Email updates

Keep up to date with the latest news and content from BMC Medical Ethics and BioMed Central.

Open Access Highly Accessed Research article

What is personalized medicine: sharpening a vague term based on a systematic literature review

Sebastian Schleidgen1*, Corinna Klingler1, Teresa Bertram1, Wolf H Rogowski23 and Georg Marckmann1

Author Affiliations

1 Ludwig-Maximilians-University Munich, Institute of Ethics, History and Theory of Medicine, Munich, Germany

2 Helmholtz Zentrum Munich, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany

3 Ludwig-Maximilians-University Munich, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany

For all author emails, please log on.

BMC Medical Ethics 2013, 14:55  doi:10.1186/1472-6939-14-55

Published: 21 December 2013

Abstract

Background

Recently, individualized or personalized medicine (PM) has become a buzz word in the academic as well as public debate surrounding health care. However, PM lacks a clear definition and is open to interpretation. This conceptual vagueness complicates public discourse on chances, risks and limits of PM. Furthermore, stakeholders might use it to further their respective interests and preferences. For these reasons it is important to have a shared understanding of PM. In this paper, we present a sufficiently precise as well as adequate definition of PM with the potential of wide acceptance.

Methods

For this purpose, in a first step a systematic literature review was conducted to understand how PM is actually used in scientific practice. PubMed was searched using the keywords “individualized medicine”, “individualised medicine”, “personalized medicine” and “personalised medicine” connected by the Boolean operator OR. A data extraction tabloid was developed putting forward a means/ends-division. Full-texts of articles containing the search terms in title or abstract were screened for definitions. Definitions were extracted; according to the means/ends distinction their elements were assigned to the corresponding category. To reduce complexity of the resulting list, summary categories were developed inductively from the data using thematic analysis. In a second step, six well-known criteria for adequate definitions were applied to these categories to derive a so-called precising definition.

Results

We identified 2457 articles containing the terms PM in title or abstract. Of those 683 contained a definition of PM and were thus included in our review. 1459 ends and 1025 means were found in the definitions. From these we derived the precising definition: PM seeks to improve stratification and timing of health care by utilizing biological information and biomarkers on the level of molecular disease pathways, genetics, proteomics as well as metabolomics.

Conclusions

Our definition includes the aspects that are specific for developments labeled as PM while, on the other hand, recognizing the limits of these developments. Furthermore, it is supported by the quantitative analysis of PM definitions in the literature, which suggests that it it is widely acceptable and thus has the potential to avoid the above mentioned issues.

Keywords:
Biomarkers; Conceptual vagueness; Definition; Individualized medicine; Stratification; Timing