Integrating symptom science and precision health to enhance palliative care outcomes

Precision health is transforming the landscape of palliative care by enabling more individualized approaches to symptom assessment and management. Symptoms remain the primary focus of palliative care; however, traditional approaches rely largely on subjective self-report and often fail to capture the biological mechanisms underlying symptom variability and clustering.

This paper examines how integrating symptom science with precision health approaches, including multi-omics, digital health technologies, and systems biology, can enhance symptom characterization and inform individualized palliative care interventions.

This perspective paper focuses translational and clinical evidence, including exemplars from the authors' program of research utilizing genomic, metabolomic, inflammatory, and extracellular vesicle biomarkers to characterize psychoneurological symptom clusters in individuals with serious illness. Supporting literature on digital health integration and ethical considerations in palliative care was also reviewed.

Emerging evidence demonstrates that multi-omic approaches may help identify biological mechanisms underlying symptom heterogeneity and clustering, enabling more precise phenotyping and informing the development of targeted interventions. Genotype-phenotype associations, such as those involving the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism, and biomarker-informed symptom clusters, highlight opportunities for the future development of mechanism-based symptom management strategies. Digital health interventions, including remote symptom monitoring and telehealth, have demonstrated improvements in symptom burden, quality of life, and care coordination although cost-effectiveness may vary across technologies, settings, and healthcare systems. However, variability in biological pathways and challenges related to implementation, equity, and access underscore the need for thoughtful integration.

This paper is innovative in its integration of multi-omic symptom science with precision health frameworks to advance a mechanism-informed model of palliative care. It uniquely bridges biological, technological, and clinical domains to move beyond symptom description toward biologically grounded, individualized symptom management, while explicitly preserving the "high-tech, high-touch" ethos central to palliative care.

Integrating precision health strategies with symptom science offers a transformative opportunity to advance palliative care through individualized, mechanism-informed symptom management. A "high-tech, high-touch" approach is essential to ensure that technological innovation enhances, rather than replaces, the compassionate, person-centered care that defines palliative practice. Future directions should prioritize scalable models, non-invasive biomarkers, and equitable implementation across diverse populations.