Review
Neurosciences
Eric J. Lenze, Ginger E. Nicol, Dennis L. Barbour, Thomas Kannampallil, Alex W. K. Wong, Jay Piccirillo, Andrew T. Drysdale, Chad M. Sylvester, Rita Haddad, J. Philip Miller, Carissa A. Low, Shannon N. Lenze, Kenneth E. Freedland, Thomas L. Rodebaugh
Summary: Precision medicine has not yet been achieved for neurobehavioral conditions like psychiatric disorders due to the limitations of traditional randomized clinical trial methods. A pragmatic solution presented is the precision clinical trial framework which includes treatment-targeted enrichment, adaptive treatments, and precise measurement methods. By incorporating new biomarkers and advanced statistical and machine-learning models, achieving individualized treatments for neurobehavioral conditions may become possible.
JOURNAL OF PSYCHIATRY & NEUROSCIENCE
(2021)
Review
Clinical Neurology
Paolo Fusar-Poli, Mirko Manchia, Nikolaos Koutsouleris, David Leslie, Christiane Woopen, Monica E. Calkins, Michael Dunn, Christophe Le Tourneau, Miia Mannikko, Tineke Mollema, Dominic Oliver, Marcella Rietschel, Eva Z. Reininghaus, Alessio Squassina, Lucia Valmaggia, Lars Vedel Kessing, Eduard Vieta, Christoph U. Correll, Celso Arango, Ole A. Andreassen
Summary: This article is a critical review on the importance and ethical challenges of precision psychiatry. It aims to address these challenges and issues by designing a roadmap for research and clinical practice, promoting the development and application of precision psychiatry, and benefiting patients.
EUROPEAN NEUROPSYCHOPHARMACOLOGY
(2022)
Review
Endocrinology & Metabolism
Sanne H. M. Kremers, Sarah H. Wild, Petra J. M. Elders, Joline W. J. Beulens, David J. T. Campbell, Frans Pouwer, Nanna Lindekilde, Maartje de Wit, Cathy Lloyd, Femke Rutters
Summary: This review examines the value of addressing mental disorders as part of diabetes care, highlighting their impact on the development and outcomes of diabetes. The review emphasizes the potential benefits of treating mental disorders in preventing diabetes and improving diabetes outcomes. Technologically enabled solutions could aid in identifying mental disorders and tailoring treatments accordingly. However, there are knowledge gaps and challenges to be addressed before treatment recommendations based on mental disorders can be stratified.
Review
Pharmacology & Pharmacy
Pedro Luiz Serrano Uson Junior, Jeremiah Bearss, Hani M. Babiker, Mitesh J. Borad
Summary: The treatment landscape for biliary cancers is rapidly evolving, with inhibitors against actionable targets FGFR and IDH1 now being included in multiple countries' treatment guidelines for advanced cholangiocarcinoma. However, there is still a need to identify resistance mechanisms and develop treatment strategies involving tumor sequencing.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2023)
Review
Oncology
Edoardo Crimini, Matteo Repetto, Philippe Aftimos, Andrea Botticelli, Paolo Marchetti, Giuseppe Curigliano
Summary: This review presents the most important molecular targets in breast cancer, classified according to their pathway and in accordance with ESCAT, assisting clinicians in making therapeutic decisions.
CANCER TREATMENT REVIEWS
(2021)
Article
Psychology, Clinical
Lisa M. Anderson, Kelvin O. Lim, Erich Kummerfeld, Ross D. Crosby, Scott J. Crow, Scott G. Engel, Lauren Forrest, Stephen A. Wonderlich, Carol B. Peterson
Summary: Objective precision medicine is an optimal goal for treating complex psychiatric disorders, including eating disorders. However, current research in this field is limited in identifying individual-level models and causal relationships of eating disorder psychopathology. This article introduces causal discovery analysis (CDA) methods as promising tools for developing personalized treatment for eating disorders.
INTERNATIONAL JOURNAL OF EATING DISORDERS
(2023)
Review
Biology
Raimondo Di Liello, Maria Carmela Piccirillo, Laura Arenare, Piera Gargiulo, Clorinda Schettino, Adriano Gravina, Francesco Perrone
Summary: Randomized clinical trials have been the milestones of oncology research, but with the rise of personalized medicine, new trial designs like umbrella, basket, and platform trials are emerging. These innovative trial designs can evaluate multiple treatments simultaneously and may become the future standard in clinical trial methodology.
