A Precision Medicine Approach to a Patient With Unresolved Pain Following Orthopedic Surgery

A Case Report

David Gazzaniga; Ashley Brenton; Brian Meshkin


J Med Case Reports. 2017;11(50) 

In This Article


The Proove precision medicine profiles combine genetic risk factors with other clinical variables in proprietary algorithms to provide information on patient pain sensitivity, disease risk, medication response, and risk of substance use disorder.

Precision medicine provides physicians with a tool to optimize patient treatment, as well as providing objective information about a patient's pain perception. Other measures of pain perception are generally subjective and self-reported by the patient, using a pain rating scale (Numeric Rating Scale or Visual Analog Scale) or through the Brief Pain Inventory[1] or McGill Pain Questionnaire.[2,3] In contrast, objective information, such as that provided by the Proove Pain Perception Profile, provides physicians with evidence-based measures of pain perception to inform their treatment decisions.

Genetic testing is routinely used in cardiology,[4] oncology,[5] and hematology[6] and the field of pharmacogenetics is increasingly recognized as an important part of emerging precision medicine efforts.[7] In fact, the implications of genetic variation on medications used in pain management are well established in the literature.[8,9] In this case, our patient's medications prior to genetic testing were unable to control her pain and, following testing, a reduction in the number of medications and targeted treatment resulted in satisfactory analgesia for the first time since the initial injury, without the polypharmacy-related adverse drug events.