Volume 71, Issue 2 p. 383-393
Special Article

Individualized interventions and precision health: Lessons learned from a systematic review and implications for analytics-driven geriatric research

Anna R. Kahkoska MD, PhD

Corresponding Author

Anna R. Kahkoska MD, PhD

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Correspondence

Anna R. Kahkoska, Department of Nutrition, University of North Carolina at Chapel Hill, 2205A McGavran Greenberg Hall, Chapel Hill, NC 27599, USA.

Email: [email protected]

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Nikki L. B. Freeman MA

Nikki L. B. Freeman MA

Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Emily P. Jones MLIS

Emily P. Jones MLIS

Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Daniela Shirazi BS

Daniela Shirazi BS

Department of Medicine, California University of Science and Medicine, Colton, California, USA

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Sydney Browder BS

Sydney Browder BS

Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Annie Page BSPH

Annie Page BSPH

Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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John Sperger BS

John Sperger BS

Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Tarek M. Zikry BSPH

Tarek M. Zikry BSPH

Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Fei Yu PhD

Fei Yu PhD

School of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Jan Busby-Whitehead MD

Jan Busby-Whitehead MD

Division of Geriatric Medicine, Department of Medicine, Center for Aging and Health, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA

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Michael R. Kosorok PhD

Michael R. Kosorok PhD

Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

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John A. Batsis MD, AGSF

John A. Batsis MD, AGSF

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Division of Geriatric Medicine, Department of Medicine, Center for Aging and Health, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA

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First published: 16 December 2022
Citations: 3

Funding information: National Institutes of Health, Grant/Award Numbers: K23 AG051681, KL2TR002490; School of Medicine, University of North Carolina at Chapel Hill, Grant/Award Number: ACTP1R1001

Abstract

Older adults are characterized by profound clinical heterogeneity. When designing and delivering interventions, there exist multiple approaches to account for heterogeneity. We present the results of a systematic review of data-driven, personalized interventions in older adults, which serves as a use case to distinguish the conceptual and methodologic differences between individualized intervention delivery and precision health-derived interventions. We define individualized interventions as those where all participants received the same parent intervention, modified on a case-by-case basis and using an evidence-based protocol, supplemented by clinical judgment as appropriate, while precision health-derived interventions are those that tailor care to individuals whereby the strategy for how to tailor care was determined through data-driven, precision health analytics. We discuss how their integration may offer new opportunities for analytics-based geriatric medicine that accommodates individual heterogeneity but allows for more flexible and resource-efficient population-level scaling.

CONFLICT OF INTEREST

Dr. Batsis holds equity in SynchroHealth LLC, a remote monitoring startup.The authors have no conflicts of interest to disclose.