Review
Medical Laboratory Technology
Deepali Yadav, Bhagyashri Patil-Takbhate, Anil Khandagale, Jitendra Bhawalkar, Srikanth Tripathy, Priyanka Khopkar-Kale
Summary: Next-generation sequencing (NGS) has revolutionized genomics and is dramatically changing clinical diagnosis and precision medicine. NGS enables rapid and cost-effective analysis of large-scale genomic data, facilitating comprehensive exploration of disease genetic landscape. It is a powerful tool for disease diagnosis, prognosis, and personalized treatment strategies, allowing accurate identification of disease-causing variants and discovery of novel disease-associated genes and variants. NGS enhances our understanding of disease mechanisms and enables tailored medical interventions based on individual characteristics, contributing to the development of noninvasive diagnostic approaches.
CLINICA CHIMICA ACTA
(2023)
Article
Critical Care Medicine
Marjorie Z. Imperial, Patrick P. J. Phillips, Payam Nahid, Radojka M. Savic
Summary: This study aimed to develop risk stratification tools for tuberculosis patients to inform optimal treatment durations in clinical trials, leading to high cure rates.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2021)
Article
Psychology, Clinical
Ymkje Anna de Vries, Robert A. Schoevers, Julian P. T. Higgins, Marcus R. Munafo, Jojanneke A. Bastiaansen
Summary: Statistical power is generally low in trials of psychotherapy, pharmacotherapy, and complementary and alternative medicine for mood, anxiety, and psychotic disorders. Underpowered studies tend to produce larger effect sizes, indicating the presence of reporting bias. Increasing sample sizes and reducing bias are necessary to improve the reliability of published literature in this field.
PSYCHOLOGICAL MEDICINE
(2023)
Review
Neurosciences
Eric Lenze, John Torous, Patricia Arean
Summary: Mental health treatment lags behind cardiovascular care due to traditional techniques used in clinical trials. Digital and precision trials, including decentralized trials, precision measurement, and digital interventions, offer solutions to improve the speed, quality, and equity of access to research and evidence-based treatments. This article describes these techniques, their rationales, and the challenges and solutions for their utilization, concluding with a depression clinical trial vignette.
NEUROPSYCHOPHARMACOLOGY
(2023)
Review
Oncology
Aurora S. Blucher, Gordon B. Mills, Yiu Huen Tsang
Summary: Precision treatment for breast cancers has seen significant advancements in recent decades, however challenges such as tumor heterogeneity, drug resistance, and recurrence and metastases still persist. To address these challenges, a comprehensive understanding of breast subtypes and treatment biomarkers is necessary, along with the integration of knowledge across different data types in evidence-based clinical trials. Recent cutting-edge clinical trials for precision treatment of breast cancer, including chemotherapies, targeted therapies, immunotherapies, and combination therapies, show promising directions for future development in precision breast cancer research.
CLINICAL & EXPERIMENTAL METASTASIS
(2022)
Review
Pharmacology & Pharmacy
Pedro Luiz Serrano Uson Junior, Mitesh J. Borad
Summary: Intrahepatic cholangiocarcinoma is a rare but increasingly common tumor globally, and most patients are diagnosed at advanced stages with poor prognosis. Precision medicine and genomic alterations are emerging as new therapeutic approaches. This review discusses clinical trials of targeted therapies for cholangiocarcinoma involving FGFR, IDH, BRAF, and ErbB2, as well as mechanisms of resistance and strategies to overcome clonal evolution.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2022)
Review
Pharmacology & Pharmacy
George T. Chen, Daniel H. Geschwind
Summary: Neurodevelopmental Disorders (NDDs) encompass a wide range of disorders, including autism spectrum disorders (ASD) and schizophrenia (SCZ), which are linked to brain developmental processes. The clinical treatment of these disorders has traditionally focused on symptom management due to the variability in developmental disruption and limited knowledge of the underlying molecular mechanisms. With the identification of several hundred genes associated with ASD and SCZ, there is potential for new therapeutic approaches and the opportunity for precision medicine. This review discusses the progress in research technologies that enhance our understanding of disease progression and highlights advances in targeted clinical treatment and ongoing preclinical efforts in NDD precision medicine.
ADVANCED DRUG DELIVERY REVIEWS
(2022)
Article
Psychiatry
Yao Xiao, Fay Y. Womer, Shuai Dong, Rongxin Zhu, Ran Zhang, Jingyu Yang, Luheng Zhang, Juan Liu, Weixiong Zhang, Zhongchun Liu, Xizhe Zhang, Fei Wang
Summary: The study developed a precision medicine framework for depression based on neuroimaging and achieved promising results in clinical practice. By utilizing subtype classification and precise rTMS treatment, the research provides new insights into individualized diagnosis and treatment of depression.
