Personalized Medicine for the Critically Ill Patient: A Narrative Review
Round 1
Reviewer 1 Report
In this contribution, the authors have provided a comprehensive review on the personalized medicine. The section "Concluding notes" is a bit fragmented and would benefit from minor modifications.
Author Response
Please see the attachment.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
This review focuses on the topic of personalized medicine for critically injured patients. The topic could be interesting to a broad range of audiences. However, the manuscript has some problems in writing and organization and is not ready for publication. There is no line number, so it becomes difficult to point out the locations of individual problems. Detailed comments are given below.
1. Abstract is not covering the whole scope of the manuscript. The abstract only points out the problem to be studied in this review, but it doesn’t cover the major topics included in this review, and why this review is helpful to other researchers.
2. This reviewer finds it hard to relate this review to “critically ill patient”, which is included in the title. Most sections have no relation to this specific target and descriptions are very general and broad. Only section 3 carefully discussed how personalized medicine is important for critically ill patients, while other sections are applicable to personalized medicine broadly. Thus, the manuscript needs to significantly change to match the topic, or the authors are suggested to adjust the scope of this review.
3. Sections are unbalanced. Sections 2 and 3 are detailed and long, while 4-6 are very short. For example, section 6 only has three sentences. If this is the case, this shouldn’t be an independent section.
4. The arrangement of the paragraphs seems quite random. Multiple places throughout the manuscript just make each individual sentence a separate paragraph. For example, the conclusion section has several sentences just piled up, with no internal logic.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Reviewer 3 Report
Lazar et al. presented personalized medicine for the critically ill patient as a narrative review. In this review, the concept of personalized medicine is first discussed. The historical perspective and the modern definition is included in the review. Considering the increasing cost of drugs and case by case differences of individuals that requires precision and personalized treatment, the concept of personalized medicine is important. The presented review did a good job discussing different aspects of personalized medicine. It is important and useful to link and discuss the recently popularized research tools and areas such as big data, machine learning and digital twins in the topic of personalized medicine. Authors did a good job with that. Overall the review is well written. I have the following comments that I think could benefit to the manuscript.
*Authors should include more discussions of different commercially available personalized medicine and their cost per application dose. There is considerable data on this aspect and it can be useful.
*Preparing a table including precision medicines that are commercially available, FDA approved and not approved can be useful. Their cost can also be included in the table. This table can be helpful to elaborate on the topic presented as economic challenge.
*some discussion of fabrication/synthesis of precision medicine especially microfluidics methods and referral to relevant review papers can be useful.
*Discussion of the ethics under "5. Ethics of Personalized Medicine" is a good touch by the authors.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
Thanks for the authors' responses to my previous comments and corrections to the manuscript.
