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New "P" in Medical Model.

Byline: Chun-Song. Hu, Tengiz. Tkebuchava

To the Editor: With the increase of human noncommunicable disease (NCD) and the release of Big Health Data in China in March 2015, people need to call for more effective action to address the challenges posed by NCD. For example, according to the latest evidence in the Global Burden of Disease Study 2013, for most countries, NCD remains a leading cause of death. In general, people accept the preventive, predictive, personalized, and participation,[sup][1] or “4P” medical model from treatment to prevention as an effective strategy. For example, exceptional responders can help scientists predict the responses of many patients with cancer. Therefore, the authors propose adding another “P”, that is, “Platform” to the medical model. Constructing new platform that may help people tackle the increase of NCD in China, and globally, is a further challenge.

First, consider the platforms of diagnosis, treatment and clinical trial. There has been a rapid increase in a variety of systemized, large scale of medical organisms (such as state-owned or private hospitals and clinics), community service centers of health in cities and the rural communities, and centers of physical examination. There are also a number of network bookings, clinics, drugstores, consultation, and tele-healthcare websites to meet people's increasing medical needs and effectively alleviate the difficulties and expenses of seeing a doctor. Of particular note is the increase in robotic operations in recent years. Clinical trials based on a “one population, one disease, one drug” strategy need a special platform as an efficient strategy for evaluating multiple treatments, such as the BRIGHT and the CSPPT randomized clinical trials in China.[sup][2],[3] Since NCDs such as hypertension are increasing globally, there is an urgent need for a novel management program for it,[sup][4] funding for the undertaking of high-quality trials, and also a good platform which is covered by the new “5P” medical model we summarized.

Fortunately, a general formula for NCDs or health and longevity was set up in, and that was based on previous work, such as the RT-ABCDEF strategy, E(e)SEED-BasED healthy lifestyles (named for Hu's healthy lifestyles), and “Level 210” of comprehensive prevention:

Management of NCDs or health and longevity = RT-ABCDEF + E(e)SEED-BasED + 210.

Next, we must consider the platform of academic exchange. The number of academic events has been increasing from common discussions within departments and seminars to a variety of local, regional, state, or international conferences. In addition, there are prominent annual international conferences, such as the American Heart Association, American College of Cardiology, European Society of Cardiology, Great Wall International Congress of Cardiology, and China Heart Congress. Further, there are a large number of special topic forums. These academic events disseminate updated research information and advanced technology by inviting renowned specialists or scholars to present reports via a website or a satellite meeting. These forums are ideal exchange platforms for scientists and researchers, graduate students, doctors, training, or primary care staff as they enable participants to discuss the topic or ask questions in near real time.

Third, we need to discuss the platform of exhibition. It becomes normal to exhibit related academic events, medical devices and products of pharmaceutical companies, updated information, and the latest research achievements through the mass media or social media including website, blogs, newsletters, and videos. These are efficient exhibition tools because they are rapid, convenient, and distributed widely. Further, an exhibitor's booth at a trade show or conference along with a technical poster can become a valuable venue for a business to reach specific customers. The popularity and ubiquity of broadband Internet, Wi-Fi, smartphones, and new exhibition platforms result in convenient and fast academic interactions.

Finally, we will consider the platform of education and study. Here, we should consider a variety of software, video seminars or interviews, massive open online courses, and multiple levels of continuing education programs that give individuals a broad selection for education and learning.

In conclusion, to keep up with the progress of modern medicine and technology, scientists need to encourage the construction of these platforms for understanding modern medical knowledge to foster the development of outstanding clinical doctors. Thus, the current medical model needs to evolve from “4P” to “5P”. As we all know, “no platform, no service; good platform, good service”. We believe that only a good platform can nurture excellent specialists. Also, this model would address complicated diseases, such as obesity-obstructive sleep apnea-hypertension syndrome, cardiovascular, diabetes, and cancer strips.[sup][5] We believe that the proposed “5P” model will become an important and prudent strategy for meeting the challenges of NCDs that are due to an aging population in the coming era of precise medicine.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1. Wang J, Wang Q. Chinese constitution research and the practice of 4P medical model (in Chinese). Chin J Integrated Trad Western Med 2012;32:693-5.

2. Han Y, Guo J, Zheng Y, Zang H, Su X, Wang Y, et al . BRIGHT investigators. Bivalirudin vs heparin with or without tirofiban during primary percutaneous coronary intervention in acute myocardial infarction: The BRIGHT randomized clinical trial. JAMA 2015;313:1336-46. doi: 10.1001/jama.2015.2323.

3. Huo Y, Li J, Qin X, Huang Y, Wang X, Gottesman RF, et al. Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: The CSPPT randomized clinical trial. JAMA 2015;313:1325-35. doi: 10.1001/jama.2015.2274.

4. Hu CS, Han YL, Ge JB, Wu QH, Liu YN, Ma CS, et al. A novel management program for hypertension. Cardiovasc Diagn Ther 2015;5:316-22. doi: 10.3978/j.issn.2223-3652.2015.05.13.

5. Hu CS, Wu QH, Hu DY. Cardiovascular, diabetes, and cancer strips: Evidences, mechanisms, and classifications. J Thorac Dis 2014;6:1319-28. doi: 10.3978/j.issn.2072-1439.2014.07.15.
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Article Details
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Title Annotation:Correspondence
Author:Hu, Chun-Song; Tkebuchava, Tengiz
Publication:Chinese Medical Journal
Article Type:Letter to the editor
Date:Apr 1, 2016
Words:1000
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