ASIAN JOURNAL OF PSYCHIATRY
(2024)
Article
Health Policy & Services
Ujjwal Ramtekkar, Melissa Maras, Wendy Ell, Ginger Nicol, Laine Young-Walker
Summary: Due to shortages in the behavioral health workforce, primary care providers have become essential mental health providers. Child psychiatry access programs can support them through case consultations. This article introduces the innovative Missouri Child Psychiatry Access Project, discussing its unique enhancements and the partnership between community and academic settings to improve behavioral health access in primary care.
PSYCHIATRIC SERVICES
(2022)
Letter
Pharmacology & Pharmacy
Eric J. Lenze, Angela M. Reiersen, Shelley N. Facente
Review
Pharmacology & Pharmacy
Madeline J. Nykamp, Charles F. Zorumski, Angela M. Reiersen, Ginger E. Nicol, John Cirrito, Eric J. Lenze
Summary: Selective serotonin reuptake inhibitors (SRIs) are not only widely used for psychological disorders, but may also have potential clinical value for other diseases such as COVID-19 and cancer. Further research and randomized controlled trials will be necessary to confirm the utility of SRIs for new indications.
PHARMACOPSYCHIATRY
(2022)
Article
Public, Environmental & Occupational Health
Gilmar Reis, Eduardo Augusto dos Santos Moreira-Silva, Daniela Carla Medeiros Silva, Lehana Thabane, Aline Cruz Milagres, Thiago Santiago Ferreira, Castilho Vitor Quirino dos Santos, Vitoria Helena de Souza Campos, Ana Maria Ribeiro Nogueira, Ana Paula Figueiredo Guimaraes de Almeida, Eduardo Diniz Callegari, Adhemar Dias de Figueiredo Neto, Leonardo Cancado Monteiro Savassi, Maria Izabel Campos Simplicio, Luciene Barra Ribeiro, Rosemary Oliveira, Ofir Harari, Jamie Forrest, Hinda Ruton, Sheila Sprague, Paula McKay, Alla Glushchenko, Craig R. Rayner, Eric J. Lenze, Angela M. Reiersen, Gordon H. Guyatt, Edward J. Mills
Summary: Treatment with fluvoxamine (100 mg twice daily for 10 days) among high-risk outpatients with early diagnosed COVID-19 reduced the need for hospitalisation defined as retention in a COVID-19 emergency setting or transfer to a tertiary hospital. The trial showed a higher probability of superiority (99.8%) surpassing the prespecified threshold of 97.6%.
LANCET GLOBAL HEALTH
(2022)
Article
Rehabilitation
Ryan J. Walsh, Virginia R. McKay, Piper E. Hansen, Peggy P. Barco, Kayla Jones, Yejin Lee, Riddhi D. Patel, David Chen, Allen W. Heinemann, Eric J. Lenze, Alex W. K. Wong
Summary: This study describes the process of adapting an evidence-based patient engagement intervention for inpatient spinal cord injury/disease (SCI/D) rehabilitation using an implementation science framework. The study demonstrates that structured processes guided by this framework can help researchers and clinicians identify adaptation targets and modify the intervention program.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2022)
Editorial Material
Neurosciences
Joshua S. Siegel, Ginger E. Nicol
NEUROPSYCHOPHARMACOLOGY
(2023)
Meeting Abstract
Psychology, Developmental
Ginger E. Nicol
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
(2022)
Article
Health Care Sciences & Services
Abigail Schweiger, Thomas L. Rodebaugh, Eric J. Lenze, Katie Keenoy, Jason Hassenstab, Jeanne Kloeckner, Torie R. Gettinger, Ginger E. Nicol
Summary: This paper describes the Mindful MyWay study, which aims to test the efficacy of online mindfulness training for older adults with depression. Through innovative approaches such as fully remote trials and precision clinical trials, the study recruits participants from across the United States and collects high-frequency data, providing insights for individualized interventions and treatment optimization.
JMIR RESEARCH PROTOCOLS
(2022)
Article
Psychology, Clinical
Nicholas J. Ainsworth, Ram Brender, Neta Gotlieb, Haoyu Zhao, Daniel M. Blumberger, Jordan F. Karp, Eric J. Lenze, Ginger E. Nicol, Charles F. Reynolds, Wei Wang, Benoit H. Mulsant
Summary: This study investigated the relationship between lean muscle mass and treatment response in treatment-resistant late-life depression (TR-LLD). It found that older age, higher physical comorbidities, higher depressive symptom severity, and poorer treatment response were associated with lower lean muscle mass. However, lean muscle mass was not significantly associated with depression severity or treatment outcome.
