Introduction into PPPM as a new paradigm of public health service: an integrative view

Over the course of its history, medicine has given special attention to the already diseased individual, focusing on studying a type of disorder (nosology) rather than one’s health or the so-called pre-nosological conditions, the latter being left in the shade. Meanwhile, at present, medicine is undergoing a paradigm shift from the real-time diagnostics and treatment to prediction and prevention[1-3].This major upheaval is expected to transform the nature of healthcare from reactive to preventive[4]. The changes will be catalysed by a new system approach to disease that will trigger the emergence of personalised medicine—a medicine that focuses on the integrated diagnosis, treatment, and prevention of disease in individual patients (Figure 1). This change is rooted in new science [5].The convergence of system approaches to disease, new measurement and visualisation technologies [6,7], and new computational and mathematical tools can be expected to allow our current, largely reactive mode of medicine, where we wait until the patient becomes ill before responding, to be replaced over the next 10 to 20 years with predictive, preventive, and personalised medicine (PPPM) (Figure 2) that will be cost-effective and increasingly focused on the ‘well-being’ concept [2,3,5].It was at the turn of the 1990s that this dramatic turning point in the view of the role and place of medicine in healthcare system occurred, following the implementation of the achievements of innovative omics technologies (genomics, transcriptomics, proteomics, metabolomics, etc.) (Figure 3) and bioinformatics (Figure 4) into clinical medicine which make it possible to penetrate tissues and organs and create conditions to secure the visualisation of lesion foci that is previously unknown to clinicians [8].Omic-based presymptomatic prediction (see Figures 3, and 4) of an illness and allied events, finer diagnostic subclassifications, and improved risk assessment tools applied early in life will permit mor