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December 2018

Precision Medicine in Neurocritical Care

Author Affiliations
  • 1Department of Anesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
  • 2Departments of Anesthesiology and Critical Care Medicine, Neurology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Brain and Spinal Injury Center, Department of Neurology, Zuckerberg San Francisco General Hospital, University of California, San Francisco
JAMA Neurol. 2018;75(12):1463-1464. doi:10.1001/jamaneurol.2018.3157

Precision medicine is “an innovative approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person” and has expanded from oncology to many other fields of medicine.1 Most clinical trials testing neurocritical care treatments have not been based on principles of precision medicine. Rather, they have used a “one-size-fits-all” approach. This has left us with largely neutral results regarding blood pressure (BP) management or surgical intervention for intracerebral hemorrhage, intracranial pressure (ICP) management in traumatic brain injury (TBI), and neuroprotection for ischemic stroke, TBI, and spinal cord injury. Neurocritical care now finds itself at a crossroads, or perhaps an inflection point, regarding the clinical science and evidence necessary to know how to best treat patients.

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