We do what we can…

The only way I was ever going to get a first-author publication in Nature was if I just made it all up. So that’s what I did. Hat tip to David Dobbs for providing the scientific inspiration.

Sorry if it’s behind a pay wall. Email me and I’d be happy to send a pdf.

When a Q-tip becomes a sledgehammer

Some days it still feels like September 12, 2001:

Millions of Americans arrested for but not convicted of crimes will likely have their DNA forcibly extracted and added to a national database, according to a bill approved by the U.S. House of Representatives on Tuesday.

By a 357 to 32 vote, the House approved legislation that will pay state governments to require DNA samples, which could mean drawing blood with a needle, from adults “arrested for” certain serious crimes. Not one Democrat voted against the database measure, which would hand out about $75 million to states that agree to make such testing mandatory.

***

House Speaker Nancy Pelosi and the Democratic leadership scheduled Tuesday’s debate on the bill–called the Katie Sepich Enhanced DNA Collection Act of 2010–using a procedure known as the “suspension calendar” intended to be reserved for non-controversial legislation.

“Suspension of the rules is supposed to be for praising the winner of the NCAA championship or renaming Post Offices,” Harper says. “Things like collecting Americans’ DNA are supposed to be fully debated in Congress.”

(hat tip: Jenny Reardon)

Whoa Nellie

Walgreens puts the kibosh on Pathway Genomics, at least for the moment. Genomics Law Report has details and analysis.

If I were Pathway, I would take this opportunity to look in the mirror. Whether it was a factor in the FDA’s sudden interest in the company or not, there seems to be a paucity of information on Pathway’s website. There is a list of conditions that Pathway tests for, but there are no details and the list is “current” as of October 20, 2009. In clinical genomics, that’s a long time ago.

More troubling, I think, is the lack of specifics about exactly what’s included in Pathway’s tests. 23andMe, for example, has been completely upfront about what alleles are being screened for in its services. Without giving up my credit card or logging in, I can learn that for cystic fibrosis, the company screens for 31 mutations and that for Caucasians, these variants cover 85-97% of all known mutations; for African Americans, Hispanics and Asians it’s more like 50-75%. Thus, before I’ve spent a red cent, I can know that 1) this test will not get me completely off the hook and 2) my ancestry can have significant bearing on my risk.

My point is, if you want to be taken seriously, not only by the FDA but by docs and, oh yeah, by your customers, then don’t insult us. Give us the technical data, explain what fraction of our risk can be attributed to genes insofar as is known, link out to the primary references, and when the science changes, don’t wait six months to change your website. Indeed, you might want to do it before you launch your national retail marketing campaign.

As I’ve tried to make clear below, I’ve got no problem with genetics in the drugstore. But it’d be nice to know exactly what’s inside the box.

The Sky is Falling, Chapter 38

I am reading the coverage of the Walgreens genetic testing story and scratching my head, wondering where the freak-out comes from. “OMG, it’s IN THE DRUGSTORE.”

Yes, people will have access to their genetic information without help from a man in a white coat (assuming, of course, that they don’t want that help). But the fact of the matter is, except in New York, they already have this access: they can order a spit kit from any of dozens of companies and send it along with their credit card number to a lab to be analyzed. The only substantive difference in this case is that instead of going online, they go to the drugstore and possibly burn a few calories in the process. Customers still have to pay for the analysis and the kits must still travel through the mail. The analysis is still accessed by customers on the web. So, when Pathway Genomics says it is “revolutionizing the way people access information about their genetics,” I say, “Um, not really.”

My hope is that this is not taking place in a vacuum. I think genetics education is extremely important and I hope the folks at Pathway Genomics are providing their customers with answers to their questions, access to genetic counselors and that they are specifying exactly what it is customers are and are not getting and what it does and does not mean. But I see the panicked response to this from doctors and academics as elitist: it assumes that the ordinary person is stupid and/or not entitled to his or her genetic information without a third-party “expert.” Let’s be real: that ship sailed in 2007.

For the record, I have no conflict of interest, financial or otherwise, and have never spoken to anyone at Pathway Genomics.

Get Out My Face

“So, Mr. Public Genome, why aren’t you on Facebook already?”

“Oh, I don’t know. Just because.”

Shameless self-promotion interlude

Here is a Human Being: At the Dawn of Personal Genomics will be published this fall by HarperCollins. The book is part memoir, part science geek fest, and part journalism. It traces the emergence of a once-radical notion that has, in a just a few short years, become entrenched: the idea that nearly anyone can get access to his or her own DNA sequence for any reason at all. It gives an inside account of the Personal Genome Project, Harvard geneticist and visionary George Church’s ambitious plan to sequence many genomes and make them public. It tells the human stories behind the technology that has enabled personal genomics, the companies seeking to sell you your genetic information, the do-it-yourselfers trying to track down genetic answers about themselves and their families, and the conflicted doctors and scientists who find themselves less than completely prepared for the genomic age. I also tell my own story: a trained human geneticist and genetic counselor eager (perhaps too eager) to experience the life of a research subject and begin to understand what this information means for me, for my family…for all of us.

I’m working on a page for the book, which so far looks…exactly like this. If there is a deeply remedial technical school for WordPress, then I am a promising candidate.

The Peter Gunnslinger

I don’t know who picks out his clothes, but this Jeff Beck guy is pretty good.

Blood relations

Dan Vorhaus has written his usual cogent and insightful review of the issues raised by Amy Harmon’s piece on the Havasupai tribe and its settlement with Arizona State University. In my view, the core of the matter is fairly simple:

“I’m not against scientific research,” said Carletta Tilousi, 39, a member of the Havasupai tribal council. “I just want it to be done right. They used our blood for all these studies, people got degrees and grants, and they never asked our permission.” [emphasis added]

If, as researchers, we can’t be bothered to 1) tell research participants what they’re getting into insofar as we know; 2) respect their cultural beliefs; 3) go back to them if our plans change and ask for their consent again; and 4) share with them what we find and what we think it means in a timely and ongoing fashion, then we will find human subjects increasingly hard to come by…and increasingly litigious.

The milkman of human kindness

Billy Bragg in NatureNews:

Belonging goes beyond science. It’s very tenuous. Is identity genetics, or is it a fundamental personal construct? I believe it’s a construct: DNA can tell you things, but it can’t define you. We have choices. I’m not interested in identity itself — this thing you construct for the public like a mantelpiece — but in what it does for you. It gives you a sense of belonging.

Requiescat in pace

Veteran science reporter Constance Holden has died.