Hype is Easy. Genomics is Hard.

Stop the presses.  This just in from the Gray Lady:  Genomics is hard.

According to an article in today’s New York Times, “The era of personal genomic medicine may have to wait. The genetic analysis of common disease is turning out to be a lot more complex than expected.”

Really?  More complex than expected?

The Times continues, “One issue of debate among researchers is whether, despite the prospect of diminishing returns, to continue with the genomewide studies, which cost many millions of dollars apiece, or switch to a new approach like decoding the entire genomes of individual patients.”

Specifically, “A set of commentaries in this week’s issue of The New England Journal of Medicine appears to be the first public attempt by scientists to make sense of this puzzling result.

But the Times story is somewhat misleading. The NEJM articles aren’t about molecular diagnostics (Herception, Warfarin, etc.) but rather the attempt by some companies “to offer personal genomic information” that would offer customers specific genetic risk for common diseases.

That’s something else entirely.  In fact, it's what confuses people (meaning "people" but also "journalists" and "politicians") about what “personalized medicine” is all about.

The unintended (one hopes) consequences of articles such as the one in the New York Times and the commentaries in NEJM are that the important momentum behind pharmacogenomic research gets slowed – along with all-important funding for same.  Case in point:  how will this article play in the battle to fund the FDA's Reagan/Udall Foundation?

Alas, there is no magic bullet.  Frustrating?  Sure.  But anyone who thought it was going to be easy wasn't paying attention.  But hype is like that -- you want to believe it. Just because alluring promises of a personalized genomic map aren’t panning out doesn’t mean that genomics aren’t the most crucial pathway forward for 21^st century medicine and the roadmap in achieving the four rights (the right medicine for the right patient at the right time in the right dose).

The complete New York Times article can be found here.

Such misunderstandings also play into the hands of those who believe that the only way forward is through 20^th century comparative effectiveness.  And this is why we need a robust critical path for 21^st century clinical effectiveness measurements.