MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'decodeme'. Sat, 03 Sep 2011 02:51:12 +0100 http://www.medworm.com/index.php?rid=3655734&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2010%2F06%2Fanswer-to-genomicslawyers-question-what.html Dan Vorhaus JD on his blog says "The path of least resistance may be to simply agree with the FDA....The viability will depend on how the FDA intends to categorize the specific product...."I agree, these companies have big choices to make. If it is any indication, Counsyl (full of smart people) and now, Pathway Genomics (full of smart people) have both decided to go the route of Medical test.Perhaps it is because they think the burden will cost less to investors than fighting the "Man"Well, in guessing what the FDA will do, it is always best to see what they have done to a "similar" product. In this case, they have a great product that is very similar. That would be the FDA's approval of AmpliChip.A friend of mine in Canada argues about the holes in this platform, but unfortunately it is t... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3655734 Sat, 12 Jun 2010 11:32:00 +0100 3655734 http://www.medworm.com/index.php?rid=3655735&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2010%2F06%2Fi-am-glad-we-can-all-put-this-behind-us.html As you now may be aware. DTCG is considered a medical diagnostic according to the FDA. I look forward working with companies who may now allow me to use their tests for medicine. The Sherpa Says: If we work together, we can deliver the best preventative and personalized care in the world! (Source: Gene Sherpas: Personalized Medicine and You) Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3655735 Fri, 11 Jun 2010 17:46:00 +0100 3655735 http://www.medworm.com/index.php?rid=3652583&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2010%2F06%2Fcellulite-on-your-bod-blame-your-genes.html Could I go on a huge rant about 23andMes mess up and how it was discovered by a customer rather than LabCorp or 23andMe?Yes. Would it be useful?No.Why?I need to save my rants, and any doctor will tell you, labs screw up all the time.It is something we are used to thinking.So much so, that a knee jerk answer for a lot of doctors is to repeat a test if the results are so far out there.......So, my rant today will be directly placed at the rocket scientists who dreamed up CelluliteDX"The CelluliteDX Genetic Test is only available for sale through participating physicians' offices. If you would like to learn more about the CelluliteDX Genetic Test and receive a Welcome Package to establish your office as a CelluliteDX Genetic Test provider, please contact us Monday through Friday between 8 a.... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3652583 Fri, 11 Jun 2010 01:26:00 +0100 3652583 http://www.medworm.com/index.php?rid=3599653&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2010%2F05%2Fbreaking-23andmes-terms-of-service-not.html A blogger over at 5Am Solutions Blog is about to break 23andMe's Terms of Service."So I called my primary care physician's office and told the appointment-taker I wanted to discuss my 23andMe results with my doctor. She said 'ok' and scheduled an appointment for next week."May I just add. It is not the doctor breaking the Terms of Service here. It is the customer by bringing it in to their doctor.From Andrew Yates Blog at ThinkGene"BOOM! That patient coerced that doctor into malpractice liability.Section 3 of 23andMe Terms of Service: “The Services Content is not to be used, and is not intended to be used, by you or any other person to diagnose, cure, treat, mitigate, or prevent a disease or other impairment or condition, or to ascertain your health.”The worst of this is that 23andMe A... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3599653 Wed, 26 May 2010 13:49:00 +0100 3599653 http://www.medworm.com/index.php?rid=3111601&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F11%2Fhey-dtc-genomics-stay-private-stay_6757.html Today's lesson in start up business in the field of DTC Genomics is this.....Stay Private and Stay Alive. IPO and doom yourself to a painful and public death.Huh? Ah, yes our first DTC Genomics venture is going to be restructured to someone else and the thought experiment will become a reality. "When a DTC Genomics bust, what happens to the data?"Well, someone else can buy it, at a rock bottom price. Hell, the selling company can even violate YOUR TERMS OF AGREEMENT!Daniel, posts a great email from some sucker who bought DeCodeMe......or maybe just an "Early Adopter"" there has also been filed with the court an offer by Saga Investments LLC to purchase deCODE's Icelandic subsidiary, Islensk Erfdagreining (IE). IE, which is not declaring bankruptcy, carries out all of deCODE's human genetic... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3111601 Tue, 17 Nov 2009 15:53:00 +0100 3111601 http://www.medworm.com/index.php?rid=3111603&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F11%2Fargument-23andserge-can-win23andme-but_4221.html "As I had postulated before, in order to move towards a profitable direction the DTC companies would have to choose "Medically Relevant" or "Novelty Testing" From this recent email sent to me by a reader it is clear, 23andME is Choosing to become a clinical service, without accepting the clinical responsibility."This from my post February 14 2009That was the day the announced that they were doing BRCA testing. Since then we have created a little video that may now be running through the silicon valley.........Why?Because, at the Spittoon (brrrrrrr-ding) they have announced that they will be splitting their service into 2 different types of testsThe first "A Novelty Test" which will be solely for ancestry.23andMe Ancestry Edition – $399 The second "A health test" which will be solely for ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3111603 Sat, 14 Nov 2009 15:28:00 +0100 3111603 http://www.medworm.com/index.php?rid=3111606&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F11%2Fgood-enough-science-apparently-so-at_6680.html "A total of 61 individuals involved in five norovirus outbreaks in Denmark were genotyped at nucleotides 428 and 571 of the FUT2 gene, determining secretor status, i.e., the presence of ABH antigens in secretions and on mucosa. A strong correlation (P 0.003) was found between the secretor phenotype and symptomatic disease, extending previous knowledge and confirming that nonsense mutations in the FUT2 gene provide protection against symptomatic norovirus (GGII.4) infections." This from a report at 23andSerge's "Norovirus Resistance" report.I don't know what I would do with a Norovirus resistance report........Go on more cruises? Work in a daycare? Have more kids?I bring this up because I begin to wonder what level of science is good science.Is highlighting every article as useful as highli... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3111606 Thu, 05 Nov 2009 03:34:00 +0100 3111606 http://www.medworm.com/index.php?rid=3111608&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F11%2Faway-and-now-back-what-did-i-miss_5370.html 23andSerge has layoffs, big surprise. When Linda left, she had a tribe that left too. I am working on hiring one or 2 and will see what exactly was going on over there......Likely a huge cash bleedGAPPNet has their first meeting, which I missed.I will email Dr. Khoury and find out how it went.Daniel MacArthur pointing out that 23andSerge could have bashed bad science, yet instead promoted it......No surprise there either.It looks like 23andSerge fired the engineers and scientists.....and kept the PR and marketing wonks.......Well, in the end it is crystal clear It turns out the lawyers questioned this as well as Misha.....Turns out, if you took the genome, then you probably can sell it.......better yet, if you "acquired it via firesale" you also can probably sell it and break all kinds of ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3111608 Mon, 02 Nov 2009 15:47:00 +0100 3111608 http://www.medworm.com/index.php?rid=2950913&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F11%2Faway-and-now-back-what-did-i-miss.html 23andSerge has layoffs, big surprise. When Linda left, she had a tribe that left too. I am working on hiring one or 2 and will see what exactly was going on over there......GAPPNet has their first meeting, which I missed.I will email Dr. Khoury and find out how it went.Daniel MacArthur pointing out that 23andSerge could have bashed bad science, yet instead promoted it......No surprise there either.It looks like 23andSerge fired the engineers and scientists.....and kept the PR and marketing wonks.......Well, in the end it is crystal clear It turns out the lawyers questioned this as well as Misha.....Turns out, if you took the genome, then you probably can sell it.......better yet, if you "acquired it via firesale" you also can probably sell it and break all kinds of "terms of service" What'... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2950913 Mon, 02 Nov 2009 15:47:00 +0100 2950913 http://www.medworm.com/index.php?rid=3111612&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F10%2Fexcuse-me-harvard-and-navigenics-wtf_8525.html Ok,So I was blown away when I read this juicy little tid bit from Genome Web. NEW YORK (GenomeWeb News) – Navigenics and Beth Israel Deaconess Medical Center in Boston announced today that they will collaborate on training physicians in personal genomic testing.Amazing! I had spoken with Mike Murray up there a while ago and have neen involved in his training curriculum with CMEs for providers. I have always interpreted his opinion on the DTC companies to be suspect of what the hell the companies are doing.In fact when we, Mike and I presented together at the Association of Program Directors in Internal Medicine meeting in 2008 in New Orleans I assumed that their department as well as he didn't much support DTC genomic testing.Which is why the BID move had me puzzled, so I emailed him. Bu... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=3111612 Wed, 21 Oct 2009 15:10:00 +0100 3111612 http://www.medworm.com/index.php?rid=2762088&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F09%2Fsome-confusion-exists.html I have a great comment string going on with Daniel MacArthur over at his blog Genetic Future I think there is some confusion going on here and I place blame on just about everyone in this space who has a mouthpiece.......But mainly I lay blame on the marketing teams for the Direct to Consumer Genomics companies.These companies have an interest in making you "think" that their products have some particular health relevance.Otherwise, no one in their right mind would waste their time with these tests.......Other than the HUGE field of ancestry buffs like Blaine Bettinger J.D. (woohoo) We need clarity here. From Daniel- "The American College of Medical Genetics is saying "Genetic tests of individuals or families for the presence of or susceptibility to disease are medical tests." The fine pri... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2762088 Thu, 03 Sep 2009 12:03:00 +0100 2762088 http://www.medworm.com/index.php?rid=2752079&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F09%2Fiom-not-webcast-today-why-not.html The IOM conference "Direct-to-Consumer Genetic Testing: A Cross-Academies Workshop" will not be webcast today? I wonder why not? Was it supposed to be and then submarined after Muin Khoury quoted an email I wrote him while he was presenting?Why is there no webcast for this important conference today?Maybe I am just a conspiracy theorist.But I would like IOM and the National Academies to explain why the cover one day but not the second.The second day by the way has some great topicsFrom the AgendaSession 5: The Impact of DTC Genetic Tests on the Medical System"If the medical system is no longer required to mediate genetic testing, how will the system cope with losing oversight (and reimbursement) of these services while retaining the full responsibility of caring for patients the services a... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2752079 Tue, 01 Sep 2009 12:43:00 +0100 2752079 http://www.medworm.com/index.php?rid=2727338&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F08%2Fphg-foundation-and-my-point.html A long time ago I had a post entitled "Beware Doctors Bearing Genetic Tests" back in April of 2007. It was an interesting post where I point out that this wonderful GI doctor who was IVY league trained completely hashed genetic testing for HNPCC.I went on to explain the shortcomings with Internists in interpreting APC testing for familial adenomatoid polyposis coli. 1 in 3 misinterpret tests.....Wait till you see the DTC interpretation!Everyone who gets all in a huff when I say that these DTC genetic tests should be regulated. But I am here to say there is a good reason for it, and it has nothing to do with the people getting the tests.......There is now threat of public harm.....But first let me explain my frustration. Saturday I was on Twitter and Daniel MacArthur and I had a conversatio... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2727338 Mon, 24 Aug 2009 11:49:00 +0100 2727338 http://www.medworm.com/index.php?rid=2649196&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F07%2Fpharmacogenetic-indication-for.html That's one way to market the newest medication to prevent stroke, heart attack or stent thrombosis. Wha? Yes, I mean, Prasugrel otherwise known as Effient is FDA approved for use in these patients. But one thing I was thinking is that, since the FDA put on the insert of Plavix that 2C19 testing may be useful to identify people who will not respond to Plavix (generic Clopidogrel)Perhaps, the marketing geniuses over at Eli Lilly could use this as an FDA suggestion that these 2C19 people may be better off with Prasugrel. Yes, it would be one of the most brilliant ways to market pharmacogenomics. I can only imagine the DTC genomics companies salivating over this "We offer the 2C19, test. Act now, save your life." Technically, It actually could. Yes, all the stops would be pulled out and it co... