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Research News
March 20, 2008
Genomic Medicine Review Article by HSR&D Investigator in JAMA
Advances in understanding the human genome sequence will likely be felt in genomic medicine's shift from a focus on rare genetic diseases to more common chronic disease, e.g., heart disease, stroke, diabetes, and cancer. With this shift, numerous genetic tests may emerge that hold promise for significant changes in the delivery of health care, particularly in preventive medicine and in tailoring drug treatment. However, integrating genetic/genomic knowledge about chronic conditions into clinical practice is still in the early stages, and many questions remain, such as: What is the current level of consumer understanding? And, what are the barriers to integrating genomic medicine into clinical practice? To help answer these questions, investigators in this study conducted a systematic review of 68 articles published between January 2000 and February 2008 to learn what is known about the current state of genomic medicine.
Their review revealed a "very large gap" between what is available and what we need to know about outcomes, consumer needs, and barriers to the integration of genomics into the regular practice of medicine. The most consistent finding was that the primary care workforce feels under-prepared to be on the frontlines of the integration of genomics into clinical practice. In general, consumers were interested in the prospect of genomics but were worried about the possible adverse consequences of genetic testing, e.g., privacy issues and discrimination in health insurance and employment. Thus, both providers and consumers will need more and better information to understand the real value of genomics. This article points out critical areas of health services research that can help to fill these gaps in the knowledge.
Scheuner M; Sieverding P; and Shekelle P. Delivery of genomic medicine for common chronic adult diseases: A systematic review. JAMA 2008 Mar 19;299 (11):1320-34.
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