A Global Survey of Precision Medicine in Emergency General Surgery
Oon-Hui Ng, Elizabeth O’Connell, Rajarshi Mukherjee- Surgery
Abstract
Background
Since first sequencing the human genome, precision medicine has become a modern-day reality. However, translation to all areas of medicine has not been equal. This study aimed to provide a ‘status update’ of precision medicine in EGS to guide future priority setting.
Methodology
An observational study was conducted utilising two curated global on-line databases: 1. Pubmed publications from 2001 & 2. Clinical trials registered on ClinicalTrials.gov. The top 10 presenting conditions in EGS, Oncology, and Acute Medicine were identified from literature review. Publications/trials in these areas were identified using associated keywords: precision, personalised, genomics, genome-wide association studies, exome studies, epigenetics, transcriptomics, proteomics, metabolomics, microbiomics, and pharmacogenomics. Duplicated publications/trials were removed prior to final analysis and only active, recruiting or completed trials were included. Temporal trends were compared and annual growth rates were calculated.
Results
There were 209,423 EGS publications, 1807 (0.9%) being precision-focused. Oncology had 1,137,396 publications, with 127,556 precision-focused (11.2%), and Acute Medicine had 1,647,046 publications, with 80,240 (4.9%) precision-focused. The rate of rise of annual publications since 2001 (human genome project publication) was significantly (p<0.05) lower for EGS (x2.9) versus oncology (x3.5) and medicine (x6.0). Only 7 precision-focused clinical trials were identified for EGS compared to 96 for Oncology and 39 for Medicine. x10 fewer precision-focused EGS publications and trials exist over 20 years, compared to covid-19 over 2 years.
Conclusion
Research and implementation of precision medicine in EGS remains inadequate. Increased investment and improved global implementation are warranted to address the widening gap in translation.