PREDICTIVE MEDICINE - ECONOMIC-IMPLICATIO NS

Predictive medicine is an emerging field that has not yet come within the province of practicing physicians. However, it has been present in the collective unconscious since time immemorial. Staying in good hea lth by anticipating the development of diseases and thus initiating op timal therapy is probably a first priority for many individuals. This approach requires the development of tools for measuring the risks of disease. Pedigrees and gene maps are commonly used for this purpose, f or instance in families afflicted by Down's syndrome or Duchenne's mus cular dystrophy. HLA-B27 and factor 5 may hold promise for risk evalua tion. Emphasis should be put, not on the prediction of future disease, but rather on risk behavior modification and availability of treatmen ts capable of modifying the natural history of the disease. For some d iseases, failure to detect the risk would have devastating social and economic consequences. At the other end of the spectrum, risk evaluati on has no impact in diseases for which no useful management strategy i s available. From a social and economic viewpoint, predictive medicine can be either beneficial or harmful.