Study Hints at the Limits of Medical Genomics

[xchrom]

http://www.technologyreview.com/biomedicine/40033/?p1=A2

On the steep slope of plummeting DNA sequencing costs rides the suggestion that whole-genome sequencing will soon be a part of the clinical experience for most patients. But researchers have now shown that deciphering the genetic code of most people would alert them to an increased risk for at least one of 24 common diseases, but fail to warn them about other diseases they will ultimately develop.

It's not easy to predict the ultimate usefulness of medical genomics, in part because the field is so young and not widely adopted. The researchers estimated the potential of the technique to alter a patient's lifestyle and medical treatment by studying disease rates from identical twins.

The result is not a big surprise, but experts disagree over the study's implications. Some welcome a more skeptical look at the promise of the technology that deciphers the As, Ts, Gs, and Cs of a person's genetic blueprint, and point out that it's not easy to interpret that blueprint for medical information. Others complain that the new analysis only knocks down a straw man, since we already know that whole-genome sequencing has limits, and it hasn't yet been applied to common diseases in a clinical setting.

Provoking these disparate reactions may be exactly the authors' intentions. "We became interested in trying to start a debate about the utility and potential benefit of genome-wide sequencing for personal medicine," says Nicholas Roberts, a graduate student at Johns Hopkins University, and the first author on the study. Roberts says whole-genome sequencing has proved useful for patients with diseases that have a strong link to genetics, but less useful for those with many common and complex diseases, such as cancer or heart disease, that are caused by both genetics and environmental or lifestyle factors.

[bemildred]

1. Large bodies of self-modifying code can be difficult to understand.

Especially when you catch them far along in the course of execution, so you don't know how things started out.

[saras]

2. Especially if you're ideologically prohibited from seeing some fundamental principles...

[bemildred]

3. Maybe we could have "free market" evolution one of these days ...

So we wind up with one big amorphous stromatolite covering the whole planet 6" deep.