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2649196 Wed, 29 Jul 2009 12:01:00 +0100 2649196 http://www.medworm.com/index.php?rid=2606153&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F07%2Ftruvalue-is-coming-valuation-of-gmg.html Valuation, it is a fickle beast. I love this post from AskTheVC.comValuation – especially for early stage companies – falls in the category of “more art than science.” While buyout investors who are acquiring companies with meaningful cash flow streams love their multi-sheet Excel models with 37 pivot tables, most early stage VCs can do valuations on a napkin (or – if they are good at simple math (e.g. addition and subtraction) – in their head.) In the early stages three things drive valuation: (a) ownership dynamics, (b) market terms, and (c) competitive deal dynamics. Remember Again - this is art - there is no scientific way to really value three guys and a powerpoint slide or a web service with 10,000 subscribers of which 250 are active (although no one can prove that only 2... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2606153 Thu, 16 Jul 2009 11:55:00 +0100 2606153 http://www.medworm.com/index.php?rid=2594565&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F07%2Fhooray-invited-to-gappnet.html In what turns out to be a brilliant decision on part of the CDC, they have created this network of collaborators called GAPPNet.Which stands for Genomics Applications in Practice and Prevention Network..... I think I had mentioned the great work of the CDC on this for quite some time.I first noticed their work while trolling through webcasts of the SACGHS meetings. The first which caught my eye was when Dr. Muin Khoury breifed the committee on the public health initiatives in this space. This was back in 2005 when we were trying to think about how best to expand access to genetic testing. My partner and I at the time were wet behind the ears in this space, in fact our initial feelings were very similar to Anne Wojcicki and Linda Avey......until we began to ask for advice and watch these me... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2594565 Mon, 13 Jul 2009 11:39:00 +0100 2594565 http://www.medworm.com/index.php?rid=2591635&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F07%2Fsergey-wants-to-be-coriell-and-navi.html I have begin to think, Charlie Rose is compromised by the people in Mountain View...... He has 23withoutSergey on the TV and here's Anne, blabbing about how amazing and important Factor V Leiden testing is and how "Wouldn't You Like to Know you were at risk Charlie?" This just days after AHRQ released there report saying that when it comes to blood clots, this test is basically not indicated and not useful...... In addition, and what I may have failed to mention is Anne blabbing about how we need a good way to cohort patients, give them test results and follow up surveys online.She basically was reading from the informed consent methods section of Coriell's Personalized Medicine Collaborative............Which leads me to believe that Mike Christman has had it right all along..........Evalu... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2591635 Fri, 10 Jul 2009 13:16:00 +0100 2591635 http://www.medworm.com/index.php?rid=2588382&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F07%2Fahh-crp-genotyping-is-such-sweet.html This study in JAMA shows a smiliar finding. CRP also known as C-reactive protein is associated with increased risk of heart disease.............there are certain SNPs which are also associated with elevated CRP levels.....so using rat brain thinking, we postulate that the SNPs must ALSO be linked with increased risk of heart disease....... WRONG!!!!rs6700896, rs4537545, rs7553007, rs1183910 and rs4420638 contribute nothing to risk for heart disease, but are significantly linked with elevated CRP.....Which goes to show that there is a problem which cannot be solved by our current mode of thinking. Because there is a problem with the way in which we think.And those who huddle together telling stories about there genome scans are nothing more than cave people exchanging superstitions............ Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2588382 Thu, 09 Jul 2009 14:30:00 +0100 2588382 http://www.medworm.com/index.php?rid=2576782&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F07%2Ftuesdays-doc-getting-bamboozled-in.html Warning! If you don't want to hear me go off on the Public Relations and Journalism field, click away now!!!!! Now!!! Seriously, now. For centuries advertising and journalism have existed. In fact there relationship has been one of symbiosis. Think about, papers can't print without money, the money often doesn't come from subscribers, it comes from advertisement's..........This is one of the big reasons why papers are dying. Online Media Outlets just keep seeing the money flow in though......... Why pay to get marketed to? That is essentially what the savvy news reader is saying.....which is why they have turned away from newspapers and turned towards blogs and twitter......what used to be the gold standard of journalism is now being exposed as a piece of paper for rent to the highest bid... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2576782 Tue, 07 Jul 2009 11:37:00 +0100 2576782 http://www.medworm.com/index.php?rid=2561484&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Finfer-game.html What really gets me upset is that marketing people infer something but don't outright make a claim.They do this because to make a claim which isn't true is grounds for the FTC to investigate you, but if you "infer" something, you don't make the claim.... Why do I jump on this?Because I don't play "infer" for my patients.In fact, health information and healthcare is too important to "infer" anything. You cannot manipulate peoples' trust in you....Either we can justify via science and current medical practice or we cannot. Why let people dangle in the wind with false information..... But this little game is nothing new. Vitamin hucksters and weight loss supplements play this "infer" game too.....so I guess the DTC genomics companies want to be seen as Hucksters....otherwise, why infer someth... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2561484 Tue, 30 Jun 2009 19:43:00 +0100 2561484 http://www.medworm.com/index.php?rid=2517362&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2F23andmx-looking-to-cook-books-in-ca.html Daniel MacArthur and I have been noticing something and he decided to cover it today, which is why I have decided to provide a counterpoint here....Also GenomeWeb published on this. SB 482 is a bill I glossed over in a post in the past and was recently interviewed for in the San Jose Mercury News....... Daniel leads this as 23andMx leading the regulatory push.....but this is more insidious than that. This is 23andMx trying to cook the books and create laws which exempt them from the stringent regulation which they should receive...... I told this to the newsies over at San Jose on Sunday, so I am going to post this today...... It turns out that this bill SB 482 essentially exempts DTC companies from facing the harshest regulations that medical providers/labs have to face From Daniel"In oth... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2517362 Thu, 25 Jun 2009 15:56:00 +0100 2517362 http://www.medworm.com/index.php?rid=2512311&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fanne-wojicki-first-benadryl-doping-now.html I was actually watching the Charlie Rose interview with the 23andMx ladies....When Charlie Asks what the advantage of 23andMx is.Anne and Linda both say "The problem with the GWAS is that you aren't followed over time. You get one shot and people can't give you further information" What Anne and Linda are saying is: The Coriell Personalized Medicine Collaborative is the gold standard, we are merely trying to monetize something they are doing for FREE.In addition, we are not IRB approved and are unethically doing this business, which is ultimately research. Which IS being done by a Not For Profit Medical Institution, Who is charging nothing I.E. FREE, and we would like to do what they are, but charge you 399 and have the right to sell your data......Oh and did we mention that Google just pu... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512311 Tue, 23 Jun 2009 16:44:00 +0100 2512311 http://www.medworm.com/index.php?rid=2512312&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fwatch-out-corporate-bloggers-ftc-is-on.html Now not only am I bashing corporate bloggers (Some may even call me corporate) Now the Federal Trade Commission has gotten into the game. It turns out that the FTC is on to the game of freebies for good blogging.So to all of you who took free Navi or 23andMx or DeCodeme scans in hopes of them getting good press on your blog, you may have some issues. At least if you are in the US..... From the Yahoo News What some fail to realize, though, is that such reviews can be tainted: Many bloggers have accepted perks such as free laptops, trips to Europe, $500 gift cards or even thousands of dollars for a 200-word post. Bloggers vary in how they disclose such freebies, if they do so at all. The practice has grown to the degree that the Federal Trade Commission is paying attention. New gui... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512312 Tue, 23 Jun 2009 12:15:00 +0100 2512312 http://www.medworm.com/index.php?rid=2512313&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fcrazy-friday-awesome-call-tru-blocks.html I was amazed the first time I met Francis Collins, longtime a hero of mine, Francis was gracious and kind when I met him. I also share a common bond with him. Francis' Intern at UNC was a guy by the name of Jim Sabetta, one of my instructors.... That being said, before I started HH, I watched webcast after webcast of the SACGHS. This was 2005 and 2006 I'm talking about. I did it because it was research. But I saw a guy on there who inspired me, who had such a sense of reason that the whole group respected. His name is Muin Khoury.....and I just met him Friday!It turns out we also have people in common. But more importantly, we have a healthy respect for family history in common...... This guy and his team at the CDC have been researching Family History tools and the state of the science of... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512313 Mon, 22 Jun 2009 11:58:00 +0100 2512313 http://www.medworm.com/index.php?rid=2512314&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Ffree-scans-free-scams-maybe-not-race-is.html Misha just posted on what I believe is the true value of all of these genome scans, currently.....Free, until value is demonstrated in a way that doesn't include a "testimonial"There is a new company called "TruGenetics" which is Enhancing Life Through GenomicsAs I prep for my 11 AM conference call with the CDC, I have to get this post out there.....They are giving away 10,000 scans for free. That's 500,000 SNPs from your genome, for free!There are some big questions I have.1. Who the hell is running this?CEO-Jason Chien, MD, MS, Chief Executive Officer Dr. Chien is currently a faculty member at the Fred Hutchinson Cancer Research Center and in the Department of Medicine at the University of Washington.COO-A.Edward Mohebi, MBA, PhC, Chi... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512314 Fri, 19 Jun 2009 14:48:00 +0100 2512314 http://www.medworm.com/index.php?rid=2512315&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Ffactor-v-leiden-testing-not-useful.html I was at morning report about 6 months ago after hearing a talk from the Leiden people. It turns out they had never intended the testing to be used the way it has in the US.In fact, it seems for the last few years, everywhere you turned, every doctor was doing genetic testing......this time not for Hemochromatosis, which, again is not particularly useful as a screening test for disease state. This given the low penetrence and of the disease in those who have the mutations (Which is once again why DTC HFE testing is silly)This time it was for Prothrombotic state with Factor V Leiden and GP20210A mutations/polymorphisms.Why did we do this? Well, we ere taught that having these mutations put these patients at risk of having Deep Vein Thrombosis. Even perhaps that we give aspirin or blood thin... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512315 Thu, 18 Jun 2009 08:45:00 +0100 2512315 http://www.medworm.com/index.php?rid=2512316&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Flove-my-readers.html The other day I was flooded with emails from my readers about my post about the whole genome scan dirty little secret. Some agreed with me others vociferously defended the need for "further study" But the best was an email from someone who worked for one of the big scan companies, can't say which one, can't say who.I Quote"The speculative questions that you ask about interpreting whole genome sequencing indirectly relates to exactly what the cyclical problem is with an industry of genomic researchers who don’t practice science. Instead, they practice following the recommendations and protocols developed by instrumentation vendors, as if Mike Hunkapillar, Sue Siegel, and Jay Flatley had once parted the Red Sea"I tend to agree that this comes down to a question of thought leaders in the fi... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512316 Tue, 16 Jun 2009 13:07:00 +0100 2512316 http://www.medworm.com/index.php?rid=2512317&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fgenome-scan-dirty-little-secret.html You know what I love, you take a company who is inferring that science IS clinical utility and then you hire them to perform interpretation on something that in it's current for is often uninterpretable......and then you sell that for something on the lines of 90-48, 000 USD. My business is healthcare, my business is also risk prediction, but what my business is most is disease prevention......My profession is physician, my oath is to do no harm and if I must harm, do so healing or palliating suffering....A noble profession to be sure.But no one, I repeat no physician is leading the charge to do whole genome scans for risk prognostication.Maybe for certain disease detection, but not for true risk prediction. But, guess what? The business people are...... The business side of Genomics is a... