• P W Franks, E Melén, M Friedman, J Sundström, I Kockum, L Klareskog, C Almqvist, S E Bergen, K Czene, S Hägg, P Hall, K Johnell, A Malarstig, A Catrina, H Hagström, M Benson, Gustav SmithJJDepartment of Cardiology and Wallenberg Center for Molecular Medicine, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden.Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, M F Gomez, M Orho-Melander, B Jacobsson, J Halfvarson, D Repsilber, M Oresic, C Jern, B Melin, C Ohlsson, T Fall, L Rönnblom, M Wadelius, G Nordmark, Å Johansson, R Rosenquist, and P F Sullivan.
• From the, Department of Clinical Sciences, Lund University Diabetes Center, Lund University, Malmö, Sweden.
• J. Intern. Med. 2021 Sep 1; 290 (3): 602-620.

AbstractThe fields of human genetics and genomics have generated considerable knowledge about the mechanistic basis of many diseases. Genomic approaches to diagnosis, prognostication, prevention and treatment - genomic-driven precision medicine (GDPM) - may help optimize medical practice. Here, we provide a comprehensive review of GDPM of complex diseases across major medical specialties. We focus on technological readiness: how rapidly a test can be implemented into health care. Although these areas of medicine are diverse, key similarities exist across almost all areas. Many medical areas have, within their standards of care, at least one GDPM test for a genetic variant of strong effect that aids the identification/diagnosis of a more homogeneous subset within a larger disease group or identifies a subset with different therapeutic requirements. However, for almost all complex diseases, the majority of patients do not carry established single-gene mutations with large effects. Thus, research is underway that seeks to determine the polygenic basis of many complex diseases. Nevertheless, most complex diseases are caused by the interplay of genetic, behavioural and environmental risk factors, which will likely necessitate models for prediction and diagnosis that incorporate genetic and non-genetic data.© 2021 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

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