NOVEMBER - 20218In My OpinionRAISING THE FLOOR AND BRIDGING THE GAP Sam Gray, Managing Partner, Apposite Capital LLPByMuch is written in the mainstream press about the well-established trend towards personalised medicine. Scientific advances in fields such as genomics, epigenetics, proteomics and companion diagnostics increasingly enable precise characterisation of a patient and their disease; and drawing on sophisticated clinical trials and real-world data sets an optimal personalised drug or biologic therapy options can then be selected­possibly guided by AI decision support algorithms.Despite all the (justified) hype and investment in these pharmaceutical and biologic technologies, in the majority of clinical practice, physical interventions such as surgery remain by far the most important treatment modality. Even in cancer treatment, surgery and radiation-based treatments still account for the vast majority of cancer cures and this is expected to remain the case for the foreseeable future. However, by their very nature physical interventions such as surgery and anatomical characteristics of disease are more difficult to precisely characterise and define than genetic or biochemical markers. This makes it more difficult to precisely specify and control interventions, measure and map the outcomes and precisely establish best practices. There is also a much larger human element in the treatment pathway from the radiologist interpreting images to the surgeon performing the procedure. This leads to more subjectivity, more variation and inevitably also more human error. Sam Gray
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