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2512317 Mon, 15 Jun 2009 15:21:00 +0100 2512317 http://www.medworm.com/index.php?rid=2473869&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fok-guys-seriously.html What I loved about the second day of CGS coverage was that Dan now had some partners covering some of the space, heck I even saw twitter messages straight from Illumina.....I want you all to listen to some very important statements. Francis Collins had his genome sequenced under an alias by 23andMe, deCode Me, and Navigenics - tells them here at Consumer Genetics Show - He says1. Substantial differences exist in info revealed (carrier, non-medical, ancestry); not clear which markers are tested 2. Interpretations sometimes vary, even with the same data; exhorts DTC companies to collaborate on this.3. Parents willing to pay nearly $2K for cord blood banking are unlikely to be daunted by cost of genome sequencing as it falls. So here's the take home. When you get a cholesterol test, don't you... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2473869 Thu, 11 Jun 2009 11:58:00 +0100 2473869 http://www.medworm.com/index.php?rid=2464330&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fprior-authorization-for-medically.html As if this couldn't get any worse for genetic counselors, who BTW get paid next to nothing by insurers........ United Healthcare is now requiring Prior Authorization for BRCA testing. In their policy bulletin from May, Volume 31.......The coverage determination made regarding BRCA testing for your patient will be based on the UnitedHealthcare medical policy for BRCA testing, which is based on the clinical evidence and is closely aligned with the criteria developed by the organizations listed above. This coverage determination will be conveyed to you promptly by either phone, or letter or both. Of course, adverse determinations are subject to all applicable appeal rights.Add that to the list of scut work which the counselor will get stuck doing.... So much for same day testing in a timely f... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2464330 Mon, 08 Jun 2009 14:58:00 +0100 2464330 http://www.medworm.com/index.php?rid=2463191&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Frs2200733-ok-now-what.html I am busy pouring through all sorts of association studies which I had let sort of slip through my fingers. I have been cue'ing a lot of these and only in the last few days have been able to get to them. Most of the SNP that the press put out there now seems to be dying off pretty nicely.Although there are bits of useful data out there, most is just noise......but one of the SNPs which caught my eye was rs2200733 studied in Icelandic, Italian and other Caucasian populations with a small replication in an Asian population as well......What does rs2200733 predispose to? Atrial Fibrillation. A condition that can lead to unannounced strokes, syncope, and heart failure (at times) Atrial fibrillation is the most common arrhythmia in the United States. About 2.3 million Americans have atrial fib... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2463191 Mon, 08 Jun 2009 12:05:00 +0100 2463191 http://www.medworm.com/index.php?rid=2452969&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fgappnet-hacked-records-and-icob.html Happy Donut Day Everyone!"Wha?"That's what I said as I walked into my Dunkin Donuts across the street from our new HQ. The guy saw me coming in, prepped my coffee, Large Blueberry, Milk and Sugar......As I went to pay, he said, "Happy Donut Day" I barely understood what he said when the manager said "Pick your donut, FREE"OMG, as if I wasn't fat enough. How many other of my readers took the free Donut today. I looked around in my DD and it seemed everyone took the donut.People certainly are game for free......... Speaking of FREE, the Coriell Personalized Medicine Collaborative is in essence a Navi/23andM- scan for FREE. I just got some more results this week. I don't have Hemochromatosis HFE type, Hooray! This can be yours as well.....That is if you are willing to participate in the study... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2452969 Fri, 05 Jun 2009 12:44:00 +0100 2452969 http://www.medworm.com/index.php?rid=2447962&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F06%2Fwonderful-weekend-consumer-genomics.html First, a little personal info. I am the proud father of yet another Murphy Daughter! This weekend has been amazing for me. Even better, as we went into the hospital I received an email. Normally the only people emailing at this time are my patients or I am getting results from lab tests I ordered.So, I felt obligated to look when the iPhone buzzed. It was an email from John Boyce....... Who is John Boyce? From his website: John recently served as Head of Business Development for Helicos BioSciences, where he was responsible for identifying new market opportunities in which the company was able to develop new applications that gave it a substantial competitive advantage. John founded Delphi Bio a strategic consulting group for genomic start ups....... So about a week after I got done trashi... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2447962 Mon, 01 Jun 2009 12:15:00 +0100 2447962 http://www.medworm.com/index.php?rid=2442244&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F05%2Fbargain-basement-consumer-genomics.html Step right on up, come one come all....to the greatest show on earth!Demand is so high, that we've dropped the price 99%That's right, the greatest show on earth, known as the Consumer Genomics Show has reduced its exorbitant cost, just like genome scanning is going to do!!!From 850 USD, which was dropped from over 1000 USD, to now 8 dollars and 76 centsJust use the special coupon code DNA123Yes, that IS recessionary pricing at its best.This Show has "Shown" me its true value.......A sandwich at Cosi......minus the fulfillment of that Chicken Pesto and less the substance....Ahhh, PT would be proud of thee.....See you there suckers!The Sherpa Says: What an unbelievable scam. I am blown away at what our profession has allowed the hucksters in business to get away with....perhaps we are too bu... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2442244 Wed, 27 May 2009 19:08:00 +0100 2442244 http://www.medworm.com/index.php?rid=2442245&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F05%2Flong-weekend-lots-to-cover.html First, I want to thank reporter Devon Lash at the Stamford Advocate, who wrote a very nice piece about the CT State Dept. of Health asking seniors to speak up about diseases in their family. So many people didn't speak of these things just a few decades ago, but they need to. The article misstates what I said, which is nearly over 40% of women were reclassified when using the Reynolds Risk score in comparison with the Framingham. But I think you get the idea. Public Health Departments are now pushing Family Histories......NOT SNP SCANS..... Often I am presented with a patient who says "They never spoke about it". I tell that patient to go to their family member and "Make them speak about it" What they tell you may just save YOUR life. In Detroit they are doing the same thingI am glad we... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2442245 Tue, 26 May 2009 12:41:00 +0100 2442245 http://www.medworm.com/index.php?rid=2424350&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F05%2Fthanks-genome-web-challenge-to.html I have long thought about this and remain convinced that Personalized Medicine is the most powerful tool to improve patient outcomes. The paradigm is clear......In an interview I gave to Berci Mesko at Scienceroll a while ago.....I made clear that there is a difference between personalized medicine and personalized genetics.I know want to make another important distinction......until personal genomes can improve lives by altering current medical care or behaviors known to increase risk of disease, they remain NOT PERSONALIZED MEDICINE!!!So they should not be lumped into the same category as Personalized Medicine.They are what they are. Personal Genomics recreational testing.......Unless of course they are giving you data about disease, but that of course is a different animal....So when I... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2424350 Wed, 20 May 2009 17:51:00 +0100 2424350 http://www.medworm.com/index.php?rid=2424351&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F05%2Fauthor-smackdownsorry-dr-kari.html I just received an email from Annals of Internal Medicine and I see a letter to the Authors from Dr Gulcher and Dr Stefansson. I chuckled to myself because I just finished writing a letter to the editor and had another published in Nature Biotechnology entitled "In Need of a Reality Check"Why did I laugh? Letters to the author or editor are written to clarify issues or problems with articles in a NON-Peer Reviewed Manner. They are done to make points for the avid readers of the Journals.It turns out that Doctors Jeff and Kari have found fault with an Article published by Dr. Ridker and Dr. Paynter PhD.....this article showed that the addition of 9p21.3 SNP data to the reynolds risk predictive model, which already includes family history of early heart disease and CRP markers....This additi... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2424351 Tue, 19 May 2009 18:16:00 +0100 2424351 http://www.medworm.com/index.php?rid=2390157&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F05%2Feasy-way-to-find-overconfident-and.html I always wonderd who would admit to using the cliniclaly unvalidated SNP chips into their medical practice as if it were standard practice, without having any training at all in genetics.Do you remember my blog post 2 years ago entitled "Beware Physicians Bearing Genetic Tests"Basically I state that if you have not had any training interpreting genetic testing, you are likely to make a hash of it. This is especially true with the highly probabilistic and non-clinically validated SNP scans.So just when I wonder who in their right mind would admit to using this as a clinical tool without any validation......Navigenics makes it easy to find the krazies!!! From the site."Find a physician"A growing number of doctors have collaborated with Navigenics to integrate genetic testing into their medic... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2390157 Wed, 06 May 2009 19:34:00 +0100 2390157 http://www.medworm.com/index.php?rid=2353989&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F04%2Fsurprise-surprise-genetic-risks-in.html The Annals of Internal Medicine has a great article this week on genetic risks so does the ACMG Genetics in Medicine Journal for May.The take home point is something which people may find interesting and it is something I feel is very real. I have begun to think that these Genomic tests act a lot like a placebo. They often don't add anything clinically. Hell, they may not even do anything to guide therapy (Pgx and high penetrance genes aside)But they often act psychologically, either for good, or for bad.First in the Annals of Internal Medicine; People have been arguing that perhaps testing only ONE snp and representing its risk is for disease is silly and in fact taht the REAL way to represent these risks is with a multiSNP panel. In Fact, this is what has been perhaps the selling point o... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2353989 Tue, 21 Apr 2009 12:00:00 +0100 2353989 http://www.medworm.com/index.php?rid=2349208&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F04%2Fgenome-app-store.html I was reading an article in the economist the other day, a good article mind you. It turns out that Drew Yates was correct. It appears that the hype for DTC Genome scans is waning......That being said, in the article George Church says something which sticks with me:"Dr Church even argues that genome sequencing “will in effect be available free” because companies will give away sequencing to sell other services, such as genetic interpretation—much as mobile operators “give away” handsets to get customers to sign up for lucrative service plans. And when this happens, he reckons, “it will be just like the internet: once all this information is floating around, a lot of creative people with PCs will nose around and develop applications.”Daniel over at Genetic Future put this out... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2349208 Mon, 20 Apr 2009 12:08:00 +0100 2349208 http://www.medworm.com/index.php?rid=2295293&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fyales-healthcare-2009-conference-and.html I am preparing to speak at Yale School of Management's Healthcare 2009 conference. It looks to be quite a conference. The theme this year will be "Where is the Value? Managing Cost and Quality in a Healthcare System Facing Reform."From the site:The Yale Healthcare Conference is a joint effort between the School of Management and the Health Professions Schools at Yale University that aims to bring together professionals, academics, and students to engage in an instructive interdisciplinary conversation concerning current healthcare issues. This will be the 5th consecutive year and we expect the conference to continue growing to over 400 participants. The planned title and theme for Healthcare 2009 is Where is the Value? Managing Cost and Quality in a Healthcare System Facing Reform. This co... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2295293 Fri, 27 Mar 2009 15:34:00 +0100 2295293 http://www.medworm.com/index.php?rid=2295294&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Ftruth-in-advertising-hello-navigenics.html "San Jose Mercury News writer Chris O’Brien recently featured Navigenics in his write-up of Bay Area companies that are succeeding during this global economic downturn. His profile is a pleasant acknowledgement of all the hard work that has gone into creating the genetic testing service that is most recommended by physicians."That from the Navigenics Corporate Blog.Are corporate blogs a form of advertising? Because if they are I would love to see the statistical research done to prove that Navigenics' testing is the service most recommended by physicians...... I am certain there are many other clinically useful laboratories out their who would beg to differ with Navigenics' assessment of what physicians want. Sorry, Vance.Can I get a little help from the FTC here? The FTC is charged with... