Anhui and IBM Pave the Way for Accelerated Precision Medicine Adoption

On November 9, 2015, JAMA Internal Medicine published an article on overmedicalization. The article pointed out that among the 400 million outpatient visits annually, many somatic symptoms are related to psychological states, and nearly 75% of these symptoms can resolve spontaneously within weeks or months, requiring no treatment at all. According to the article, these 75% of treatment interventions constitute overmedicalization. So, what is overmedicalization?

The precise medical definition is:If the potential harm of a treatment to a patient outweighs its potential benefits, such treatment is considered misuse, including overprescription, excessive testing, and overtreatment., specific behaviors include: conducting unnecessary or repeated tests, taking medication without illness, overtreatment of minor ailments, futile treatment for terminal illnesses, excessive medical care resulting from the lack of separation between prescribing and dispensing, and overmedicalization driven by private healthcare providers.

According to statistics, the U.S. healthcare system wastes up to $750 billion annually on unnecessary and ineffective treatments, accounting for 30% of total healthcare expenditures. Dr. Zhaolong Gong, a renowned expert in new drug development and former senior new drug reviewer at the U.S. Food and Drug Administration (FDA), recently stated publicly at a pharmaceutical conference that, among oncology drugs, an average cancer drug is effective in only 25% of patients.

VCBeat has learned that this issue is not only prominent in the United States but also globally, as evidenced by the following examples:

In China, more than 57% of patients received inappropriate antimicrobial therapy. A study by the Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, revealed that mainland China consumed 162,000 metric tons of antibiotics in 2013, accounting for half of global usage. Of this amount, 52% was used in veterinary medicine and 48% in human medicine, with over 50,000 metric tons discharged into soil and water environments.

In the United States, up to 70% of patients in some regions underwent hysterectomies that could have been avoided;

In the United States, 34% of knee replacement surgeries are unnecessary, while in Spain, this figure is 26%.

The World Health Organization (WHO) estimates that approximately 6.2 million unnecessary cesarean sections are performed globally each year, with more than 50% of these occurring in Brazil and China.

Unlike in foreign countries, where overtreatment is primarily concentrated in diagnostic tests and surgical procedures, overtreatment in China is more prevalent in the pharmaceutical sector. The misuse of medications, particularly the overuse of antibiotics and traditional Chinese medicine (TCM) proprietary formulations, has become a distinctive characteristic of China’s healthcare landscape. Overtreatment not only wastes pharmaceutical resources but also poses risks to patient health. How, then, can this issue be avoided?

To address the issue of overtreatment, in addition to measures such as policy reforms and physician education, precision medicine is now recognized as a key solution. Precision medicine can help reduce overtreatment by avoiding excessive testing, overprescription of medications, and unnecessary surgeries, thereby offering technical support to curb such practices. After U.S. President Barack Obama introduced the “Precision Medicine Initiative” in his State of the Union address, “precision medicine” quickly became a hot topic worldwide, stirring significant activity in the pharmaceutical and healthcare industries. So, what exactly is precision medicine? And why has it garnered such widespread popularity?

Precision Medicine is an emerging approach to disease prevention and management that takes into account individual differences in genes, environment, and lifestyle.

Essentially, it leverages omics technologies—such as genomics and proteomics—alongside cutting-edge medical advances to analyze, identify, validate, and apply biomarkers in large population cohorts and specific disease types. This approach enables the precise identification of disease etiologies and therapeutic targets, as well as the accurate classification of different disease states and processes, ultimately achieving personalized precision medicine for diseases and individual patients to enhance the effectiveness of diagnosis, treatment, and prevention.

In fact, as artificial intelligence technology gradually matures today,Precision medicine has expanded from biogenetic technologies to encompass medical imaging, big data, and artificial intelligence. Broadly speaking, any approach that enables precise prevention, diagnosis, and treatment can be considered precision medicine.

VCBeat has learned that in a bid to seize this new frontier in medicine, countries around the world are making concerted efforts. The U.S. fiscal budget for 2016 allocates $216 million in research funding to actively advance precision medicine, establishing both short-term and long-term objectives for the initiative. Short-term goals include expanding applications within cancer research. The National Institutes of Health (NIH) aims to leverage knowledge of disease genetics and biology to identify new, more effective cancer treatments.

The long-term goal focuses on the large-scale introduction of precision medicine and healthcare across various fields. The National Institutes of Health (NIH) plans to collect genetic data, biological samples, and other health information from more than 10,000 volunteers across the United States. By analyzing large-scale data, the initiative aims to better predict disease risks, understand disease mechanisms, and improve diagnostic and therapeutic strategies.

