Stratified, precision or personalised medicine? Cancer services in the “real world” of a London hospital

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Title: Stratified, precision or personalised medicine? Cancer services in the “real world” of a London hospital
Authors: Day, S
Coombes, RC
McGrath-Lone, L
Schoenborn, C
Ward, H
Item Type: Journal Article
Abstract: We conducted ethnographic research in collaboration with a large research-intensive London breast cancer service in 2013-14 so as to understand the practices and potential effects of stratified medicine. Stratified medicine is often seen as a synonym for both personalised and precision medicine but these three terms, we found, also related to distinct facets of treatment and care. Personalised medicine is the term adopted for the developing 2016 NHS England Strategy, in which breast cancer care is considered a prime example of improved biological precision and better patient outcomes. We asked how this biologically stratified medicine affected wider relations of care and treatment. We interviewed formally 33 patients and 23 of their carers, including healthcare workers; attended meetings associated with service improvements, medical decision-making, public engagement, and scientific developments as well as following patients through waiting rooms, clinical consultations and other settings. We found that the translation of new protocols based on biological research introduced further complications into an already-complex patient pathway. Combinations of new and historic forms of stratification had an impact on almost all patients, carers and staff, resulting in care that often felt less rather than more personal.
Issue Date: 27-Jul-2016
Date of Acceptance: 19-Apr-2016
ISSN: 0141-9889
Publisher: Wiley
Start Page: 143
End Page: 158
Journal / Book Title: Sociology of Health & Illness
Volume: 39
Issue: 1
Copyright Statement: © 2017 Foundation for the Soiology of He alth & Illness. Published by John Wiley & Sons Ltd. This is the pre-peer reviewed version of the following article, which has been published in final form at
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare Charity
Funder's Grant Number: RD710
Keywords: Science & Technology
Social Sciences
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Social Sciences, Biomedical
Biomedical Social Sciences
personalised medicine
breast cancer
healthcare markets
1117 Public Health And Health Services
1608 Sociology
2202 History And Philosophy Of Specific Fields
Public Health
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine
Epidemiology, Public Health and Primary Care

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