Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jul 10;6(3):78.
doi: 10.3390/healthcare6030078.

Developing a Case-Based Blended Learning Ecosystem to Optimize Precision Medicine: Reducing Overdiagnosis and Overtreatment

Vivek Podder  1 , Binod Dhakal  2 , Gousia Ummae Salma Shaik  3 , Kaushik Sundar  4 , Madhava Sai Sivapuram  5 , Vijay Kumar Chattu  6 , Rakesh Biswas  7
Affiliations

Developing a Case-Based Blended Learning Ecosystem to Optimize Precision Medicine: Reducing Overdiagnosis and Overtreatment

Vivek Podder et al. Healthcare (Basel). .

Abstract

Introduction: Precision medicine aims to focus on meeting patient requirements accurately, optimizing patient outcomes, and reducing under-/overdiagnosis and therapy. We aim to offer a fresh perspective on accuracy driven “age-old precision medicine” and illustrate how newer case-based blended learning ecosystems (CBBLE) can strengthen the bridge between age-old precision approaches with modern technology and omics-driven approaches.

Methodology: We present a series of cases and examine the role of precision medicine within a “case-based blended learning ecosystem” (CBBLE) as a practicable tool to reduce overdiagnosis and overtreatment. We illustrated the workflow of our CBBLE through case-based narratives from global students of CBBLE in high and low resource settings as is reflected in global health.

Results: Four micro-narratives based on collective past experiences were generated to explain concepts of age-old patient-centered scientific accuracy and precision and four macro-narratives were collected from individual learners in our CBBLE. Insights gathered from a critical appraisal and thematic analysis of the narratives were discussed.

Discussion and conclusion: Case-based narratives from the individual learners in our CBBLE amply illustrate their journeys beginning with “age-old precision thinking” in low-resource settings and progressing to “omics-driven” high-resource precision medicine setups to demonstrate how the approaches, used judiciously, might reduce the current pandemic of over-/underdiagnosis and over-/undertreatment.

Keywords: CBBLE (case-based-based blended learning ecosystem); case studies; high resource setting; low resource setting; omics driven; overdiagnosis; overtreatment; precision medicine.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mapping ‘Precision’ and ‘Accuracy’ in Medicine (Accuracy—achieving patients’ requirement of best outcome, and Precision—the narrowest path to achieve it).
Figure 2
Figure 2
Illustrates the analogy of healthcare ecosystem functioning in the form of a cricket match.
Figure 3
Figure 3
Illustrating the patient data shared online into our CBBLE online network.
Figure 4
Figure 4
Illustrating the patient data shared online into our CBBLE online network.
Figure 5
Figure 5
Illustrates the graphical representation of her illness during her stay in the hospital.
Figure 6
Figure 6
Illustrates the feedback and the queries posted from the CBBLE online network.
See this image and copyright information in PMC

References

    1. Christensen C.M., Grossman J.H., Hwang J. Soundview Executive Book Summaries. McGraw-Hill; New York, NY, USA: 2009. The innovator’s prescription.
    1. Institute for Precision Medicine. [(accessed on 14 May 2018)]; Available online: http://ipm.weill.cornell.edu/about/definition(2015)
    1. Thomas B., UST Global Health Group The New Healthcare Ecosystem: 5 Emerging Relationships. [(accessed on 28 January 2018)]; Available online: https://www.beckershospitalreview.com/hospital-management-administration....
    1. Peter A. How Does Accuracy Differ from Precision in Scientific Measurements? [(accessed on 1 March 2018)]; Socratic Questions. Available online: https://socratic.org/questions/how-does-accuracy-differ-from-precision-i....
    1. Nagashree B., Manchukonda R.S. Prescription audit for evaluation of present prescribing trends in a rural tertiary care hospital in South India: An observational study. Int. J. Basic Clin. Pharmacol. 2016;5:2094–2097.

LinkOut - more resources