Figure 1.

Emerging principles for precision and systems medicine. A patient-clinician-technician alliance will be needed to work effectively with patient avatars in precision and systems medicine. The technician will feed data from the clinician and the patient into the SuperModel (in conjunction with systems medicine counseling; Brown, in review), with input that is DISCrete: employing or amenable to diagnostics, providing relevant information, appealing to simplicity using small prototypes specific to a particular condition within the comprehensive SuperModel. Centralized repositories will facilitate model automation. The resulting output will be discRETE: readable, with elucidation of individualized prognosis, recommending therapeutics, and allowing for expandable iteration when new material becomes available. The pentad principles 5LEAD should be used to guide use of SuperModels. Physiological replicas should be prepared at five levels: molecule, cell, tissue, organ, and organism, even if all five levels will not always be simultaneously called out in a DISCRETE. Implementation of SuperModels should be economical, efficient, effective, efficacious, and expedient (5E). Accurate annotation, abundance of replication, and allocation of systems medicine resources, particularly to communities in most need, should ensure anonymization and safe secure accessibility to EHR-integrated data. Patient data is mapped in 5D, regarding length, width, depth, time, and pathology (disease remission and relapse). Finally, the clinical utility, accuracy, tangible benefit, and cost-effectiveness of SuperModel or other precision or systems medicine output recommendations should be demonstrated in reproducible assays, before existing clinical strategy is replaced or complemented; suggested therapy and outcome prediction should be provided by the systems medicine simulations, with appropriate turnaround time (COTTAGE ART).