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Mapping uncertainty in precision medicine: A systematic scoping review
Simon Lohse1,2,3,4
1Institute for Science in Society, Radboud University, Nijmegen, The Netherlands.
Journal of Evaluation in Clinical Practice
|November 14, 2022
Summary
Precision medicine, while promising, presents inherent uncertainty due to its complexity. This uncertainty is a core feature, not just a temporary issue, impacting research and practice.
Area of Science:
- Medical Informatics
- Bioethics
- Health Services Research
Background:
- Precision medicine offers personalized healthcare but introduces significant uncertainties.
- The 'paradox of precision medicine' highlights the surprising prevalence of uncertainty in its practical application.
Purpose of the Study:
- To conduct a scoping review identifying factors contributing to uncertainty in precision medicine.
- To analyze the nature and levels of uncertainty within the precision medicine paradigm.
Main Methods:
- Systematic literature search across PubMed, Web of Science, and Jstor, supplemented by hand-searching.
- Analysis of 51 selected articles using MAXQDA, categorized into four themes of uncertainty.
- Thematic synthesis to explore interrelations and implications of uncertainty.
Main Results:
- Uncertainty in precision medicine is a complex, multi-faceted concept.
- Identified levels of uncertainty include ontological (complexity), epistemological/methodological (knowledge production), and practical (implementation).
- Ontological, conceptual, and evidence-related uncertainties are key dimensions of the paradox.
Conclusions:
- Uncertainty is an intrinsic characteristic of precision medicine, stemming from its inherent complexity.
- Uncertainty is unlikely to be fully resolved by further research alone.
- Further investigation into the interactions and implications of these uncertainties is crucial for advancing precision medicine research and practice.
