报告题目：Phenotyping the Hospital Patient Journey: A Systems Paradigm for Translational Medicine
报? 告? 人：Jeremy Nicholson, Imperial College, London
Understanding the complex chain of systemic events and factors leading to organic disease is key to finding new ways to treat human diseases and new disease targets. Systems medicine approaches have been much discussed and debated but the key question is whether they can deliver practical results and models to assist clinical decision making on a realistic timescale. Both timescales and costs crucially determine which technologies can be deployed in the clinical environment and a significant challenge is posed by data processing speed, integration of knowledge within existing frameworks of patient management as well as delivery of novel diagnostic information in a form that can be readily interpreted by clinicians. We are currently addressing these issues by linking together a series of metabolic phenotyping and modeling platforms in a variety of clinical settings including surgery where the real time demands of diagnosis are most extreme. Thus the Patient Journey Phenotyping Paradigm will be illustrated with respect to surgical, cancer and critical care patient management demands in relation to the technological and background patient biology modeling knowledge sets required to achieve improved patient management in a cost efficient manner. Our translational medicine process is based on nearly 1000 man years of our own underpinning research in analytical spectroscopic modeling of human and animal systems and we are currently exploring the practical implementation of these approaches in our clinics at the Imperial College Healthcare Trust in London which is closely integrated with the Faculty of Medicine of the University. In order to achieve translation, suitable technologies must be embedded within the clinical environment and to this end we have already set up a new Surgical Metabonomics unit which is NMR and mass spectrometry based, and we are currently setting up a large scale clinical phenotyping unit at St Mary’s Hospital. Reducing patient morbidity and mortality and shortening the hospital journey is the primary aim of this work but this has to be achieved in a cost effective way as well as addressing problems in unmet medical need.