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Wednesday, August 12, 2009 9:00 AM
Navigating Health Care: Personalized Medicine

Rand: You inherit many things from your parents and grandparents. They pass along photos, stories and recipes that can help you understand family culture and values. Their genes influence your appearance - your height, and the color of your eyes. And when family members share certain medical conditions, you may also be at risk of developing the same problems in the future. By practicing personalized medicine, doctors can use this information to predict your risk and take action to keep you and your family healthy. Here to talk with us more about this is AHRQ Director Dr. Carolyn Clancy. Welcome, Dr. Clancy.

Dr. Clancy: Thank you.

Rand: Dr. Clancy, what is personalized medicine?

Dr. Clancy: Generally, personalized medicine involves using your genetic information and family health history to make more accurate predictions about your risk of developing disease, and how you might respond to treatment. This could be a more effective approach to care than the traditional one, which essentially provides the same care to everyone who has a particular illness. Instead, it focuses on your family health history and individual characteristics, including age, gender, height and weight in empowering you and your doctor to develop plans for maintaining a healthy lifestyle.

Rand: How important is family health history to the care you receive?

Dr. Clancy: Family health history has always been very important in getting good health care, but it has been underused. And today, with our growing knowledge of genetics, it’s becoming even more important. This collection of information about diseases that run in your family, as well as the eating habits, activities and environment that your family shares, can help you make healthy choices and important decisions about your health care options. This is especially true when it comes to activities such as cancer screening, prevention and early detection.

Rand: Are there studies that support the link between disease prevention and heredity?

Dr. Clancy: This link has been examined most often when someone belongs to a family with unusual patterns of disease, such as a rare genetic disorder, like hemophilia, cystic fibrosis or sickle cell anemia. A recent study funded by AHRQ looks at illnesses that are more common within the population, such as heart disease, diabetes and cancer. The goal of the study was to determine the accuracy of tools now used by doctors to assess family history and predict the risk of cancer. One of the findings of the study was that more research is needed in order for us to realize all of the potential benefits of using family history to predict risk.

Rand: Are there actions that individuals themselves can engage in to help with this?

Dr. Clancy: I would say that one clear choice would be for all of us to document our family health histories. A good product to use for doing this is the Surgeon General’s Family Heath History Tool. This Internet-based tool was updated recently to make it more user-friendly for building your family’s health history. And ultimately, it could serve as the foundation for developing better risk assessment systems.

Rand: How do personalized medicine and the increased use of a family health history fit into the current debate about 21st century health care?

Dr. Clancy: Well, I think that gets to the heart of this discussion. The fact is, we’re moving into a different world. We expect more from our doctors and other health care professionals, and more and more, they are delivering value and services in ways they have not paid much attention to before. Personalized medicine, family health history, and tools like the Surgeon General’s equip all of us - consumers and health care professionals alike - with extremely valuable information that can lead to much better health care. They’re all keys to building a robust, but flexible health care system that is more widely available to everyone, and more attuned to the needs of the individual. I’m Dr. Carolyn Clancy and that’s my advice on how to navigate the health care system.

Rand: For more information about the study, "Clinical Utility of Cancer Family History collection in Primary Care," visit www.ahrq.gov. To access the Surgeon General’s Family History Health Tool, visit www.hhs.gov/familyhistory.

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