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2295294 Thu, 26 Mar 2009 12:09:00 +0100 2295294 http://www.medworm.com/index.php?rid=2295295&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fso-good-that-you-have-to-break-law.html I was asked today by a reporter if I ever gave the thought to the argument that the DTC tests were so groundbreaking, so very vital a technology that the LAWS HAD TO BE BROKEN. For the betterment of society, these DTC companies HAD to break the law. It was their Moral imperative.Really? Hmmm......let me see. Francis is glad these companies are out there raising awareness about genetics. I don't share his thoughts.1) These companies put their genetic data out as fact. Not exactly raising awareness in the right way.23andME does rate articles, but that being said, it isn't exactly and independent evaluation. Navigenics gives you rates or likelihoods, which people often don't get. I say the awareness is often hype and confusion, not a true understanding. The recent Cogent study presented at SA... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2295295 Wed, 25 Mar 2009 13:00:00 +0100 2295295 http://www.medworm.com/index.php?rid=2295301&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2F23andme-says-we-have-no-use-for-your.html In an age where no one trusts anyone and we see defiance of laws for the sake of profit I am still shocked and awed that companies that are formed to "Not be Evil" or to "Benefit Mankind" choose to ignore laws.In healthcare, imagine if your doctor was found to be breaking the law. Stole from Medicare? Non-Compliance with State regulations? Spousal Abuse? Selling Drugs? Most of these are career killers. In fact in CT we just had a large group of GI doctors who are now not doing so well because one of their partners was just charged with endangering a minor.Why is it so vital that physicians, nurses and others in the healthcare field try to stay above the law? Because patients lose trust in the system. They begin to think that their care givers are reckless criminals. And WHO would trust the... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2295301 Mon, 23 Mar 2009 10:23:00 +0100 2295301 http://www.medworm.com/index.php?rid=2295303&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fnavigenics-has-labnys-will-likely.html Navigenics now is the proud owner of a laboratory. Congratulations! Now New York State has some hefty regulations for you. Otherwise, you can't test people in New York.....Pay close attention to numbers 4 and 5....NYS Clinical Laboratory Permit Requirements1. Qualified Director, PhD, 4 yrs post doc work.2. Application and fee 1100 USD3. Inspection4. Assay validation5. Compliance with all applicable statutes and rulesAssay Validation?????1. Assay description Suitable to guide authorized person in ordering the test 2. Consent processConsistent with NYS CRL s 79-l 3. Analytical validityAbility to detect and/or measure analytical target 4. Clinical validityDocumented association of analytical target with clinical condition or outcome 5. Reporting formatInterpretation suitable for non-geneticis... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2295303 Fri, 20 Mar 2009 12:39:00 +0100 2295303 http://www.medworm.com/index.php?rid=2295305&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fi-am-sick-of-bullht-navi-has-lab-and.html Ok, so today is one of those little rant days. I am pretty sick and tired of companies, politicians and bankers......It just plain stinks that our economy hit the skids. But we did a lot of this to ourselves. How?Some say Greed.Others say lack of regulations.I say, we believed in Bull$h!t........Everyone was selling it...... That is what killed this economy.Think about it, our intuitive BS meters were dropped a long time ago. Million dollar homes in rural America???? Sure, why not? Everywhere else prices are going up....Only make 50k a year? That's ok, your house is worth that million.......We'll take that risk.The same thing was true with Biotech and this new abomination of DTC.......Have a technology that has no true clinical application, nor proven utility for informing people of risk??... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2295305 Thu, 19 Mar 2009 11:48:00 +0100 2295305 http://www.medworm.com/index.php?rid=2274478&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fdtc-genomic-tests-whos-that.html The American College of Physicians is perhaps getting the act together.....Recently I sent an article to the ACP President Jeffrey Harris, I scolded him about how short sighted it was not to include topics on Genetics at the ACP conference in April. I still have received no response back from him......BUT......It appears the ACP is looking for Internists who have experiences with DTC Genomic testing.Your thoughts exactly: direct-to-consumer genetic testsACP Internist is assessing how often internists are asked by patients about direct-to-consumer genetic tests.Tell us about your experiences.Learn more about the impact of direct-to-consumer genetic tests here and here.They link to an article from Greg Feero. In which he says:"This amounts to DTC marketing of the genetic equivalent of a full... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2274478 Tue, 17 Mar 2009 12:19:00 +0100 2274478 http://www.medworm.com/index.php?rid=2267514&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fnavis-new-job.html In case you missed my recent posts about Navigenics and 23andME, let me recap.1. They lost their CEO. Who was in essence an executive in residence for one of the venture firms funding Navi. I.E. Kleiner was running Navigenics to begin with.....2. I predicted that by the summer these companies.....Navi and 23andME would show whether they were going clinical or way of the novelty test....Surprisingly 23andME continues to thumb its nose at academics, by launching research without having its own Institutional Review Board.3. With 23andME now doing BRCA testing, while Sacramento SLEEPS, or is underfunded.....it is clear their intention is to go clinical and clinical research without taking any ethical or professional responsibility....4. It is now clear Navigenics will go clinical, looking to r... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2267514 Sun, 15 Mar 2009 12:22:00 +0100 2267514 http://www.medworm.com/index.php?rid=2260086&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Feurope-plans-on-regulating-dtcus-is.html Interestingly in a news article in the European Journal of Human Genetics, it seems to me that even the people arguing against regulations are doing so in a very "Not so convincing way"Those that are arguing for regulations are making a clear case. My guess is that they have been the ones arguing for about 30 years......so they have a little experience with ELSI issues in genetics....The end of the news article makes it clear that at minimum, there will be a place for genetics professionals in the governmental regulatory organizations to develop such guidance. This seems to me to be a reasonable approach.I have argued in the past that these companies should be getting regulated. And they should. In fact, there are already laws on the books to provide such regulations. You can call them old... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2260086 Thu, 12 Mar 2009 12:25:00 +0100 2260086 http://www.medworm.com/index.php?rid=2233846&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fsign-of-times-or-just-bad-management.html Genome Web reports yesterday that DNAPrint goes bust.Who was DNAPrint and what did they do?Who?DNAPrint Genomics, Inc. is a cutting edge company. We are concentrating our efforts in four distinct areas; Pharmacogenomics, Forensics, Genotyping, and Consumer Products. Our aim is to continue to research and develop novel products and services in each of these market areas and to be a leader in genomic-based technologies.The Company’s core patent applied for and proprietary technologies for efficiently targeting single nucleotide polymorphisms (“SNPs”) enable us to provide novel predictive genetic tests at a significant cost advantage over our competitors.What did they do?Four things really1. DNAPrint®'s genealogy product, ANCESTRYbyDNA™ 2.5, is a pan-chromosomal assay for genetic anc... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2233846 Wed, 04 Mar 2009 14:07:00 +0100 2233846 http://www.medworm.com/index.php?rid=2233847&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F03%2Fover-200-studies-what-is-bs-what-is.html With the advance of genome wide associations we need to collate them and evaluate them. A research physician associate of mine told me that on average 9 out of 10 association studies will eventually be proven incorrect. His research, not mine.That is a pretty huge number. But it is with that mindset in which I review GWAS. What do I look for? How do I evaluate them? There have been some good articles recently in JAMA which illustrate some of the key concepts.In genetic studies, one potential cause of spurious associations is differences between cases and controls in ethnicity, a situation termed population stratification. Was measurement of the genetic variants unbiased and accurate? Methods for determining DNA sequence variation are not perfect and may have some measurement error. Do the ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2233847 Tue, 03 Mar 2009 13:42:00 +0100 2233847 http://www.medworm.com/index.php?rid=2223036&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Fbeginning-of-end.html Mari Baker is leaving Navigenics......I am fairly certain of that....Unless you can be the CEO of 2 companies at once......."PlayFirst Expands Management Team to Address Growing Consumer Entertainment Market; Recruits Senior Industry Veterans in CEO, CFO Positions SAN FRANCISCO, Feb. 26 /PRNewswire/ -- PlayFirst, Inc., the award-winning entertainment company, today announced that Mari Baker, a consumer software and internet industry veteran, has been named its Chief Executive Officer. The company also announced today that Jim Wandrey has joined as Chief Financial Officer. PlayFirst, one of the leaders in casual entertainment, recruited the new leadership to address the growing market opportunity in interactive consumer entertainment."Or maybe they're restructuring. Or maybe a major VC is p... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2223036 Thu, 26 Feb 2009 19:43:00 +0100 2223036 http://www.medworm.com/index.php?rid=2216997&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Fbeginning-of-end.html Mari Baker is leaving Navigenics......I am fairly certain that....Unless you can be the CEO of 2 companies at once......."PlayFirst Expands Management Team to Address Growing Consumer Entertainment Market; Recruits Senior Industry Veterans in CEO, CFO PositionsSAN FRANCISCO, Feb. 26 /PRNewswire/ -- PlayFirst, Inc., the award-winning entertainment company, today announced that Mari Baker, a consumer software and internet industry veteran, has been named its Chief Executive Officer. The company also announced today that Jim Wandrey has joined as Chief Financial Officer. PlayFirst, one of the leaders in casual entertainment, recruited the new leadership to address the growing market opportunity in interactive consumer entertainment."Or maybe they're restructuring. Or maybe a major VC is pulli... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2216997 Thu, 26 Feb 2009 19:43:00 +0100 2216997 http://www.medworm.com/index.php?rid=2206837&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2F23andme-genetic-counseling-isnt.html Thanks to an amazing string of commentary on my blog, I think I get it.Most of the 23andME users don't understand clinically what they are getting. It turns out, what they are getting is in essence unsupervised genetic counseling.Vincent a commenter notes from my previous set of comments:"In their actual report to customers, though, their language is much more sane. E.g.Carrier for the 6174delT BRCA2 mutation. Lifetime risk of breast cancer for women is increased from 13% to 85% and risk of ovarian cancer is increased from less than 2% to 23%. May significantly increase risk of prostate cancer in men. There is also an increased risk for breast cancer in men.That an accurate (as best as I can tell) statement of fact, and one that does not cross the line into the area of clinical diagnosis."... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2206837 Mon, 23 Feb 2009 15:48:00 +0100 2206837 http://www.medworm.com/index.php?rid=2200894&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Fi-am-not-man.html As I post in the "southern command" I want to announce.....I AM Not a Man.I repeat.I Am Not a Man.I know, I have man parts. I may have a hairy chest like a man.I may have an X and a Y.But I repeat, "I Am Not a Man!"I am dead serious. I AM NOT A MAN.In a statement to Pharmacogenomics Reporter, 23andMe stressed that offering BRCA testing does not mean the firm is moving into the medical genetic-testing space. It sounds just as silly, doesn't it?BRCA testing is NOT A MEDICAL GENETIC TEST.......BRCA testing is NOT A MEDICAL GENETIC TEST......I think Myriad will beg to differ. A whole bunch of Geneticists and Counselors would as well......Just ask Ellen Matloff CGC, Research Scientist at Yale......"Only a doctor can provide a medical diagnosis and we report information that the current state of... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2200894 Fri, 20 Feb 2009 12:40:00 +0100 2200894 http://www.medworm.com/index.php?rid=2191013&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Fwhy-23andme-why-now.html A few people have been asking me these questions after my recent blog post. Andrew and Daniel (Two prolific bloggers in the personalized genomics space) are both asking these questions and rightly so.1) Why did 23andMe take such a risk? They had a nice Novelty genetic testing game working (albeit flawed). Why risk by going into truly defined medical practice?I think this move rests on 3 assumptionsA) Most people won't buy a dunkin' donut's coffee today as they cut back costs. Why spend 399 on a vanity bobble?Thus BB) People pay for medical necessities still. So to sell tests, they can make it look like a medical need.C) Most investors are looking to shorten their ROI time frame especially in this economy.2) Why now? Why take the risk now? Aren't they risking their already set income stream... