Fig. 4.

Clinical Implementation of Precision Cardio-Oncology: The P*3 Pathway (7, 8). In the P*3 approach to precision cardio-oncology, pre-emption (P1) is represented in purple: precision medicine data should be integrated into the electronic health record (EHR) along with clinical information and other demographics such as family history and environmental or lifestyle contributors, following precision/systems medicine counseling, and with interactive electronic decision aids to facilitate shared decision-making. Then prediction (P2) is represented in blue, incorporating stratification mechanisms for risk prediction, including both clinical factors and precision medicine data. Individual would be placed into three risk categories: high, intermediate and low. Prevention (P3) is represented in orange, and involves personalized prevention strategies that simultaneously optimize therapeutic efficacy and safety for the individual patient. EHR = electronic health record. Adapted from [93], and used with permission of Springer Nature.