Longitudinal microsampling within the overall trends towards telehealth and precision medicine
Blood microsampling, which enables patients to provide longitudinal samples without attending a hospital or pathology lab, is developing rapidly and is an important component that links the other two major trends, telehealth and precision medicine.
The recalibration of the healthcare system is discussed in publications such as this very recent one from the New England Journal of Medicine; ‘The Transition from Reimagining to Recreating Health Care Is Now’. The authors discuss the perceived impediments that led to slow adoption of telemedicine, the changes that came with the Covid-19 pandemic, and advice on how to most easily implement a telemedicine program rapidly. In this context, telemedicine in conjunction with point-of-care testing and remote microsampling will become increasingly important; facilitating patient engagement and therapy while reducing viral transmission risk.
The future: large-scale multi-centre, multi-country studies
The proposal to establish a phased program to integrate multi-omics, wearable monitoring and other digital engagement is essentially a large-scale prospective cohort (longitudinal) study that will generate very large datatsets.
Even when randomised controlled trials (RCT), the gold standard, strongly favour a new therapy, its role in routine clinical practice may be unclear because of the considerable differences between its efficacy (in clinical trials) and its effectiveness (in the real-life setting). In addition, many RCTs are under-powered which means that almost half produce results that are statistically uncertain. The implication is that a large amount of information about the effectiveness of treatments could be incorrect. Large scale real-life studies provide a bridge from the results of RCTs to daily clinical practice.