• MEDICINE

A good slogan often helps to get an idea across. Politicians and advertisers love a simple phrase that captures the central idea of their manifesto or the unique selling point of their product. The same is true in medicine. The term ‘evidence-based medicine’—embracing the idea that we should base our decisions on a synthesis of the available evidence—has contributed to a culture change and improvements in healthcare. And now we have ‘personalised medicine’ starting to drive change in a similar way. As with evidence-based medicine, the underlying idea is not new. Patients have always been individuals and clinicians have always tried to apply the most appropriate evidence from population studies to their specific care.

However, in this evidence-based medicine era, the main driver has been to develop and deliver effective guidelines for management, and these inevitably focus on how to diagnose and manage ‘most patients’. This has improved outcomes, perhaps most strikingly in the outcomes for patients with strokes. But pendulums swing. Hugh Markus highlights the need for a more personalised …