UK Government Innovation CentreA “Precision Medicine Catapult” initiative will be launched to accelerate the development of precision medicine. On October 26, 2015, it was announced that six centers would be established, each serving as a regional hub for precision medicine activities within the UK’s national network. Coordinated from the headquarters in Cambridge, these centers aim to achieve a more precise understanding of diseases and to develop treatments that are more predictable, safer, and cost-effective.

March 2015,Ministry of Science and Technology of ChinaChina held its inaugural National Expert Conference on Precision Medicine Strategy, planning to invest RMB 60 billion in precision medicine by 2030. Of this amount, RMB 20 billion will be funded by the central government, with an additional RMB 40 billion provided through matching funds from enterprises and local governments. The precision medicine initiative has recently completed its feasibility study. During the 13th Five-Year Plan period, China will launch the “Key Scientific and Technological Research and Development Program for Precision Medicine” and selectively establish demonstration centers in hospitals and communities within regions across the country that possess the necessary conditions and advantages. The National Health and Family Planning Commission also announced approximately 20 medical institutions as “pilot units for the clinical application of high-throughput gene sequencing in oncology.”

Despite the promising prospects of precision medicine, its implementation still faces numerous challenges. Not to mention new technologies such as targeted drug development and gene sequencing research,Currently, many physicians lack the qualifications to perform DNA testing or are unable to accurately interpret test results for patients.。

The New Yorker magazine featured a real-life case. The interviewee was Dr. David Miller, a geneticist at Boston Children’s Hospital. At the time, a couple brought their five-year-old daughter to see him. The girl appeared to have poor coordination and was highly susceptible to external infections. Previous physicians had conducted DNA testing on her to determine whether her developmental delays were associated with any known genetic conditions.

Based on the DNA test results, the physician determined that the girl had a deletion in the 22q11 chromosomal region, indicating she suffered from DiGeorge syndrome. This syndrome typically presents with delayed learning and growth, as well as cardiac malformations, and patients may later develop psychiatric disorders. Currently, there is no known cure.

Upon receiving the test report, Miller conducted a thorough review and discovered that the deletion on chromosome 22 was not located at the same site associated with DiGeorge syndrome, suggesting it was likely an insignificant genetic marker. Miller concluded that the short-statured girl did not actually have DiGeorge syndrome. This finding came as a great relief to her parents.

Such misdiagnoses occur because physicians’ professional advancement has failed to keep pace with the rapid progress of medical technology. This is not an isolated case; VCBeat has learned that the trend toward younger gastric cancer patients in China is becoming increasingly pronounced.Data indicate that the misdiagnosis rate is as high as 27%-50%.. When assessing the severity of gastric cancer, physicians commonly classify tumors into four stages, with Stage I being the least severe and Stage IV the most severe. The five-year postoperative survival rate for patients with Stage I disease can reach 99%.

Early-stage gastric cancer is asymptomatic, making it difficult to detect. Symptoms such as epigastric pain and poor appetite, which resemble those of gastritis, typically do not appear until the disease progresses to Stage II (the 5-year postoperative survival rate for Stage II gastric cancer patients is 60%–70%). If gastroscopy is not performed and the condition is treated as gastritis, cancer cells usually spread to the lymph nodes within three to six months, at which point the disease may progress to Stage III. The 5-year postoperative survival rate for Stage III gastric cancer is only 30%–40%.

Nevertheless, some companies are making relevant efforts. Currently, Anhan’s capsule robot and Capsule Endoscopy Cloud Reading System are integrated with IBM’s cognitive medical imaging technology, leveraging artificial intelligence to assist physicians in diagnosing gastrointestinal diseases and accelerating the implementation of precision medicine. TheyHuman-Machine Collaboration DirectionThe innovative model has brought hope to the vast number of gastric disease patients in China.

Anhan Medical's cutting-edge, precision-controlled capsule gastroscopy system utilizes a capsule endoscopy robot to acquire medical imaging data, enabling more efficient and less invasive collection of gastric examination information.. Precise magnetic control of the robot's position and orientation enables more comprehensive gastrointestinal examinations. However, the approximately 20,000 images generated per examination pose new challenges for physicians in data processing and achieving precise analysis.

IBM’s cognitive imaging technology may well provide a solution to this challenge. The collaboration between IBM Research China and Anhan aims to demonstrate how intelligent lesion detection technology can help Anhan process the billions of images generated annually, thereby enhancing the accuracy and feasibility of gastrointestinal disease screening. This partnership willBy integrating precise testing, precise diagnosis, and precise prevention, this approach helps physicians reduce missed and misdiagnoses, bringing precision medicine into the public eye.。