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Precision Medicine in Neurocritical Care for Cerebrovascular Disease Cases
Nils H Petersen1, Kevin N Sheth1,2,3, Ruchira M Jha1,2,3
1Departments of Neurology (N.H.P., K.N.S., R.M.J.), Yale University School of Medicine, New Haven, CT.
Insights
Precision medicine advances stroke care by integrating complex data for personalized treatment. This review highlights key areas for improving patient outcomes in intensive care units (ICUs).
Area of Science:
- Neurology
- Intensive Care Medicine
- Biomedical Engineering
Background:
- Acute stroke care benefits from scientific advances but faces challenges due to disease complexity.
- Current practice guidelines may not fully address individual patient needs in cerebrovascular diseases.
- Personalized stroke care traditionally uses clinical exams, neuroimaging, and monitoring.
Purpose of the Study:
- To review research advances in precision medicine for stroke care.
- To outline principles for translating precision medicine into clinical practice.
- To identify critical areas needing further evidence for personalized stroke management.
Main Methods:
- Review of current research in data capture, clinical phenotyping, and biomarker development.
- Analysis of advancements in neuromonitoring and physiology-based treatment targets.
- Exploration of mathematical tools for real-time data analysis and personalized treatment recommendations.
Main Results:
- Progress has been made in data integration and analysis for stroke management.
- Several critical areas require further research and evidence for effective precision medicine.
- Mathematical tools show promise in providing real-time, personalized treatment targets.
Conclusions:
- Translating precision medicine into clinical practice requires continued research and development.
- Personalized stroke care in the ICU can be enhanced through advanced data analysis and targeted interventions.
- Integrating diverse data streams is crucial for tailoring treatment to individual cerebrovascular disease patients.
Abstract:
Scientific advances have informed many aspects of acute stroke care but have also highlighted the complexity and heterogeneity of cerebrovascular diseases. While practice guidelines are essential in supporting the clinical decision-making process, they may not capture the nuances of individual cases. Personalized stroke care in ICU has traditionally relied on integrating clinical examinations, neuroimaging studies, and physiologic monitoring to develop a treatment plan tailored to the individual patient. However, to realize the potential of precision medicine in stroke, we need advances and evidence in several critical areas, including data capture, clinical phenotyping, serum biomarker development, neuromonitoring, and physiology-based treatment targets. Mathematical tools are being developed to analyze the multitude of data and provide clinicians with real-time information and personalized treatment targets for the critical care management of patients with cerebrovascular diseases. This review summarizes research advances in these areas and outlines principles for translating precision medicine into clinical practice.
