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La Lettre
© pandpstock001 - Fotolia
The complexity of living beings, including human being (whether in good health or ill), as illustrated by
our 22 000 genes, the million regulation elements in our genome, the 3 x 10
13
cells of our body, our
cohabitation with 4 x 10
13
bacteria in the intestine and more than 10
15
viruses has to be taken into account,
as well as time and individual and collective behaviours – how is it possible to grasp this complexity, to
quantify it and extract useful elements for medicine to benefit from in ever-changing environment?
Quite logically, the number and types of available data for each individual increase rapidly, all the more
so as “connected” devices are more and more used, making it easier to remotely extract many relevant
parameters in the context of any given diseases (cardiac rhythm,
glycaemia, etc.). A systemic approach to the individual,
healthy or sick, is born. Thus, warehouses
data are being built, often involving the
individuals’ electronic medical files,
which may, in turn, be associated
to various biological pieces
of information – genome,
epigenome,
proteome,
metabolome, images, etc.
The “intelligent” extraction
of relevant data – a major
development in algorithmic
sciences – should logically
drive progress in medical
knowledge and become a
major medical decision tool in
what might be precision medicine.
A serious issue will be our ability to
link up the fruits of research that human
and social sciences reap on health, as they will
be crucial to understand the individual and collective
human behaviours of those facing health issues.
Health is a social issue with an ever-prominent place; it is in direct contact with the progress of medicine,
based on a scientific approach. Many questions call for an answer: how acceptable are preventive
measures and policies, and potential forecasts, when health is the matter? Where should we draw the
line? Efficient public health policies require quite sharp health training programmes for the people (and
caregivers), especially on grasping a better notion of the different orders of magnitude of risk involved.
How accessible is care? In France, despite a rather efficient redistribution system, health inequalities
remain: there are life expectancy differentials, lethal diseases are diagnosed at more or less early stages,
access to prevention is very diverse, etc.
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2 - O Nay, et al. Lancet 2016 , 387 : 2236-49