Methodological approaches to evaluation and prediction of individual risk to health under the exposure to a complex of different factors for tasks of personalized prophylaxis

Methodical approaches to the assessment and prediction of the individual risk for the development of diseases associated with the effect of a complex of heterogeneous factors, taking into account the features of the genetic and somatic status of the individual for the tasks of personalized prevention, are suggested. The conceptual basis of the methodology is the presentation of the individual risk for diseases as a quantity that varies with time depending on the level and duration of the exposure of the acting factors (evolution), with respect to the contribution of natural causes. There is presented a model describing the evolution of individual risk, which takes into account a complex system of dependencies of the indices of the body’s somatic state and genetic status on the variable exposure of factors. To assess the value of the individual risk, there are proposed a scale and a system of criteria for the assessment of the likelihood of the development of the disease with taking account of its severity. The established value of the individual risk in relation to a specific disease determines the list, scope and sequence of measures for the personalized prevention, and is also a measure of their effectiveness. A large-scale epidemiological study of the population (about 10 thousand people) from 12 regions of the Russian Federation was executed. There was obtained a system of dependencies which reflects the cause-effect relationships between indices characterizing the factors of habitat and lifestyle, the body’s somatic and genetic status (more than 500 indices), the probability of diseases associated with risk factors (about 20 nosological forms). There was created a special replenished information resource «Model Library» has been created, including parameters of more than 4 thousand adequate and reliable dependencies of cause-effect relationships, revealed by relying upon the results of own epidemiological studies and analysis of domestic and foreign scientific publications. An algorithm for the estimation and prediction the individual risk has been developed for the formation of personalized prevention programs aimed at its reducing. The algorithm is implemented in the form of an information and analytical system that can be used as a tool for making managerial decisions in the field of personalized prevention of diseases associated with risk factors at the group and population levels.