Jul 2026· International Journal of Molecular Sciences· Vol 27· 0 citations· 96 references
Medicine
TL;DR
A clinically oriented, pipeline-based synthesis of contemporary AI applications in genomic medicine, focusing on factors that determine model robustness and clinical utility, and common sources of failure in real-world genomic AI systems.
Abstract
The rapid expansion of next-generation sequencing technologies has generated unprecedented volumes of genomic data; however, translating these data into reliable and clinically actionable insights remains a major challenge in precision medicine. Artificial intelligence (AI) has emerged as a key enabling technology across the genomic medicine pipeline, supporting variant detection, variant interpretation, polygenic risk prediction, disease subtyping, biomarker discovery and treatment–response modelling. This review provides a clinically oriented, pipeline-based synthesis of contemporary AI applications in genomic medicine. Major computational paradigms, including machine learning, deep learning, ensemble methods, multimodal AI, explainable AI frameworks and emerging foundation models, are discussed in the context of their contribution to genomic analysis and clinical decision support. Particular emphasis is placed on the factors that determine model robustness and clinical utility, including dataset composition, class imbalance, label noise, calibration, ancestry representation, distributional shift and external validation. Evidence from rare genetic disorders, cardiovascular genetics and precision oncology is examined to illustrate both successful translational applications and persistent barriers to implementation. The review further analyses common sources of failure in real-world genomic AI systems, including overfitting, limited transportability across populations and sequencing environments, inadequate interpretability, and insufficient prospective validation. Ethical and regulatory challenges are discussed in relation to clinical accountability, genomic privacy, algorithmic bias and equitable implementation. Ultimately, the successful clinical translation of genomic AI will depend not only on methodological innovation, but also on rigorous validation, transparent reporting, continuous calibration, robust governance and sustained expert oversight.
Pharmacogenomics and artificial intelligence (AI) are emerging as important drivers of precision medicine, enabling healthcare systems to adopt individualized therapeutic approaches. Pharmacogenomics examines how genetic variations influence drug response, efficacy, metabolism, and toxicity, while AI provides advanced computational tools for analyzing complex genomic and clinical data. This review highlights the integration of AI-driven pharmacogenomics in personalized therapy and its potential to improve treatment outcomes. Machine learning, deep learning, natural language processing, and big data analytics are increasingly used to identify genetic variants, predict drug responses, optimize medication selection and dosage, and reduce adverse drug reactions. These technologies support the interpretation of large-scale genomic information and facilitate evidence-based clinical decision-making. Significant applications have been demonstrated in oncology, cardiovascular diseases, neurological and psychiatric disorders, and rare genetic diseases, where personalized treatments can enhance therapeutic efficacy and patient safety. Recent advances in genomic sequencing, multi-omics integration, digital health technologies, explainable AI, and real-time patient monitoring have further expanded the scope of precision medicine. However, challenges related to data privacy, algorithm bias, regulatory frameworks, and clinical implementation remain. Future developments in explainable AI, predictive analytics, and AI-powered personalized therapy are expected to improve treatment precision and accelerate the realization of truly individualized healthcare. Overall, the convergence of AI and pharmacogenomics represents a transformative approach to modern medicine with substantial potential to improve patient outcomes and optimize therapeutic interventions.
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