An analysis of a 108-participant wellness project highlights that P4 medicine's extensive testing may lead to O4 medicine (overtesting, overdiagnosis, overtreatment, overcharging) and increased costs.
What are the advantages and disadvantages of P4 medicine compared to the risks of overtesting and overtreatment (O4 medicine)?
Extensive biomarker testing and personalized coaching (P4 medicine) may lead to overtesting, overdiagnosis, overtreatment, and overcharging (O4 medicine), raising concerns about the best use of limited healthcare resources.
BACKGROUND: The term P4 medicine (predictive, preventative, personalized, participatory) was coined by Dr. Leroy Hood of the Institute for Systems Biology to demonstrate his framework to detect and prevent disease through extensive biomarker testing, close monitoring, deep statistical analysis, and patient health coaching. METHODS: In 2017, this group published the results of their "100 Person Wellness Project." They performed whole genome sequencing and 218 clinical laboratory tests, measured 643 metabolites and 262 proteins, quantified 4616 operational taxonomic units in the microbiome, and monitored exercise in 108 participants for 9 months. The study was also interventional, as members were paired with a coach who gave lifestyle and supplement counseling to improve biomarker levels between each sampling period. RESULTS: Using this study as a basis, we here analyze the Hippocratic roots and the advantages and disadvantages of P4 medicine. We introduce O4 medicine (overtesting, overdiagnosis, overtreatment, overcharging) as a counterpoint to P4 medicine to highlight the drawbacks, including possible harms and cost. CONCLUSIONS: We hope this analysis will contribute to the discussion about the best use of limited health-care resources to produce maximum benefit for all patients.
Fiala et al. (Wed,) reported a editorial. P4 medicine (extensive biomarker testing and coaching) was evaluated. An analysis of a 108-participant wellness project highlights that P4 medicine's extensive testing may lead to O4 medicine (overtesting, overdiagnosis, overtreatment, overcharging) and increased costs.