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Prioritizing Research in an Era of Personalized Medicine: The Potential Value of Unexplained Heterogeneity

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  • Anna Heath

    (Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
    Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
    Department of Statistical Science, University College London, London, UK)

  • Petros Pechlivanoglou

    (Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada)

Abstract

Background Clinical care is moving from a “one size fits all†approach to a setting in which treatment decisions are based on individual treatment response, needs, preferences, and risk. Research into personalized treatment strategies aims to discover currently unknown markers that identify individuals who would benefit from treatments that are nonoptimal at the population level. Before investing in research to identify these markers, it is important to assess whether such research has the potential to generate value. Thus, this article aims to develop a framework to prioritize research into the development of new personalized treatment strategies by creating a set of measures that assess the value of personalizing care based on a set of unknown patient characteristics. Methods Generalizing ideas from the value of heterogeneity framework, we demonstrate 3 measures that assess the value of developing personalized treatment strategies. The first measure identifies the potential value of personalizing medicine within a given disease area. The next 2 measures highlight specific research priorities and subgroup structures that would lead to improved patient outcomes from the personalization of treatment decisions. Results We graphically present the 3 measures to perform sensitivity analyses around the key drivers of value, in particular, the correlation between the individual treatment benefits across the available treatment options. We illustrate these 3 measures using a previously published decision model and discuss how they can direct research in personalized medicine. Conclusion We discuss 3 measures that form the basis of a novel framework to prioritize research into novel personalized treatment strategies. Our novel framework ensures that research targets personalized treatment strategies that have high potential to improve patient outcomes and health system efficiency. Highlights It is important to undertake research prioritization before conducting any research that aims to discover novel methods (e.g., biomarkers) for personalizing treatment. The value of unexplained heterogeneity can highlight disease areas in which personalizing treatment can be valuable and determine key priorities within that area. These priorities can be determined under assumptions of the magnitude of the individual-level treatment effect, which we explore in sensitivity analyses.

Suggested Citation

  • Anna Heath & Petros Pechlivanoglou, 2022. "Prioritizing Research in an Era of Personalized Medicine: The Potential Value of Unexplained Heterogeneity," Medical Decision Making, , vol. 42(5), pages 649-660, July.
    • Handle: RePEc:sae:medema:v:42:y:2022:i:5:p:649-660
    DOI: 10.1177/0272989X211072858
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    References listed on IDEAS

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