Dismantling the One-Size-Fits-All Model of Medicine

A new field within medicine brings personalized care to the forefront of treatment

For a long time, treating patients has operated on a “one-size-fits-all” model in which we have assumed that all patients with a given disease name have similar problems and thus, need the same treatment. This phenomenon, termed the homogeneity assumption, has recently been debunked by the “Unique Disease Principle” which states that disease is fundamentally different in each individual it affects. Dr. Shuji Ogino, of the Dana-Farber Cancer Institute, created and continues to develop the blossoming field of Molecular Pathological Epidemiology (MPE). Through the emergence of MPE as a new field, he hopes to make broad impacts and contribute to overall advancements of science for maximum benefits to human beings in the world, by means of transforming paradigms and frameworks of biomedical and health sciences. Dr. Ogino’s approach is bringing personalized care back to care providers while producing results that save lives.

Although MPE is a relatively new field, having been first introduced to academia in 2010, Dr. Ogino’s efforts have already largely impacted the ways in which providers and scientists think about healthcare delivery and research. It is his hope that continued efforts will accomplish various goals such as improvement of health sciences and decrease in disease burden in world population. The integration of pathology, the study of disease mechanism, and epidemiology, the study of disease in large populations, creates novel strengths never before combined in other fields. Building upon such strengths and helping the MPE philosophy to be an important part of medical training will one day prepare providers and researchers for a future of personalized medicine on a global scale. Through the lens of MPE, Dr. Ogino has been trying to elucidate disease etiologies and also develop better strategies for disease prevention and therapy for diseases ranging from diabetes to cancers.

Dr. Ogino’s work relies upon the following themes:

  • Advancing the Field: Dr. Ogino is working to advance MPE as a field helping to make it part of global research, public health, and medicine around the world. This includes developing research frameworks and statistical methods, growing the ongoing MPE Meeting Series to facilitate seamless transdisciplinary integration, developing international research guidelines, and building new integrative transdisciplinary models. By pursuing these four areas, Dr. Ogino is developing state-of-the-art research areas that have never existed, in addition to reconstructing health sciences to benefit as many people in the world as possible.

  • Applying MPE Research: Dr. Ogino is conducting research through the application of MPE within his own lab. Research projects include:

    • Diet and Lifestyle: Through the study of dietary, lifestyle, environmental, genetic, and screening factors, Dr. Ogino studies the factors that influence colorectal cancer incidence through molecular changes in cancer cells.  

    • Molecular Characteristics: Dr. Ogino has successfully built an unprecedented colorectal cancer database with longitudinal diet and lifestyle data, tumor pathology data, and clinical outcome in three studies. These studies have followed over 270,000 health professionals across the US and are helping to develop a broad-term hypothesis determining the influence patterns of immune response to cancer cells.

    • Molecular Changes: Molecular and immunity status of colorectal cancer influences patient survival and response to drugs or modifiable dietary, lifestyle or environmental factors. In addition, molecular changes differ from cell to cell even in one cancer tissue and its degree differs from case to case. Higher degree of intra-tumor heterogeneity can lead to worse clinical outcome. Dr. Ogino is the frontrunner in investigating these changes and their effects on health and disease.

Bio

Dr. Ogino’s motivation to do research stems from his childhood. As a child, he was excited about the possibility of creating something new and to discover unknowns. He eventually chose to pursue a career as a physician scientist because he felt that his research might be able to help sick people all around the world. After obtaining his M.D. degree from the University of Tokyo, Dr. Ogino started residency training in pathology in the US. His experience later as a postdoctoral fellow at University of Pennsylvania and as a faculty member at Harvard taught him many important lessons. One especially important lesson has helped to guide his philosophy behind research; research must be conducted in a way that benefits as many people as possible. This philosophy has led to his current research in which he hopes to affect health on a global scale and therefore to influence hundreds of thousands of patients around the world.

In his free time, aside from research, Dr. Ogino enjoys tennis playing, bicycling, walking, hiking, and listening to music at the concert hall. His fondness for Shogi, a Japanese board game, was enriched due to growing up in Japan.

Website: http://ogino-mpe-lab.dana-farber.org/

Publications

Establishment of the field of Molecular Pathological Epidemiology (MPE)

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Expansion of the MPE concept for broader impacts

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Development of novel research framework and methods in MPE

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Benefit from aspirin use in patients with PIK3CA-mutated colorectal cancer

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Colonoscopy is effective for cancer prevention for 10 years for average risk individuals

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Awards

2011 Ramzi Cotran Young Investigator Award, United States and Canadian Academy of Pathology

2012 Meritorious Service Award, Association for Molecular Pathology

2014 The Best of AACR Journals (selected as the corresponding author)

2014 Most Influential Scientific Minds: 2014, selected by Thomson Reuters

2014 Elected Member, American Society for Clinical Investigation