637els of disease progression and drug response. These computer-assembled
models are then queried rapidly through billions of in silico experiments (Forward
Simulation) to discover the highest-impact molecular targets for the disease being studied
and the corresponding effi cacy and toxicity biomarkers related to specifi c drug treatments.
These fi ndings are then tested in both the laboratory and the clinic, enabling a faster, more-
focused drug discovery and development process. Advantages of REFS™ are:
- Identifi cation of the molecular causes of disease, rather than those factors that are
merely correlative, thereby identifying novel, fi rst-in-class targets, and effi cacy
and toxicity biomarkers - Improvement of the quality of preclinical drug candidates and the probability of
a drug candidate’s phase I/II and subsequent successes through improved under-
standing of the mechanisms of effi cacy and toxicity. - Guiding the design of clinical trials by stratifying the patient population to
maximize the response rate of patients in clinical trials. - Improving treatment decisions by physicians for patients with complex diseases.
REFS™ is being applied in a research collaboration with M.D. Anderson Cancer
Center aimed at the rapid translation of DNA sequence and clinical data from
patients with glioblastoma multiforme, into breakthrough discoveries leading to
drugs and diagnostics for personalized management of patients.
Health Information Management
Bioinformatics can also help in health care information management. Personalized
medicine involves linking two types of information: patient-specifi c and knowledge-
based. Personal information is documented in patient records. Some personal medi-
cal documents, which are already in use to various extents in different countries,
include the personal emergency card, the mother-child record, and the vaccination
certifi cate. A more valuable but under-used source of personal medical information
is the data stored in the electronic health records, which needs to be used universally
for facilitating the development of personalized medicine.
Electronic Health Records
Electronic health records (EHRs) are important for improving healthcare and for
widening the scope of personalized medicine as they can be shared online by differ-
ent physicians and hospitals. They can improve the quality and safety of patient care
by reducing errors in prescriptions. EHRs facilitate clinical trials and collection of
adverse drug events data. In the aftermath of Hurricane Katrina in New Orleans in
2005, government and private health care offi cials were rushing to build an elec-
tronic database of prescription drug records for hundreds of thousands of people
who lost their records in the storm. This tragic happening powerfully demonstrated
the need for EHRs.
Role of Bioinformatics in Development of Personalized Medicine