of traditional medicine.

To see how it compares to our trusty old mainstream medicine, let’s take a look at the pros and cons of each:

Mainstream Medicine

Pros-

  •  Pharmaceutical Medicines go through strict trials to become licensed. It takes years of research and bundles of paperwork AND laboratory testing sessions to finally launch a new drug, did you know?
  • The physicians prescribing these medicines are highly skilled, trained professionals. Might as well trust that they know what they’re doing!
  • Both the Medical Profession and the Pharmaceutical Industry have very strict guidelines to abide by.  Any doctor not adhering to these guidelines is struck off and unable to practice again.  Pharmaceutical Companies are subject to massive fines if found to be in breach.
  • Doctors have access to highly accurate diagnostic equipment nowadays and they are trained to recognize and diagnose disease. Medicine is not a stagnant science, you know! We’ve come a long way from the days of Hippocrates.

Cons-

  • One of the most obvious problems- side effects. Some patients get stuck in a cycle of taking more Drugs to deal with the unwanted effects of the drugs they were originally prescribed.
  • Mainstream medicine focuses on dealing with the symptoms of the disease. Rather than curing the problem, most of the time it just suppresses it. This can lead to a lifetime need for drug therapy.
  • You ever notice how Doctors earn well? Yes, medical treatment is expensive, and without access to health insurance, can be out of the reach of many.  Even in countries where there is free access to health care, certain drugs or treatments may not be available, due to the local health care services being unable to pay for them.
  • Being different poses a problem. Dosing and regimen are standardized, which is ok for the majority of patients, but not for those who fall outside the norm. The treatment doesn’t work as well for them or they then have tolerability problems.

Personalized Medicine

Pros-

  • It can be used to predict a person’s risk for a particular disease, based on the analysis of their genome. The physician can thus initiate preventative treatment before the disease even presents itself in the patient. For example, if it is found that a DNA mutation increases a person’s risk of developing Type 2 Diabetes, the person can begin lifestyle changes that will lessen their chances of developing the disease later in life.
  • The detailed account of genetic ‘intel’ from the individual will help prevent adverse reactions or unfortunate events, allow for appropriate dosages, and create maximum efficacy with drug prescriptions.
  • Having information about an individual’s genetic makeup can be a major asset in deciding if a patient can be chosen for inclusion or exclusion in the final stages of a clinical trial. Such selective testing will prevent any adverse outcomes in patients. Not only will this allow for smaller and faster trials, it will lead to lower costs- a win-win situation!

Cons-

  • The validity of genomic tests, given the complexity of gene expression, would be surrounded by uncertainty, no matter how advanced the technology used, which is a major concern. No test is 100% accurate!
  • There is no guarantee against possible mishandling of private genomic information by providers and discrimination based on genomic information (by, for example, insurance companies, private companies, and the healthcare system).
  • Genetic tests can only provide limited information about a condition; they cannot determine if or when a person will show symptoms of a disease, how severe the symptoms will be, or whether the disorder will progress over time.

Both mainstream and personalized medicines have their own positive and negative aspects. Instead of being narrow-minded and choosing one over the other, it would be wiser to explore all the options available to you, the more choices you have the better, right? Since none is without its own flaws, it rests with the patient to decide which course they want to give a try. And why choose one? Just take what each offers and try to integrate them together! It’s not much of a risk, it would definitely be worth it…. but do consult with your physician first, don’t just take our word for it!

References-

http://alternativemedicineanswers.com/articles/Oct_Dec_08/WesternVsAlternativeMedicine.html

The Pros and Cons of Modern Medicine

 

http://www.pwc.com/us/en/view/issue-13/what-it-means-for-patient-centered-healthcare-and-how-to-address-its-current-challenges.html

https://en.wikipedia.org/wiki/Personalized_medicine

 

https://www.jax.org/genetics-and-healthcare/personalized-medicine/benefits-of-personalized-medicine

 

http://medical-dictionary.thefreedictionary.com/mainstream+medicine

http://www.acpm.org/?GeneticTestgClinRef#Limitations

https://www.personalizedmedicinebulletin.com/2013/10/07/clinical-adoption-of-personalized-medicine/

