Quotulatiousness

December 14, 2012

The revolution will not be revolutionary … soon

Filed under: Health, Media, Science — Tags: , , , — Nicholas @ 11:09

In the Globe and Mail, Timothy Caulfield explains that we need to be careful not to drink the “healthcare revolution” Kool-Aid:

It has been suggested that this technological advance will usher in a new health-care “revolution.” It will allow us, or so it’s promised, to individualize health-care treatments and preventive strategies — an approach often called “personalized medicine.” It will allow us to become fully aware of our genetic shortcomings and the diseases for which we’re at increased genetic risk, thus providing the impetuous to adopt healthier lifestyles.

But will having your personal genome available really revolutionize your health-care world? Will you be able to use this information to significantly improve your chances of avoiding the most common chronic diseases? Not likely.

Tangible benefits will be (and have been) achieved. But, for the most part, these advances are likely to be incremental in nature – which, history tells us, is the way scientific progress usually unfolds.

Why this “we are not in a revolution” message? Overselling the benefits of personal genomics can hurt the science, by creating unrealistic expectations, and distract us from other, more effective areas of health promotion.

The relationship between our genome and disease is far more complicated than originally anticipated. Indeed, the more we learn about the human genome, the less we seem to know. For example, results from a major international initiative to explore all the elements of our genome (the ENCODE project) found that, despite decades-old conventional wisdom that much of our genome was nothing but “junk DNA,” as much as 80 per cent of our genome likely has some biological function. This work hints that things are much more convoluted than expected. So much so that one of ENCODE’s lead researchers, Yale’s Mark Gerstein, was quoted as saying that it’s “like opening a wire closet and seeing a hairball of wires.”

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