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2191013 Tue, 17 Feb 2009 11:39:00 +0100 2191013 http://www.medworm.com/index.php?rid=2188228&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2F23andme-enters-clinical-medicine-realm.html As I had postulated before, in order to move towards a profitable direction the DTC companies would have to choose "Medically Relevant" or "Novelty Testing" From this recent email sent to me by a reader it is clear, 23andME is Choosing to become a clinical service, without accepting the clinical responsibility.Hello Patient X,There's a wealth of new information in your 23andMe account. Our scientists have recently added a number of new articles to our Personal Genome Service, including two that may be of special interest.If you take cholesterol-lowering statin drugs, be sure to check the new article for Statin Response, which deals with rare but serious side effects that may be influenced by genetics. And for our members who have the data> from our v2 chip, we've added important informatio... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2188228 Sat, 14 Feb 2009 18:45:00 +0100 2188228 http://www.medworm.com/index.php?rid=2173430&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Fdont-take-my-kodachrome-away.html Do you remember when you had to send your film to Rochester NY or Ohio to get developed......you would stop by the store check your last name.........Nope......sorry no pictures yet!! Even the thought of keeping that little tear off tag drove me nutty!It was exciting, but it also was a huge pain in the a$$......What if the pictures were screwed up, you would have to send your negatives back so that they could get run again.........That being said, Kodachrome is the gold standard of photo film, but that is so 1980s. In fact, there is only one processor of Kodachrome in the entire US left other than Kodak of course......These guys had a great economy of scale with the processing centers and in fact it made a very nice business model for a while until Kodak discontinued Kodachrome......Well i... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2173430 Mon, 09 Feb 2009 02:42:00 +0100 2173430 http://www.medworm.com/index.php?rid=2167991&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Flike-i-said.html If you have been following me at this blog for any amount of time, you know that I have been a careful watcher of these GWAS studies, and the testing companies who sprung up after them.I have been skeptical of most of these studies unless they have had replication and fairly large Odds Ratios or Relative Risks........why? We are looking for clinical relevance and asking what can we do with this to better our patients lives........Personalized medicine relies on several things but these 3 are absolutely needed: Prediction, Prevention and Privacy. It is rich in fields like Cancer Genetics, PGx, Preconception Genetics.You see Personalized medicine is not just Prediction, which these DTC companies are touting, it is therapies and action......which, these tests unfortunately are lacking in........ Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2167991 Sat, 07 Feb 2009 09:05:00 +0100 2167991 http://www.medworm.com/index.php?rid=2167992&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F02%2Frecessionary-discretionhotcoupons4u.html Yes, I am a big fan of the race to the bottom. At least in the case of SNP scanning. We have seen Navigenics drop their price, deCode drops off the earth and 23andMe???? Well, in a discretionary move they show use the true value of SNP scans.....I give you HotCoupons4U.....The 23andMe special, pay close attention...From the website.....Featured Savings & Discount DealsWin $5000 A Week For Life (Expires 2/26/2009)Win $25,000 Room A Day (Expires 3/6/2009)Dicks Sporting Goods Coupon: $10 OFF (Expires 4/30/2009)Win a Smart Fortwo Car or $14,000 Cash (Expires 10/31/2009)Get Free Nutrish Dog Food Sample (On Going)Honey Baked Big or Small Ham Feast (On Going)$3 Off Disney DVD in The Store (On Going)ToysRUs Free Shipping on Select Toys (On Going)Victoria's Secret December $10 off Any Purchase ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2167992 Fri, 06 Feb 2009 12:22:00 +0100 2167992 http://www.medworm.com/index.php?rid=2149663&cid=t_157250_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FOYsK0PypSK4%2F I hear so much about genetic testing these days that I’ve always wanted to find out what that experience is like for people who had the test done. Sure, it’s painless (just a saliva or cheek scrape will do). But more than the test itself, I want to know what your life is like these days. What was it like to know you are at risk for this X disease? What did you do with your results? Are you now eating, living better? Do you feel trapped, empowered, confused? I do want to know. Maybe I’m the coward who can’t face the mortality of my future. I don’t know that if I knew, I would do something about it, or I would be scared stiff to change. (What’s the point, right?) So hearing from other people who are more adventurous than me would probably help. It turns out, I’m not the only... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=2149663 Sat, 31 Jan 2009 15:02:12 +0100 2149663 http://www.medworm.com/index.php?rid=2149746&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F01%2Frazzle-dazzle-em.html I was reading Daniel's Blog and this person's comments caught my eye... "The marketplace for genetic testing is basically an uneducated one (with the exception of people who are really excited about it)."I think she is right. To do the education to get someone to use this test will ultimately make them not use this test...because once you can understand the implications, you could understand that these tests are of limited value.......unlike Pgx testing...Caveat: I like the people at Navigenics. I think they have great scientists. BUT, I am extremely skeptical of any physician who is working for this company to promote tests which are not clinically validated.....To continue...She then goes further...."Add to that, Navigenics also wanted to offer disease related testing (I'm leaving the qu... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2149746 Sat, 31 Jan 2009 12:19:00 +0100 2149746 http://www.medworm.com/index.php?rid=2141593&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F01%2Fnavigenics-does-market-research-finally.html First, I hate blogging about this when so many people have, including Daniel over at Genetic Future.....I probably wouldn't have posted if he hadn't blocked my comment with an error message which states "too many comments have been posted by you in a short period of time"Funny, I have commented on his blog in over 2 weeks.......That being said, at The Sherpa, you can comment a zillion times a day if you want to. No matter whether you want to flame me or praise....Now back to Navi. Who didn't know this was coming? I sure as hell did when I sat with their marketing team and they asked why I wasn't ordering their test....I told them that I had patients paying less for our services for the year than for their test....Prior to that I saw their marketing survey on Gerson Lehman Group....thank fo... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2141593 Thu, 29 Jan 2009 12:03:00 +0100 2141593 http://www.medworm.com/index.php?rid=2110825&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F01%2Fpersonalized-genomics-critical-review.html I just want to point everyone's attention to a great meeting that happened in December. I wish I could have been there. I still maintain to this day that Personalized Medicine does not equal personalized genomics. In fact, in an interview I gave to Berci Mesko at Scienceroll, I talk about the differences between personalized medicine and personalized genetics. The scans are a tool we can use (maybe) for personalized medicine, just like all the other tools we have....This meeting which was held by the CDC and NIH was for the sole purpose of reviewing Personal Genomics.Purpose:This 2-day workshop, cosponsored by CDC and NIH, explored the type of scientific foundation that is crucially needed to make the promise of personal genomics a reality. The workshop participants examined how the integr... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2110825 Fri, 16 Jan 2009 13:37:00 +0100 2110825 http://www.medworm.com/index.php?rid=2101474&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2009%2F01%2Fanother-stephen-this-time-its-pinker.html No I don't spell my name with a ph, but that is just one of a few differences I have with Dr. Stephen Pinker(Erratum, turns out he spells it with a V, just like me. My Mistake) , one of the PGP 10. His article that I read on Saturday online is now being read by millions in print.Steven and I both are participating in Genomic Research. I haven't told many people, but I am a participant in the Coriell Personalized Medicine Collaborative. So I read his article with curiosity. Not only because he is a developmental psychologist, but also because he (like me) thinks that most behavior is inherited. So I wondered how his response to having his Exome released would further "shape him".....and thus when my results come in how will they "shape me"."All this sets the stage for what we can expect fro... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2101474 Tue, 13 Jan 2009 11:05:00 +0100 2101474 http://www.medworm.com/index.php?rid=2061532&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F12%2Fcopy-number-variation-epigenetics-bio.html I was watching National Geograpghic HD last night. Yes, I do have a few minutes to watch TV. I always love to watch their in the womb specials. This time it was Twins.What I love is the way they tell the story and teach the science (very lightly). I have to say, I have tried to teach doctors these subjects for a while now and most of what I get are these blank stares.NatGeo has these wonderful graphic animations and weave a story around the animations with real clinical examples that bring the science to life.Maybe we need to start having physicians watch NatGeo. We could scrub NCHPEG and anything EMedicine or UpToDate has to offer (which are average tools and topics).Why? In one brief 60 minutes episode of NatGeo, they covered1. Twins have epigenetic differences, explained epigenetics inc... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=2061532 Mon, 22 Dec 2008 12:02:00 +0100 2061532 http://www.medworm.com/index.php?rid=1975624&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F11%2Fgenes-provide-minimal-benefit-seriously.html Conclusions A genotype score based on 18 risk alleles predicted new cases of diabetes in the community but provided only a slightly better prediction of risk than knowledge of common risk factors alone. The C-statistic was 0.900 versus 0.901......some on....can we even call that better? The nearer the C statistic to 1, the better the predictive value of the test...so can we really say it is worth it???Paper Two: Conclusions As compared with clinical risk factors alone, common genetic variants associated with the risk of diabetes had a small effect on the ability to predict the future development of type 2 diabetes. The value of genetic factors increased with an increasing duration of follow-up. In this study they use the area under the ROC, where the change is 0.74 to 0.75....again lacklus... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1975624 Thu, 20 Nov 2008 18:17:00 +0100 1975624 http://www.medworm.com/index.php?rid=1969286&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F11%2Fnot-intended-to-diagnose-or-treat.html Andrew Yates at ThinkGene comments on something that I have not been able to effectively explain. We trust health assets like “medical advice” to exist. That is, we trust that public medical information describes reality such that it may be applied to measurably improve health. This is a challenge because medical advice, especially preventative medical advice like genomics, is a trust asset: an abstract idea with value applied to the indefinite future. This is a very precise explanation. We pay for medical advice.......which may include diagnosis or treatment.......We trust trained health professionals to give that advice. We trust that they are capable of giving that advice......Why?Well, we have a licensing system in this country that helps us assure that quality. In addition to that... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1969286 Tue, 18 Nov 2008 14:45:00 +0100 1969286 http://www.medworm.com/index.php?rid=1939660&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F11%2Fnature-is-so-wrong.html Nils over at SciPhu has decided to stop posting about DTC and his stance. Why would such a great scientist/blogger decide enough is enough? Nature made him do it...Huh? Yes Nature and its eloquent arguments about personal genomics......From Nils"I have voiced opinions on this too, but have decided to desist more arguing (for a while) after reading this editorial in Nature biotechnology"I am going to deconstruct the arguments in Nature right Now!1. We need to move from late to early diagnosisIt is virtually impossible to conceive of a sustainable form of healthcare that operates as the current systems in industrialized nations do. At present, healthcare is based on the late diagnosis of disease and the division of diseases into a few categories based on some overarching gross similarities. ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1939660 Thu, 06 Nov 2008 15:32:00 +0100 1939660 http://www.medworm.com/index.php?rid=1921188&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F10%2Fin-new-england-journal-again-crp.html Trick or Treat..... That's Russ Altman, Disguised as a Wolf-Man!!!First the Treat!Ok, so I hate to say it, but I am firmly convinced that the New England Journal of Medicine has been taken over by geneticists!!! I jump for glee as I open a new edition and see genetics plastered all over it.....just like the week before......and the week before that! It is true....medicine will soon be a small sub specialty of genetics!!!!!! At least if the NEJM has their way with it!Now for the TrickBut then I stop....pinch myself and ask "Now which company will rush to market with these findings???"""The biggest danger to Personalized Medicine is not the lack of physician understanding. Nor is it the lack of good reimbursement systems. Nor is it the lack of education in medical school. Nor is it the lack ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1921188 Fri, 31 Oct 2008 11:25:00 +0100 1921188 http://www.medworm.com/index.php?rid=1856401&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F10%2Fsherpas-plan-criminal-acts-for-200.html There is a storm coming. The way clinical genetics services are delivered in academic centers needs to change. Trying to make money through incident services could costs counselors and genetics departments everywhere. Billing through an extender leverages the already busy clinician and helps us see many patients.When a physician needs to bill for an extender they pick an NP or a PA. If they pick a CGC and never see the patient, bill for a clinical consult, and have someone forge their name, then they could be in a little bit of trouble. Especially with Medicare.....Yet that is precisely what is happening in a majority of medical centers in the country. In my unscientific poll, 15 of the top 30 institutions who host cancer genetics clinics are doing this exact thing. I won't point fingers a... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1856401 Tue, 07 Oct 2008 10:15:00 +0100 1856401 http://www.medworm.com/index.php?rid=1791727&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F09%2Fdemocratization-or-capitalization-take.html An old post.......interesting that I seemed to be right on track....In reading through my RSS feeder over a year ago now I stumbled across an interesting video at Testing Hiatus. It comes from the website Master Plan the Movie. This is especially timely given the new shiny 399 USD SNP scan.....which BTW is still more expensive than Coriell's Free Scan!Before you watch this YouTube video I first would like you to take a gander at an excerpt from "The Google Story"Sergey Brin and Larry Page have ambitious long-term plans for Google's expansion into the fields of biology and genetics through the fusion of science, medicine, and technology. . . .One of the most exciting Google projects involves biological and genetic research that could foster important medical and scientific breakthroughs. Th... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1791727 Mon, 15 Sep 2008 08:48:00 +0100 1791727 http://www.medworm.com/index.php?rid=1782864&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F09%2Flot-to-chew-and-then-spit.html As my friends and I work furiously to get the Sherpa's Plan to public(BTW it will be released in parts, and no I didn't spend a T.Boone Pickens like 1.2 billion dollars on it.) , some things have happened in the blogosphere. Let's recap.Last month I receive an emailer about price point from Navigenics. My friends who took the test did too.This had me wondering......what is the market for a test? I delved back into my business plan from 2005. You know...the one where I actually created 23andMe but called it HelixHealthcare. I looked at the stats on who would pay what for a test and it hit me.......they're gonna drop their price and service. And switch to a full subscription model. BTW, in my old model the feds don't get us, but the customers do b/c they aren't trusting what we are doing wit... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1782864 Thu, 11 Sep 2008 11:39:00 +0100 1782864 http://www.medworm.com/index.php?rid=1720543&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F08%2Fcalifornia-ok-with-snp-chip-testing.html In the New York Times today it appears, California has been satisfied by 2 of the big 3 DTC SNP Chip testing companies. From the article: Two closely watched companies that offer consumers information about their genes have received licenses that will allow them to continue to do business in California, a state official said Tuesday. The licenses, granted to Navigenics and 23andMe, should help defuse a controversy that began in June when the California Department of Public Health sent “cease and desist” letters to the two companies and 11 others that offer genetic testing directly to consumers. I don't think Andrew spoke to the geneticists I work with. I don't think a state license will ever defuse this powder-keg. But I do congratulate both companies on working within the state regula... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1720543 Wed, 20 Aug 2008 15:11:00 +0100 1720543 http://www.medworm.com/index.php?rid=1551851&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fabc-misinformation-and-government.html I have to comment on something. ABC news tonight covered the whole drama in California.....But they really didn't. In fact they gave 20 seconds (approx) to the fact that the government was finally regulating this industry....they did even manage to squeeze in that the FTC is investigating deceptive advertising. What the piece really was.......A human interest story....much like the excellent work done by Amy Harmon at the NYT....Which reminds me....did anyone see Kathy Hudson throw the Federal Gov't under the bus???? She now really has put them on notice and put their backs slammed against the wall. So the ABC report? 52 year old woman caring for her mother with Alzheimers. The pitch "I am taking an at home test to find out what my risk for Alzhemier's" Whoa!!!!! No one....I mean no one... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1551851 Thu, 26 Jun 2008 23:59:00 +0100 1551851 http://www.medworm.com/index.php?rid=1543906&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fburrill-reportdecoded.html Consumers are worried about developing genetic based diseases, but remain reluctant to use genetic tests that will provide early warning signs.That is the lead statement in the executive summary from the Burrill and Company Personalized Medicine and Wellness report issued last week. Many may ask "What's this report have to do with me?" many have even doubted the validity of the report in favor of the blogosphere......In the arena of Genomic Medicine, I would say the blogosphere is pretty one sided.....IN fact, that is why the Sherpa is popular. Until I started blogging, this place was pretty much a mutual admiration society. Further proven by the backlash I received when I said that governmental regulation was coming and then came.So let's go back to the poll.....Second LineCompanies need ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1543906 Tue, 24 Jun 2008 09:00:00 +0100 1543906 http://www.medworm.com/index.php?rid=1538277&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Flets-just-say.html I, Steven Murphy MD, am for Genomic Medicine, I am for patient empowerment, I am for the revolution known as patient centered genomic healthcare. I did not delight in the governmental actions, I did not enjoy watching the smack down. I was happy with the fact that my estimates were right. I was happy that the Sherpa "called this one". I was also happy that the public may now begin to start trusting these tests. But don't ever say I was happy about governmental regulations.......I am not for any added regs. It just doesn't make any sense to add what is already there. Unless you are talking about enhanced protection from discrimination.I did some thinking over the weekend and even watched the Sunday Morning Shows including CBS. They put together a nice review of the changing face in West Tex... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1538277 Mon, 23 Jun 2008 11:10:00 +0100 1538277 http://www.medworm.com/index.php?rid=1535926&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fdaniel-is-great-guy.html I wanted to post quickly today on a this whole turf topic again. I thank Daniel over at Genetic-Future (Pound for pound the best new blog in this arena). It took some discourse to figure it out.What happens normally with genetic testing?Traditionally a lab scientist, being PhD or MD runs the lab and when results are in writes a report that is to be delivered to......Guess who? A physician. That physician or genetic counselor working with the physician interprets the report clinically at the interface of the patient.......presenting the patient the results and the clinical implications. (This is the part that laboratory scientists often never see)Eureka! I have finally figured out this whole play!!!! Why is the state cracking down? When these DTC companies, Genetic, SNP, or not deliver resu... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1535926 Sat, 21 Jun 2008 18:39:00 +0100 1535926 http://www.medworm.com/index.php?rid=1531668&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fdna-traits-among-13.html I just finished emailing David Ewing Duncan (Who has a great new blog) about the frustration I have. You see, everyone is saying....these SNP tests are information/data, not really medicine. But I reminded him that there were 11 others named and letter sent. It turns out our friends at Wired show that a DTC genetic testing company was named. The cease and desist letter is clear enough.So what is DNA Traits?From the siteDNATraits was founded on one simple idea: if science can tell us whether we carry inheritable disorders, we have the right to know, for our own health and for the future of our families.With years of experience in genotyping for large corporations and delivery of DNA-related information to hundreds of thousands of customers, a group of scientists and entrepreneurs formed DNA... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1531668 Thu, 19 Jun 2008 23:24:00 +0100 1531668 http://www.medworm.com/index.php?rid=1526761&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fruh-roh-shaggy.html You know. I have been racking my brain why all of these "early adopters" kicking me on this blog have such an aversion to going to see a doctor. They claim that they want information, but I ask "How many of you know your cholesterol? How about your Systolic Blood Pressure? What about your family history of Heart Disease? What the hell is wrong with all of you. Those who say....."The government can't keep us away from our knowledge or data!" I challenge you to this.Tell me you had a physical last year, tell me you know your LDL, tell me you know your family history. Then and ONLY then will I listen to your argument against regulation of knowledge. These bits of information will be much more prognostic of your health than a 1 million SNP scan.That being said, these 13 companies are not just ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1526761 Wed, 18 Jun 2008 02:25:00 +0100 1526761 http://www.medworm.com/index.php?rid=1522430&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fstreets-of-philadelphia.html I want to point all of you to a comment on my blog. This is in regards to my post yesterday. I was accused of responding arrogantly. I don't think it is arrogance....I am just shocked and awed that some in the public think that they can do this on their own without professional help. Do you build your own home? What about fight your own court cases? Some do their own taxes...but only when it isn't complicated. Trust me, this IS COMPLICATED! Now on to the comments.well, I am a geneticist (though not a human one) so I guess that makes me not a typical customer but I can only say that my experience talking genetics with MDs has been appalling. I agree. Most physicians can make a hash of it. This does not mean that they do not understand the medical risk of those genes, just the mechanisms. I ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1522430 Mon, 16 Jun 2008 11:00:00 +0100 1522430 http://www.medworm.com/index.php?rid=1522431&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fdo-you-hear-that-sound-mr-anderson.html In an obvious move California has taken their stance. This was the sound of inevitability. I find it funny that the same journalist hyping these tests 1 year ago is now reporting on how California has sent cease and desist letters to the genome firms. This week, the state health department sent cease-and-desist letters to 13 such firms, ordering them to immediately stop offering genetic tests to state residents.As I sat near Dietrich Stephan, Joanna Mountain of 23 and Me, Ryan Phelan and the number 2 from deCode it was evident on their faces. I knew they had received the letters (Well maybe not Ryan, she was ebullient)*. Their faces showed what I already knew to be true. Medical Genetic testing will and should fall in the realm of healthcare and practitioners. * It turns out Ryan Didn't ge... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1522431 Mon, 16 Jun 2008 05:13:00 +0100 1522431 http://www.medworm.com/index.php?rid=1512321&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fsherpa-hits-san-francisco.html Imagine rounding up everyone that is influential in the Genome Sequencing world on the science side, then add a healthy set of journalists, mix in a group of Venture Capitalists and put the leaders in corporate industry at a table to answer their questions. Including, the Sherpa!!!This was a whirlwind tour, where I managed to meet with some pretty influential people in silicon valley. I introduced them to Helix Health and our plans for the future of Genomic Medicine. They introduced me to some people looking to make that happen.Also I was involved in discussion and gave a talk to the group at Beyond Genome Conference, hosted by CHI. I also was asked to advise CHI on a novel educational initiative for them. I am honored. In addition I was able to meet with a good friend of mine and begin to... