Personalized PREvention of Chronic DIseases

Medical practitioners are increasingly adopting a 'personalised medicine' (PM) approach involving individually tailored patient care. The PREvention of Chronic DIseases consortium (PRECeDI) project, funded within the Marie Skłodowska Curie Action (MSCA) Research and Innovation Staff Exchange (RISE) scheme, had fostered collaboration on PM research and training with special emphasis on the prevention of chronic diseases. From 2014 to 2018, the PRECeDI consortium trained 58 staff members on personalized prevention of chronic diseases through training and research. The acquisition of skills from researchers came from dedicated secondments from academic and non-academic institutions aimed at training on several research topics related to personalized prevention of cancer, cardiovascular and neurodegenerative diseases. In details, five research domains have been adressed: 1) identification and validation of biomarkers for primary prevention of cardiovascular diseases, secondary prevention of Alzheimer disease, and tertiary prevention of head and neck cancer; 2) economic evaluation of genomic applications; 3) ethical-legal and policy issues surrounding personalized medicine; 4) sociotechnical analysis of the pros-and cons of informing healthy individuals on their genome; 5) identification of organizational models for the provision of predictive genetic testing. Based on the results of the research carried out by the PRECeDI consortium, in November 2018 a set of recommendations for policy-makers, scientists and industry has been issued, with the main goal to foster the integration of personalized medicine approaches in the field of chronic disease prevention.

Based on the results of the research carried out by the PRECeDI consortium, a set of recommendations for policy-makers, scientists and industry has been drawn up, with the main goal to foster the integration of PM approaches in the field of chronic disease prevention.
The projects, the scientific publications and the recommendations are summarized in the document “How to integrate Personalized Medicine into Prevention? Recommendations from the Personalized pREvention of Chronic Diseases (PRECeDI) consortium (2018)” http://www.precedi.eu/docsmedia/communications/pers._medicine_prevention.pdf
When the recommendations were drawn up, the PRECeDI consortium took into account both the Strategic Research and Innovation Agenda -PerMed Consortium (https://www.permed2020.eu/_media/PerMed_SRIA.pdf) and PHG Foundation report on personalised healthcare [http://www.phgfoundation.org/documents/REPORT%20-%20Personalised%20healthcare%20bringing%20the%20future%20into%20focus.pdf].
Taking into account that personalized prevention can only be successfully implemented when handled as a truly cross-sectoral topic, these recommendations integrate the perspective of experts across the entire healthcare value chain that are represented in the PRECeDI consortium. As a matter of fact, this document is also the result of the discussions of the one-day PRECeDI workshop “Policy development in Personalized Medicine” held in Amsterdam on March, 15th, 2018 that convened experts and representatives of relevant stakeholders in the field of PM. The experts participating fully endorsed this document. These recommendations were shared and discussed during the final conference in Brussels on November, 7th, 2018. Moreover, this document was open for public consultation until December, 11th, 2018 on the PRECeDI website.

The implementation of the PRECeDI recommendations will benefit citizens, patients, healthcare professionals, healthcare authorities and industry and ultimately seek to contribute to better health for Europe’s citizens. The PRECeDI project, in fact, is fundamental since that public health professionals may play different roles translation of genomics research into health benefits. First, they may act as the “honest brokers” responsible for evaluating the effectiveness of genomic applications, preventing potential harm and unnecessary health care expenditure through premature use. They may use genomics tools to evaluate the health impact of public health interventions on different subsets of the population. Most importantly, public health professionals can contribute to modelling and evaluating the implementation of evidence based genomic applications. In this regard, among the priorities of the public health genomics movement, there is the assurance of an adequate public health capacity on genomics. Moreover, despite the prominence of frontline research, the vast majority of potential genetic/genomic applications (tests or interventions) have not yet been implemented into clinical practice; indeed, it is estimated that not more than 3% of published research focuses on the translation from experimental genetic/genomic applications to evidence-based guidelines and health care practice. Thus, this “implementation research” receives relatively little attention, with few genetic and genomic applications actively considered for introduction into clinical practice. One barrier to such implementation is a lack of appreciation of the cost-benefit of new testing regimes, particularly pertinent nowadays, when health care systems are under financial pressure. Therefore, economic evaluations of candidate technologies are essential for clinicians and public health officials when deciding which genetic tests to introduce, how to manage carriers and non-carriers, and how to assess the impact of testing on health-related quality of life. In fact, economic analysis allows one to collect and integrate all relevant factors linked to genetic testing (prevalence of disease and mutation, specificity and sensitivity of the test, association between genotype and phenotype, efficacy of interventions in preventing disease) and to estimate the benefits and costs of an entire health care program, beginning with the characteristics of a target population and continuing with preventive surveillance, prophylactic treatments and consequent follow-up.
The European Commission recognized how the project accomplished to involve healthcare professionals, authorities, and researchers. For this reason, the PRECeDI Project is reported as an example of the most recent successful stories from EU Research in the European Commission website on the page dedicated to Research and Innovation Projects -Successful Stories (http://ec.europa.eu/research/infocentre/article_en.cfm?artid=49872).

Periodic Reporting for period 2 - PRECeDI (Personalized PREvention of Chronic DIseases)

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