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These broad parameters are unlikely to reflect underlying molecular profiles and may account for the observed heterogeneity in treatment response. Precision medicine offers identification and integration of molecular profiles into clinical decision-making. Despite several promising scientific and technological advances, the pathogenesis and targetable molecular drivers of IBD remain incompletely understood. Precision medicine therefore remains aspirational. This comprehensive narrative review describes our current understanding of IBD pathophysiology, highlights preliminary genetic, immunological and microbial predictors of treatment response and outlines the role of \u2018big data\u2019 and machine learning in the path towards precision medicine.<\/jats:p>","DOI":"10.1136\/egastro-2023-100006","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T04:00:50Z","timestamp":1705550450000},"page":"e100006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Pathogenesis and precision medicine for predicting response in inflammatory bowel disease: advances and future directions"],"prefix":"10.1136","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5314-6666","authenticated-orcid":false,"given":"Robert D","family":"Little","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Alfred Health, Melbourne, Victoria, 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