Medical beakers

La quimera de la medicina de precisión

BOSTON/NUEVA YORK – Hace poco, la administración del Presidente estadounidense Barack Obama llamó a proponer ideas para avanzar en su “iniciativa de medicina de precisión”, que se propone destinar millones de dólares de fondos federales a estudios que apunten a adaptar tratamientos clínicos a pacientes individuales. La idea de una medicina personalizada que aproveche los enormes avances en genética y biología molecular suena ciertamente atractiva, no sólo en Estados Unidos sino en el Reino Unido y otros países. Lamentablemente, el supuesto de que la medicina de precisión beneficiará la sanidad pública al mejorar la práctica clínica no se sostiene.

Gran parte de los niveles de liderazgo científico de Estados Unidos, en particular los Institutos Nacionales de la Salud (NIH), han apoyado con entusiasmo la iniciativa de Obama. Según Harold Varmus, director del Instituto Nacional del Cáncer, y Francis Collins, director de los NIH, un “programa de investigación así de amplio […] para desarrollar la base de evidencias necesaria que orientar la práctica clínica” es precisamente “lo que hoy se necesita”.

Sin embargo, al centrarnos en la detección y el tratamiento de enfermedades a nivel individual, la medicina de precisión obvia los patrones de salud más generales. Si se mira más en detalle la salud de las poblaciones (en particular, los segmentos más pobres de la sociedad), “lo que hoy se necesita” resulta ser algo bastante diferente.

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