It’s a personal thing: You say stratified medicine and I say…

The UK Academy of Medical Sciences (AMS) does not do hyperbole.  This is a good thing considering the histrionics that usually accompanies discussion about stratified medicine.

AMS brought out its long-awaited report on stratified medicine on Friday entitled ‘Realising the potential of stratified medicine.’ It’s straight-laced approach to the subject matter means it failed to make any headlines. But given who the AMS is, how these things work, and the strong hand of Sir John Bell (former President of the Academy, Chair of the Office for the Strategic Co-ordination of Health Research) behind it, it is likely to be very influential.

This is a veritable tome, if not textbook report, on current knowledge and issues involved in stratified medicine and well worth making the effort to try and read if you can. Its main thrust is how pricing and regulation are holdings things back in terms of this new knowledge being applied for patient benefit. The case studies and examples are very helpful in grounding one’s perspectives in what has actually happened in the field thus far. I should add that I was involved in many of the AMS events and activities that led up to its publication.

The report has two main recommendations on public involvement and engagement. The first (recommendation 6) is that a consortium of organisations including INVOLVE and others should come together to consider the outcome of the Technology Strategy Board (TSB)funded public dialogue exercise. This exercise is about to begin and I am on the TSB Oversight Group which is overseeing the project.

The second (recommendation 18) is more interesting as it calls for the expansion of the existing UK Stratified Medicine Innovation Platform – led by the TSB – to embrace a public/private partnership of organisations looking at how stratified medicine works in clinical settings but focusing on, among other things, public understanding. The public/private mix will be very important in this latter piece as my impression is that the public sector, commercial sector and patients are often talking at cross-purposes and to different agendas if not priorities.

A key theme of this report and other developments over the past few weeks is the NHS’ state of readiness (or lack of it) to incoporate this fast-developing area of medicine into clinical practice (what you and I receie as patients). Hence the significant investment we are seeing in things like Genomics England (see my blog from two weeks ago), NIHR’s Diagnostic Evidence Co-operatives – one of which is focusing on diagnostics in stratified medicine if I remember rightly, even networks like the new Health Informatics Centres as launched in May.

I heard a quite brilliant presentation on this and other ways in which the UK is ‘gearing up to lead,’ by the Scottish Chief Scientist, Andrew Morris, on Friday. He was speaking at the UK Clinical Research Facilities annual conference. Andrew was also a member of the AMS group that produced the report. It was good to hear him say how important the public involvement piece was for him in conversation before the meeting. I shall include a link to his presentation if I am given a copy.

However, whether we arrive at a simple, plain English term for ‘stratified medicine’ is another matter….

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