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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Applying systems biology to biomedical research and health care: a précising definition of systems medicine

Authors: Sebastian Schleidgen, Sandra Fernau, Henrike Fleischer, Christoph Schickhardt, Ann-Kristin Oßa, Eva C. Winkler

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Systems medicine has become a key word in biomedical research. Although it is often referred to as P4-(predictive, preventive, personalized and participatory)-medicine, it still lacks a clear definition and is open to interpretation. This conceptual lack of clarity complicates the scientific and public discourse on chances, risks and limits of Systems Medicine and may lead to unfounded hopes. Against this background, our goal was to develop a sufficiently precise and widely acceptable definition of Systems Medicine.

Methods

In a first step, PubMed was searched using the keyword “systems medicine”. A data extraction tabloid was developed putting forward a means/ends-division. Full-texts of articles containing Systems Medicine in title or abstract were screened for definitions. Definitions were extracted; their semantic elements were assigned as either means or ends. To reduce complexity of the resulting list, summary categories were developed inductively. In a second step, we applied six criteria for adequate definitions (necessity, non-circularity, non-redundancy, consistency, non-vagueness, and coherence) to these categories to derive a so-called précising definition of Systems Medicine.

Results

We identified 185 articles containing the term Systems Medicine in title or abstract. 67 contained at least one definition of Systems Medicine. In 98 definitions, we found 114 means and 132 ends. From these we derived the précising definition: Systems Medicine is an approach seeking to improve medical research (i.e. the understanding of complex processes occurring in diseases, pathologies and health states as well as innovative approaches to drug discovery) and health care (i.e. prevention, prediction, diagnosis and treatment) through stratification by means of Systems Biology (i.e. data integration, modeling, experimentation and bioinformatics). Our study also revealed the visionary character of Systems Medicine.

Conclusions

Our insights, on the one hand, allow for a realistic identification of actual ethical as well as legal issues arising in the context of Systems Medicine and, in consequence, for a realistic debate of questions concerning its matter and (future) handling. On the other hand, they help avoiding unfounded hopes and unrealistic expectations. This especially holds for goals like improving patient participation which are intensely debated in the context of Systems Medicine, however not implied in the concept.
Appendix
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Footnotes
1
The methods presented here are based on the approach developed in [16]. Differences in methods result from taking into account applicable critiques of the original account [41].
 
3
As stated above, medical applications can be defined by the means they employ to reach certain ends. From this it can be inferred that defining a medical term is necessary if either (1) new medical means (or new combinations of medical means) are employed to reach conventional ends, or (2) conventional medical means are employed to reach new ends, or (3) new medical means (or new combinations of medical means) are employed to reach new ends.
 
4
See Additional file 1 for an overview of all the papers identified.
 
5
See Additional files 2, 3, 4, 5, 6, 7, 8 and 9.
 
6
See Additional file 10 for an overview of all definitions and definition-like text passages identified.
 
7
See Additional file 11 for a list of all definitions separately divided into ends and means.
 
8
See Additional file 12.
 
9
See Additional file 13.
 
10
See Additional file 14.
 
11
See Additional file 15.
 
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Metadata
Title
Applying systems biology to biomedical research and health care: a précising definition of systems medicine
Authors
Sebastian Schleidgen
Sandra Fernau
Henrike Fleischer
Christoph Schickhardt
Ann-Kristin Oßa
Eva C. Winkler
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2688-z

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