Precision medicine: discovering clinically relevant and mechanistically anchored disease subgroups at scale

This is the authors' abstract. We don't add key points for this paper.

American medicine is on the precipice of dramatic change, forced by disruptive technologies in measurement, computation, and communication.This change is inevitable, because society can no longer afford the nearly $1 trillion in annual waste, a major fraction of which is caused by poorly informed medical decisions and misaligned incentives.In America, if top-down solutions remain stalled, the needed change can only occur through better health decisions based on more valid measurements and analyses that improve medical decisions and the health of individuals and populations.In our view, precision medicine, by this or any other name, is the science-based application of modern measurement and analysis to improve each health decision.Precision medicine must define clinically relevant and mechanistically anchored health and disease subgroups for which optimal strategies can be followed (when known) and discovered (when not).Precision medicine is the scientific framework of the learning health system that can bring informed innovations to clinical practice (1).As such, precision medicine has the potential to exploit the technology revolutions (2), as most other industries are doing, to improve the health of Americans at more affordable costs.