About the Journal

 

Rationale for a New Precision Medicine Journal

Precision medicine is a clinical framework for medical practice that extends beyond classic modern Western medicine (see Primer). Modern Western medicine has been shaped largely by population-derived evidence and reductionist disease models, including Germ Theory in infectious disorders. Precision medicine builds on these foundations but shifts toward an individual-centered approach, beginning with a patient’s genetic architecture and integrating multiple variants into predictive, dynamic models.
A major challenge to Western medicine is the large number of interacting and unpredictable variables in complex disease biology. Precision medicine is therefore especially useful when refining differential diagnoses, improving early detection, clarifying prognosis, and anticipating complications in patients with established clinical findings.
Sub-disciplines include:
Pharmacogenetics - focusing on genetic variants altering drug metabolism or actions.
Precision oncology - focusing on tumor genomics, over germline variation.

Why Genetic Reports Fail Clinicians

True personalized medicine depends on the combined effects of multiple genetic variants within an individual. However, physicians and healthcare providers are typically trained only in Mendelian genetics, which emphasizes highly penetrant variants that are so damaging that they produce predictable inheritance patterns.
However, for most diseases, Mendelian etiologies account for less than 5% of cases within the category. Most arise from polygenic and multifactorial contributions in which individual variants are neither sufficient nor necessary to cause disease. In these cases, the Precision Medicine paradigm is needed for sophisticated models to integrate genetic and non-genetic factors.
Clinicians typically receive limited training in genomic modeling or systems-level integration. As a result, genetic reports may be informative biologically yet impractical clinically. This gap between genomic data and practical decision-making remains a central barrier to implementation. New tools are needed.

SMART-MD Journal of Precision Medicine

How should physicians, healthcare providers, and patients understand complex genetic profiles variable disease features? How can meaningful findings be translated into structured clinical reasoning? Genetic testing companies cannot provide prescriptive management advice, so interpretation is left to the treating physician.
SMART-MD Journal of Precision Medicine addresses this translational challenge. It is designed to be read by physicians and is structured as a tool for clinical decision support (CDS). It may then be used to help guide the management and treatment of patients with complex chronic medical conditions. These conditions represent >90% of the >$4 trillion healthcare expenditure in the USA. A breakthrough approach is desperately needed. 
Content is peer-reviewed, systematically formatted, and linked to standardized biomedical codes and classifiers to facilitate integration into CDS systems for physicians, at the point of care, in real time. Rather than issuing instructions, SMART-MD connects clinicians to transparent reasoning from experts that is applicable to patients with comparable profiles.

The Future

SMART-MD is not an esoteric specialty journal. It is a practical platform for healthcare providers seeking to integrate genomic and systems biology data into everyday care. By translating complex biological information into structured clinical frameworks, SMART-MD advances precision medicine from theory toward routine implementation.