Precision medicine is promoted as a promising new medical approach leading to better health outcome. The term precision is used liberally to describe a wide variety of tools aimed at adding patient-specific information to the responsible physician. However, in-spite of point demonstrations of one technology or another in a specific medical situation, the employment of the full paradigm has never been demonstrated as leading to a better overall health.
Aim: Our project intends to demonstrate the benefit, or lack there-of, of evaluating all members registered in a primary care-clinic for a variety of markers, on the overall health status of the local community.
Methods: Unselected, full population cohort of adults insured in several multi-physician primary-care practices are invited to participate. This is done in the context of a Randomized Controlled Trial where clinics are selected and randomly allocated to genome-driven (intervention) clinics and usual-care clinics (controls). Preliminary steps include the training of the clinic medical teams to deal with results of extensive genomic and pharmaco-genomic tests. The target clinic population is also undergoing education about the new approach. Each participant is undergoing a genomic evaluation (spectrum: NGS panels, GWAS, WES, WGS), microbiome testing, as a planned use of wearable sensors. These test results are provided to the primary care physicians in the form of genetic risk-alleles of various diseases, pharmaco-genomic variants and informatics findings, potentially leading to medical action resulting in better health indicators (disease rates, use of health service, health economics, quality of life/satisfaction/adherence). A plethora of findings (prevalence of genetic variants, ethnic diversity, clinical associations with incidence/survival/disease-control) and insights (degree of acceptance by population, medical providers, health systems providers) is already available after recruiting the first 1500 participants.