INTERNATIONAL PSYCHOGERIATRICS
(2023)
Review
Psychiatry
Joshua S. Siegel, James E. Daily, Demetrius A. Perry, Ginger E. Nicol
Summary: Psychedelic drugs are becoming more accessible in the US, prompting the need for consensus on treatment models, education for healthcare professionals, and plans for implementation and regulation.
Article
Health Care Sciences & Services
Ginger Nicol, Ruoyun Wang, Sharon Graham, Sherry Dodd, Jane Garbutt
Summary: Background: The COVID-19 pandemic has led to a crisis in adolescents' mental health, with increased symptoms of depression and anxiety, suicidal ideation, and self-harm. Primary care providers (PCPs) are often relied upon to provide care for these youth. This study evaluated the feasibility of using an evidence-based mobile health app with a chatbot to deliver cognitive behavioral therapy (CBT) to symptomatic adolescents in primary care settings during the pandemic. The results showed that the app was feasible, acceptable, and usable, and further study is needed to establish effectiveness.
JMIR FORMATIVE RESEARCH
(2022)
Article
Medicine, General & Internal
E. J. Lenze, B. H. Mulsant, S. P. Roose, H. Lavretsky, C. F. Reynolds, D. M. Blumberger, P. J. Brown, P. Cristancho, A. J. Flint, M. A. Gebara, T. R. Gettinger, E. Lenard, J. P. Miller, G. E. Nicol, H. A. Oughli, V. T. Pham, B. L. Rollman, L. Yang, J. F. Karp
Summary: This study investigated the benefits and risks of augmenting or switching antidepressants in older adults with treatment-resistant depression. The study found that augmenting existing antidepressants with aripiprazole significantly improved psychological well-being compared to switching to bupropion. Among patients in whom augmentation or a switch to bupropion failed, the effects on psychological well-being and remission were similar with lithium augmentation or a switch to nortriptyline.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Health Care Sciences & Services
Ginger E. Nicol, Madeline O. Jansen, Amanda R. Ricchio, Julia A. Schweiger, Katie E. Keenoy, J. Philip Miller, Elaine H. Morrato, Zhaohua Guo, Bradley A. Evanoff, Joseph J. Parks, John W. Newcomer
Summary: This study describes a hybrid study design to adapt and pilot-test a mobile health intervention for obesity prevention in individuals with early severe mental illness and Class I or early-stage obesity. The study identified relevant aspects for adaptation through an investigation of the clinical and digital treatment environments, and made adjustments to the intervention content and functionality based on the findings. The study aims to advance the use of simple technology for obesity prevention in individuals with early-stage mental illness.
JMIR RESEARCH PROTOCOLS
(2023)
Article
Health Care Sciences & Services
Alex W. K. Wong, Mandy W. M. Fong, Elizabeth G. S. Munsell, Christopher L. Metts, Sunghoon Lee, Ginger E. Nicol, Olivia DePaul, Stephanie E. Tomazin, Katherine J. Kaufman, David C. Mohr
Summary: This study used intervention mapping (IM) and the taxonomy of behavior change techniques (BCTs) to design a digital intervention to manage chronic symptoms and support daily life participation in people after stroke. The study identified key service needs after stroke and developed the iSMART intervention program based on appropriate behavior change techniques. The study found that iSMART intervention was acceptable, appropriate, and feasible.
JMIR HUMAN FACTORS
(2023)
Article
Medicine, General & Internal
Eric J. Lenze, Benoit H. Mulsant, Steven P. Roose, Helen Lavretsky, Charles F. Reynolds, Daniel M. Blumberger, Patrick J. Brown, Pilar Cristancho, Alastair J. Flint, Marie A. Gebara, Torie R. Gettinger, Emily Lenard, J. Philip Miller, Ginger E. Nicol, Hanadi A. Oughli, Vy T. Pham, Bruce L. Rollman, Lei Yang, Jordan F. Karp
Summary: In this study, a two-step open-label trial was conducted to investigate the effects of augmenting or switching antidepressants in older adults with treatment-resistant depression. The results showed that augmenting existing antidepressants with aripiprazole significantly improved well-being compared to switching to bupropion. Furthermore, augmentation with lithium or a switch to nortriptyline showed similar effects in patients who did not benefit from augmentation or a switch to bupropion. These findings highlight the potential benefits of aripiprazole augmentation in the treatment of treatment-resistant depression in older adults.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