7 Indian Genetic Sequencing Startups You Can’t Ignore

With the age of personalized medicine at the brink, it only makes sense that Indian genetic sequencing startups mushrooms to chip in on this medical revolution. With that spirit in mind, here’s a list of 7 startups which provide genetic sequencing as a service.
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1. Ganit Labs Bio-IT center– An independent not-for-profit research Centre established as a public-private partnership initiative between the Institute of Bioinformatics and Applied Biotechnology and Strand Life Sciences, both in Bangalore, India.
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2. Medgenome– MedGenome Inc. is a genomics-based diagnostics and research company delivering the best of health care by decoding the genetic information contained in an individual’s genome. They are the first mover and market leader in genomics-based diagnostics and research from India with global offices in San Francisco and Boston and is considered to be among the pioneers of Indian genetic sequencing startups.
Mapmygenome
3. Mapmygenome– Mapmygenome is a molecular diagnostics company to make people proactive about their health. They offer personalized health solutions based on genetic tests that help people to get to know about themselves. By combining genetic health profile and health history with genetic counseling, Mapmygenome provides actionable steps for individuals and their physicians towards a healthier life. Mapmygenome is focused on preventive health care through healthy habits.
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4. Xcelris– Considered to be among the most versatile of Indian genetic sequencing startups, They cutting-edge solutions to researchers across fields such as agriculture, human health, animal science, wildlife conservation, bio-energy, microbial and environmental genetics. Xcelris partners with the biotechnology industry, academia, research institutes and individual researchers in India and abroad. They cater to the needs of researchers by their comprehensive service portfolio ranging from Molecular biology kits, Oligosynthesis services, Sanger Sequencing services, Next Generation Sequencing and Bioinformatics analysis.
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5. SciGenom– A Genomics R & D Services company, that provides genomic sequencing and bioinformatics services to life sciences and healthcare businesses globally as well as academic and government institutions in India. SciGenom started operations in Jan 2010. It is headquartered in Cochin, India with offices in Chennai & Hyderabad in India and San Francisco in the U.S. SciGenom is an NABL and ISO certified company, with a fully functional state-of-the-art molecular biology laboratory in Cochin and over 100 employees. It also has an R& D lab that is recognized by Department of Scientific & Industrial Research (DSIR), Ministry of Science & Technology, Government of India.
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6. Jai Health– They develop and commercialize preventive health, genomic, molecular diagnostic and personalized medicine solutions for India, Asia, the Middle East and Africa. Research and innovation are at the heart of what they do and they build each solution up from the ground tailored specifically for the markets we serve.
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7. Xcode Life sciences– With a panel that covers over 300 parameters that screen for several aspects of disease predisposition, skin aging manifestations, nutrition, and fitness, based on personal genomics. The custom-made genomic testing panels have been hand-picked by their researchers using stringent selection criteria, Xcode’s core area of focus is genomics. Their products are offered in India, Australia & South Africa.

With these string of startups offering the basic requirement of genome mapping it’s only a matter of time before the field of personalized medicines booms in the medical sector. Watch out for these companies and brace yourself for the unparalleled efficiency of personalized medicine!

Personalized Medicine In India

Personalized medicine in India is a young but rapidly advancing field of healthcare that is informed by each person’s unique clinical, genetic, genomic, and environmental information. It is about making the treatment as individualized as the disease. It involves identifying genetic, genomic, and clinical information that allows accurate predictions to be made about a person’s susceptibility of developing the disease, the course of the disease, and its response to treatment.

Specific advantages that personalized medicine may offer patients and clinicians include:

 Ability to make more informed medical decisions

 Higher probability of desired outcomes thanks to better-targeted therapies

 Reduced probability of negative side effects

 Focus on prevention and prediction of disease rather than reaction to it

 Earlier disease intervention than has been possible in the past

 Reduced healthcare costs

Advances in Genomics Technology Have Set the Stage for a Revolution in Personal Genomics that will ultimately work towards preventive healthcare, disease burden reduction and Personalized Medicine in India. Positive hqdefaultBioscience has partnered with Medanta – The Medicity to launch India’s first personal genomics clinic, which offers state-of-the-art facilities and services in preventive healthcare and personalized medicine within the country. This partnership seeks to offer comprehensive personal genomics services to the customers along with advice from leading experts associated with the Medanta – The Medicity under one roof.

Advances in genomics now enable scientists to examine the DNA of each-and-every individual and then predict if the person would be susceptible to a particular disease or whether a particular medicine is suitable for that person in case he falls sick. This is where pharmacogenomics comes into play. Companies have started investing in pharmacogenomics as it offers several advantages such as the elimination of the unpredictable nature of drug development, bring new products to the market and the company could also benefit up to $200-to-$500 million for each drug.

main-thumb-t-265506-200-aduztyxvjxylkhxrkxzmaztfmjqdxhyxA start-up company called Xcode Lifesciences has come up with the InDNA technology to provide solutions to lifestyle-related diseases such as coronary, diabetes and obesity. A person has to order the test online after which a saliva kit will be shipped to the customer. This saliva kit is completely non-invasive and safe. DNA extracted from the saliva will then be used to determine the allelic information of the individual using high-throughput genotyping techniques.

sgdsdgssfgsdfgdNutraGene launched the country’s first commercial genetic test for type 2 diabetes. NutraGene’s Type 2 Diabetes Genetic Scan is a DNA testing service that screens DNA variations that have been widely replicated as risk factors for type 2 diabetes. It is based on a buccal (cheek) swab sample and the methodology of targeted mutation screening (genotyping).

AvesthagenAvesthagen is another major player focusing on pharmacogenomics field. One of the major projects of the company is the AVESTAGENOME Project. It is a system biology-based study of the Parsi population to determine the genetic basis of longevity and age-related disorders. This study aims to develop a model for pharmacogenomics-based therapies, development of biomarkers for predictive diagnostics and drug discovery and to enable the archiving of the genome of the community. Avesthagen started this Rs125 crore project in 2007.

Despite the optimism expressed regarding the impact that this field might have on the health of people, many barriers need to be crossed. Researchers, diagnostic firms and regulatory authorities need to establish methodologies by which to judge their effectiveness. Application of genomic and personalized medicine in India needs a change in the regulatory system.

PERSONALIZED MEDICINES: TAILORED TO FIT ‘U’

Imagine, next time when you visit your doctor for treatment, he asks questions like –where do you live and what do you do, in addition to symptoms; before prescribing you a medicine. And ‘YES’ everything is official about it! Maybe because he wants to find the medicine that ‘FITS’ you the best. Here we are talking about the concept of Personalized Medicines wherein “one drug fits all” approach in combination with Pharmacogenomic research can evolve into an individualized approach to therapy where optimally effective drugs are matched to a patient’s unique genetic profile.

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