对于许多肿瘤疾病而言，实施及时并针对患者的靶向治疗，即精准医学，是一项重大的治疗发展，已经提供了相当大的临床益处。然而，尽管应用了越来越复杂的技术、先进的生物信息学和机器学习算法，这一成功仍未在风湿疾病中得到复制。例如，在风湿性关节炎中，尽管有一系列个体化生物学治疗和传统治疗方案，治疗选择仍然很大程度上基于试错。风湿疾病“精准医学鸿沟”这一概念可以帮助我们确定阻碍精准医学应用于风湿疾病发现和应用的因素。在诸如风湿性关节炎之类的风湿疾病中，有四个主题可能会减缓进展，解决这些问题应有助于缩小精准医学鸿沟。这些主题与我们对疾病发病机制的基本理解、如何确定治疗反应、治疗结果的混淆因素以及试验设计有关。 ©2022年 Springer Nature有限公司。

For many oncological conditions, the application of timely and patient-tailored targeted therapies, or precision medicine, is a major therapeutic development that has provided considerable clinical benefit. However, despite the application of increasingly sophisticated technologies, alongside advanced bioinformatic and machine-learning algorithms, this success is yet to be replicated for the rheumatic diseases. In rheumatoid arthritis, for example, despite an array of targeted biologic and conventional therapeutics, treatment choice remains largely based on trial and error. The concept of the 'precision gap' for rheumatic disease can help us to identify factors that underpin the slow progress towards the discovery and adoption of precision-medicine approaches for rheumatic disease. In a rheumatic disease such as rheumatoid arthritis, it is possible to identify four themes that have slowed progress, solutions to which should help to close the precision gap. These themes relate to our fundamental understanding of disease pathogenesis, how we determine treatment response, confounders of treatment outcomes and trial design.© 2022. Springer Nature Limited.