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1512321 Thu, 12 Jun 2008 15:43:00 +0100 1512321 http://www.medworm.com/index.php?rid=1502734&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2Fnewborn-screening-for-alzheimers.html Don't Forget that Gene Genie is up at Neurophilosophy so check it out!I want to thank the Connecticut Geriatric Socitey for inviting me to speak at their wonderful group's Annual Meeting. It was a lively time and the Salmon was excellent. At the end of the lecture we had a lively debate with several clinicians. Family history is king when it comes to Alzheimer's Disease. APOE e4 testing is not super worthwhile, unless you identify ApoE e4 in an affected and then work the family up that way. But the 3 gene panel for Early Onset Alzhemier's is definitely a must. Provided the 3 tenets of Informed Consent are met.What are those 3?1. A plan of action for results. "What would you do if you had a positive or negative or uncertain test result?2. Are you Psychologically prepared to handle the resul... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1502734 Mon, 09 Jun 2008 11:30:00 +0100 1502734 http://www.medworm.com/index.php?rid=1492318&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F06%2F14-years-and-still-no-good-genes.html I am preparing a talk for the Connecticut Geriatric Society and I am just can't get over it. We haven't found good genes for Late Onset Alzheimer's Disease since 1994. Sure we have SORL1, GALP and MAPT from the sexy Genome Wide Studies....but nothing increases risk like APOE Epsilon4.In fact when you look at all the other genetic risks, NONE top an Odds Ratio of 1.5. Why do a I always harp on Odds Ratios? It's simple. If you can't beat the family history risk increase (300-500%) for a first generation relative, then you can't have much clinical significance, unless you have a multiple gene panel that does.Why is clinical utility so important? Why not just test everyone with everything. I see several problems with this.1. False Reassurances, patients are led to believe they won't get some d... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1492318 Wed, 04 Jun 2008 12:58:00 +0100 1492318 http://www.medworm.com/index.php?rid=1472689&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2Fgenetic-susceptibility-to-cancer.html I love the pen. It has the ability to befuddle, convince, coerce, and give false or true hope. This is the case with journal articles. I am always amazed by what is reported and what is real. You see, the Buddhists will tell you that all reality is merely false. Why? Because perception is what we view to be reality. Since reality needs to be constant, yet perception not only changes but is viewer dependant....it is not constant. Hence, there is no spoon.This is the case with a recent article published in JAMA's clinician's corner. The article entitled "Genetic Susceptibility to Cancer" did something wonderful. It took 161 meta and pooled analyses encompassing 18 cancer sites and 99 genes/344 variants (Trust me, this took some heavy lifting) and evaluated for Odds Ratios and evaluated stati... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1472689 Wed, 28 May 2008 14:10:00 +0100 1472689 http://www.medworm.com/index.php?rid=1470034&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2Fcarrier-state-is-disease-state-pre.html This study actually paired cancer-free siblings with their α1ATD carrier brethern. Guess what? 2 fold increased risk of lung cancer. In CARRIERS!!!!This serves as a modest control for environment and some modicum of epigenetic regulations.So what we are saying is, that a previously "benign" carrier state...Is not so Benign! This is the same with CF carriers, Sickle Cell carriers, I could go on and on. Ladies and Gentleman, I submit to you Exhibit C. Further proof that Mendel has been screwing up genetics and medicine for over a century. We must be careful in how we consult and counsel patients.The Sherpa Says:I have been called a blasphemer. But I do maintain, teaching Mendelian Genetics is a disservice to the medical community and to our undergraduate communities. It leads to be rigid in... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1470034 Tue, 27 May 2008 14:33:00 +0100 1470034 http://www.medworm.com/index.php?rid=1467131&cid=t_157250_107_f&fid=36585&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHighlightHEALTH%2F%7E3%2F297549151%2F Conclusion That concludes the 32nd edition of Gene Genie. My thanks to everyone who submitted an article. You can find more information about the carnival as well as the hosting schedule and past editions at the Gene Genie Website. The next edition will be hosted at Neurophilosophy on June 8th. References Google Backs Harvard Scientist’s 100,000-Genome Quest (Update2). Bloomberg.com 2008 Feb 29. Pearson H. Genetics: what is a gene? Nature. 2006 May 25;441(7092):398-401. View abstract Gotlib et al. HPA axis reactivity: a mechanism underlying the associations among 5-HTTLPR, stress, and depression. Biol Psychiatry. 2008 May 1;63(9):847-51. Epub 2007 Nov 19. View abstract McGowan et al. Promoter-wide hypermethylation of the ribosomal RNA gene promoter in the suicide brain. PLoS ... Highlight HEALTH blogs http://www.medworm.com/rss/comments.php?id=1467131 Sun, 25 May 2008 04:01:35 +0100 1467131 http://www.medworm.com/index.php?rid=1458850&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2Fthank-to-all.html Once again, I would like to thank everyone who has surrounded me and helped me launch this new webcast service. Including the wonderful DNA Network! We are committed to doing monthly series for both public and physicians. I really am excited to have this fantastic list of speakers on board. I am absolutely convinced of the educational potential these webcasts can bring to everyone. In fact, as I actively work on building the next big thing in medical care and genomic medicine, I am creating a novel delivery system for genomic education. Sir William Osler always said to let the patient do the teaching...This is precisely the case with Jessica Queller. No one knows the difficulty of the decisions faced by BRCA carriers better than her.That being said, even with such powerful genetic risk as ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1458850 Tue, 20 May 2008 23:09:00 +0100 1458850 http://www.medworm.com/index.php?rid=1451970&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2Fbrca-webcast-sherpas-repost.html I vowed I would never post when family took precedence. I have to break that vow again today. I wish I didn't but there is something so vitally important that I must share with you. Why is this important? Because it might save more lives than have been previously lost. The scourge of Ovarian and Breast cancer has ravaged several populations. With very few cases of early detection in Ovarian cancer, many women present with spread of the cancer and very poor prognosis. Even more importantly, women who have ovarian cancer and BRCA mutations still are at risk for other cancers including breast cancer. Despite this I have heard comments from Oncologists like "Why do we need testing?" This is why I have pulled myself away from my grief stricken family. To fight this lack of knowledge I have dedi... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1451970 Mon, 19 May 2008 13:51:00 +0100 1451970 http://www.medworm.com/index.php?rid=1434598&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2Fworkmans-compensation-stereotypes-and.html Have you ever had back pain? Almost everyone has. Who has sciatica?Sciatica a very common condition accounts for a significant amount of lost work days, medical costs and psychologic stress. Treatment failures are not uncommon, are often related to posttraumatic or work-related injuries, and may result in litigation. Although most people experience back pain during their lifetime, only a fraction experience lumbar radiculopathy or sciatica as a consequence of root compression or irritation. Almost 5% of males and 2.5% of females experience sciatica at some time in their lifetime. It is so costly to society and common that in Sweden they did a cost-benefit analysis and found the surgery to be cost effective. Although studies casting doubt on its effectiveness are now in the mainstream.Becau... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1434598 Sun, 11 May 2008 01:01:00 +0100 1434598 http://www.medworm.com/index.php?rid=1432784&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2F276-pages-of-pure-reality.html Have you read it? Come on.....You didn't. Well, you are missing out. Back in 2004 I started watching the Secretary's Advisory Committee on Health, Genetics and Society. But even more importantly I began watching back meetings that were webcast, including the SACGT. I studied the players in the field, the advisors, the government. I began to notice trends and agendas. This is why I saw all of the regulations coming. I began emailing members, speaking with advisors, and learning how and when all of the issues would arise and then be solved. Then in 2005 I began to develop the business plan for Helix Health. The safest climb to the summit is with trained genetics professionals like the ones we have. The riskiest is D-I-Y. The SACGHS is against D-I-Y...notably this 276 page report goes into th... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1432784 Thu, 08 May 2008 19:19:00 +0100 1432784 http://www.medworm.com/index.php?rid=1413591&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F05%2Fwhy-i-love-genome-technology-online.html I hope everyone who reads this will subscribe to Genome Technology Online (This is not a paid advertisement this is my opinion).Why? If you are asking this, it is likely because you have never received the email newsletter. I am always impressed by their ability to capture the essence of what is going on in the Genome World Daily. They have excellent reports for purchase as well. But frankly, just getting the email everyday makes my heart twitter (I can't get sued for using that word can I?)Today they poke fun at Corporate Genomics and make mention of 2 very well written articles. One over at the Wall Street Journal. Yesterday I took Marilyn Chase to task. Marilyn, please don't get mad. Just give me a call next time you are writing about genome studies. And another story at Portfolio. The ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1413591 Thu, 01 May 2008 19:07:00 +0100 1413591 http://www.medworm.com/index.php?rid=1409898&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fnew-brca-and-subsegments-of-segment.html First and Foremost,To all women who have hereditary patterns of Breast Cancer, but have a negative BRCA work up....there is new information which deCode has released in Nature Genetics. I was very excited about this and look forward to some significant replications.From a recent MarketWatch report Common variants previously discovered by deCODE on chromosomes 2q35 and 16q12 are together involved in an estimated 25% of ER+ breast cancers. The analysis in today's paper also reveals that a fourth known set of variants, located on chromosome 10q26 and accounting for approximately 16% of breast cancers, appear to confer risk exclusively of ER+ tumors. deCODE is applying these variants as the basis for a DNA-based reference laboratory risk-assessment test the company plans to launch in the comin... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1409898 Wed, 30 Apr 2008 17:45:00 +0100 1409898 http://www.medworm.com/index.php?rid=1400744&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fhappy-dna-day.html Lots of great posts on this DNA Day. First, I would like to tell Misha at GenomeBoy....Doubting Thomas was eventually one of the greatest supporters.... This is in response to my post yesterday. I think he might have called me Sherpa Buzzkill if he wasn't my friend.I love that guy....seriously. Here's a man who has the paper and is a hell of a writer. Now he throws caution to the wind and signs up for the PGP. You gotta admire the courage. Pre-GINA mind you! But after the clarification of my exaggeration of the PGP informed consent profile, I thought it would be good to clarify the policy of the Delaware Valley Personalized Medicine Project. For full disclosure, I sit on the ICOB where we will meet and determine whether a SNP is medically actionable. The first meeting is in June.The view f... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1400744 Fri, 25 Apr 2008 20:24:00 +0100 1400744 http://www.medworm.com/index.php?rid=1378045&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Ftoo-good-to-miss.html Ok....so I have been reading Hsien's discussions about DTC testing good or evil?This spirited debate is very important. Everyone has concerns about regulations. It is the reason why 23andMe jumped the non-clia certified lab ship (And probably Why Andrew's results were delayed) But it is also why LabCorp has now locked out all other corporate genomic companies for now....This debate is going to boil down simply to this...I posted yesterday and maintain this position"Predisposition is Pre-Disease". This is the case with BRCA testing, it is the case with some robust SNPs. The ICD10 codes will catch up with this....If it is not the case (i.e. for entertainment purposes only, NO HEALTH IMPLICATIONS) then they don't need medical regulation.So I ask, are the SNPs which are being tested for and re... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1378045 Thu, 17 Apr 2008 00:34:00 +0100 1378045 http://www.medworm.com/index.php?rid=1373796&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fgenetic-over-regulation-simple-answer.html Why all the worry over regulations?I was washing the dishes this morning when it finally hit me. With all of this concern coming from Washington D.C. and all the entrepreneurs (like myself) pushing something to market for "brand recognition" i.e. the Mayo or Coca Cola....face it....there is a Branding Element. Well, while we are now moving through MBA or MD 101 what hit was the answer....You may be asking yourself "What is the question?" But I am here to tell you that the question doesn't matter as much as the answer does. But if you must know....the question is "What is disease?" We have all these people talking about the wellness industry, but we have to be serious with ourselves. There are a whole lot of well people walking around with LDL's that are over 160 (BTW that is pretty high). ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1373796 Tue, 15 Apr 2008 12:34:00 +0100 1373796 http://www.medworm.com/index.php?rid=1369152&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fupcoming-journals.html It is important for all of us to contribute to the literature and assure the success of new and upcoming journals. I want to point you in the direction of 2 of these journals published by Future Medicine in London.I mention this because I just finished my manuscript for The Journal entitled Personalized Medicine. This is an excellent journal with a tremendous potential. I recently published here and intend to send a significant amount of my work its way. But what is most important about these journals, Pharmacogenomics and Personalized Medicine, is that they are giving an opportunity for younger scientists, physicians and stake holders a voice. This is important especially because as we interview with reporters, there is no guarantees that it will end up in their article. BTW Anna, I loved... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1369152 Sun, 13 Apr 2008 11:56:00 +0100 1369152 http://www.medworm.com/index.php?rid=1363845&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fback-to-basics.html I used to play football and had a coach who said "If you block and tackle better than anyone, then you will win championships"I thought he was crazy. I thought you had to have super talent to win. But year after year it is clear in the NFL that teams who block and tackle better...win. You know this to be true in all sports.So here at the Gene Sherpa, I am going back to the basics. I have been getting away from that and being a little preachy and in fact turning into a tabloid...While it does generate alot of blog hits.....Searches for Navigenics has sent my hit rate rocketing on FeedBurner....I think we need to report on how we are doing in our progression to Genomic Medicine.So when I open this month's edition of Internal Medicine News "The Leading Independant Newspaper for the Internist-... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1363845 Thu, 10 Apr 2008 13:22:00 +0100 1363845 http://www.medworm.com/index.php?rid=1361139&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fnew-hope.html I just got out of a meeting with a Very Nice Angel Investor. He had some really interesting ideas that I am dying to tell you about....but I just can't.....for now.But what I can do is now tell you about how sad I am that I missed "Navigenics 2008 Opening Day" I don't know who was pitching...but from what I heard it was a success. Speaking of success, I just had another patient come to me with the magic 84 page printout. It will be interesting to see how the Mayo study comes out regarding all of these lab reports and patient comprehension. A few days ago a patient was seen by us for Pharmacogenomic analysis and he was puzzled by the laboratory reports and data. He actually thought that the boiler plate information on the bottom of the report was actually personalized. He asked "If I only h... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1361139 Wed, 09 Apr 2008 18:12:00 +0100 1361139 http://www.medworm.com/index.php?rid=1356361&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Ft-minus-21-hours.html Till Navigenics Launch.......Stay Tuned!-Stevep.s. Congrats to Amy over at....oh wait...she hasn't started a blog yet ;) But in all seriousness, congratulations. Thanks to Jonathan at Tree of Life for leaking this...... (Source: Gene Sherpas: Personalized Medicine and You) Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1356361 Tue, 08 Apr 2008 01:11:00 +0100 1356361 http://www.medworm.com/index.php?rid=1354200&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2Fdvpmp-and-me.html So today I want to ask all of you a question. Is there a conflict of interests if I participate in the Delaware Valley Personalized Medicine Project and sit on its Informed Cohort Board? I have been giving this some thought lately....This is a wonderful project with some very secure privacy measures akin to Swiss Banking. Unlike other Direct To Consumer projects this is Funded. Unlike others we will be evaluating on a rolling basis and releasing data that is reviewed by our board. I would love to participate.So I ask.....would it be a conflict if I reviewed the data AND had submitted a sample?If I paid for the 23andME or deCodeMe would I have reviewed my OWN data. You are damned right I would. So what makes this different? I would be reviewing and commenting on others' data too. The import... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1354200 Sun, 06 Apr 2008 17:50:00 +0100 1354200 http://www.medworm.com/index.php?rid=1344601&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F04%2F4-days-too-long.html As I sit here in the Sheraton New Orleans before our presentation I am re-living my days here in New Orleans....When we arrived I immediately had to go get Jambalaya.....and then diarrhea..........The next day I went to the "World Famous" Cafe DuMonde....I was filled with excitement about this exotic sounding place.....If I only would have google'd it first. When I approached the cafe from Jackson Square I saw what seemed to be perhaps a beach side cafe with a starving artist out in front of it.....I must admit when I got in the Green and White Awning open air cafe I saw a neat business model and tasted what I deem "smooshed funnel cake". It turns out at the Cafe Du Monde, the waiters take your order, pay the cashier...almost as if they are reselling the goods........meaning the Beignet! T... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1344601 Wed, 02 Apr 2008 12:42:00 +0100 1344601 http://www.medworm.com/index.php?rid=1327599&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F03%2F500-hospitals-want-to-know.html Lots of stuff happening online today. I just left a conference call where I was the invited guest panelist along with Robert Resta CGC. The Advisory Board Company and The Innovations Center presented an Issue Brief entitled-The Genetic Testing Frontier: Impact on Clinical Care, Market Opportunities. Hundreds of hospitals were online wondering how they too can get a piece of the action.....Also....did anyone read the Washington Post today? Genetic Testing Gets Personal again another article on this "revolution" non subscription link here"We call it consumer-enabled research," said Linda Avey, co-founder of 23andMe, based in Mountain View, Calif. "It's about changing the paradigm of how research is done."Well Said.......You could also call it uninformed cohort analysis...."Free Kits?" Come-O... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1327599 Tue, 25 Mar 2008 19:11:00 +0100 1327599 http://www.medworm.com/index.php?rid=1276105&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F03%2Fnew-england-journal-prostate-cancer-and.html This study Blows mere family history out of the water. This study, dubbed CAPS, evaluated Prostate Cancer in Sweden. The analysis of SNPs revealed 5 SNPs which had significant risk implicated...Here's the kicker, if a person has 4 SNPs and Family History, then your Odds Ratio for Having Prostate Cancer is.....get this 9.46 compared to the men who had none of these factors. Take That PSA and Digital Rectal Exam!Now where does this study have shortcomings?1. It is retrospective and this is subject to bias, therefore needing prospective analysis before we will use it.2. This population is a relatively homogeneous population that breeds nationally3. Only one of the SNPs has an identifiable gene. Without a gene, we can only guess what role the SNP may play let alone devise a medication or treat... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1276105 Tue, 04 Mar 2008 01:30:00 +0100 1276105 http://www.medworm.com/index.php?rid=1269671&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fhaving-breast-augmentation-get-tested.html I never thought I would be reading the Aesthetic Surgery Journal.....but when the word BRCA pops up, I have to take notice.From Medical News Today"Plastic surgeons must play a part in monitoring women who come in for cosmetic breast procedures. These patients should be assessed for potential breast cancer risk by a physical examination as well as a family history evaluation," said Foad Nahai, MD, President of ASAPS and Associate Editor of ASJ. "It is imperative that these patients understand their potential risk, if any, as well as the implications breast surgery may have on future screening, in order for them to make the best possible decision regarding their own care." I never thought I could tell the guys from Nip Tuck to do a 3 generation pedigree.....Well, Now I can. There is a proble... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1269671 Fri, 29 Feb 2008 19:05:00 +0100 1269671 http://www.medworm.com/index.php?rid=1261803&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fone-fifth-of-gdp.html What are we doing? Why isn't it working? In a recent report by the Centers for Medicare and Medicaid it turns out the US will be spending one-fifth of it's GDP on healthcare. Here is the big question.....Will we be more healthy as a result? I started this blog to demystify and inform about the field of personalized medicine (A dying term as far as I am concerned....especially because clinicians and the public do not understand it)Let's call it like it is Genomic Medicine or more affectionately Molecular Medicine. Why are we spending so much and getting so little for it? It is called the One Size Fits all model. Last night I ast at a talk given by a physician friend of mine. We were at a very nice restaurant named Valbella! and I was amazed.......the big pharma mantra keeps on being the sam... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1261803 Wed, 27 Feb 2008 16:02:00 +0100 1261803 http://www.medworm.com/index.php?rid=1252881&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Funfounded-nyt-article.html No, I am not talking about McCain. I am talking about the fear of genetic discrimination. In the NYT today there is a wonderful article discussing the genuine fear of discrimination and the lack of proof that it exists. Francis Collins even noted that this fear stands to make genomic medicine and personalized therapies "Dead on Arrival" Guess what? I think he is right. Our patients at Helix Health have some significant privacy concerns and we assure those at the highest levels of security. How can you do it any other way? Even better, the laws do protect our medical records. What is so amazing is that this article shows people going direct to testing companies like DNATraits and DNA Direct. But what I find more telling is the story of Ms. GroveMs. Grove received a DTC test for alpha 1 anti... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1252881 Sun, 24 Feb 2008 17:45:00 +0100 1252881 http://www.medworm.com/index.php?rid=1226839&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fbe-ready-ad-and-pat-sajak.html That's right I saw the Be Ready Ad in between Vanna and Pat. The Sherpa is a "Wheel Watcher" I am always amazed with people. My mother-in-law was sitting with me and she said "Should I get this test?" I said "Wha???" She said, "Will it let me skip mammograms?" I honestly was blown away by this. Especially because she is a nurse. If you are a nurse, you should be health literate. Unfortunately, she is not genetics literate. I then went to give her my counseling shtick and tell her that no one in her family has breast/ovarian cancer. "So why does that lower my risk?" she asked? This is why Ellen Matloff has her website. I am certain that this testing has identified many people not normally thought to be at risk because of limited family structure i.e. all men relatives (But they still could ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1226839 Wed, 13 Feb 2008 00:59:00 +0100 1226839 http://www.medworm.com/index.php?rid=1222422&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fpolls-closed-myriad-tallies-up-and-we.html First I would like to thank everyone who voted on this very non-scientific poll. I extended the voting over a month, thousands of visitors later, we have our results.What Personal Genomics Company is most Likely to be sued?23 and Me - 70%Navigenics - 15%DeCode - 10%Knome - 3%You may be saying "Hey That's Only 98%" I say, "exactly" That's why it's not scientific. For all who may be reading, including my daily friends from Mountain View (that's right, everday)Who exactly will be doing the suing? Maybe an Attorney General? If you are Myriad then that is the case. I prevously posted about this dangerous predicament these genomic companies could be in and the reposted last week about it.As for Myriad, expect more BRACAnalysis ads to be coming. The WSJ reports that the Myriad ad campaign in the ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1222422 Mon, 11 Feb 2008 13:52:00 +0100 1222422 http://www.medworm.com/index.php?rid=1212308&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Flos-angeles-times-calling.html I was on the phone last night with a wonderful reporter from the Los Angeles Times. We had a great conversation about genetic and genomic health care, personalized medicine, babies, breaking and entering, and phone interviews. But what I just realized was missing from the questions she asked is "What laws and regulations will apply to these new personal genomics companies?"New York State has laws on medical privacy, genetic privacy, and human subject protection, making it among the more restrictive states for the conduct of research or genetic testing.New York prohibits the conduct of “genetic tests” without the prior written informed consent of the individual. A genetic test is defined as:“…. Any laboratory test of human DNA, chromosomes, genes, or gene products to diagnose the pr... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1212308 Wed, 06 Feb 2008 00:47:00 +0100 1212308 http://www.medworm.com/index.php?rid=1208084&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fbiowindowsdo-i-smell-buy-o-uhoh.html So I was looking at the scrolling news on the right side (left side for the MDs) of my blog. Yes, I do review some of the stuff on my blog. I found this interesting company that I was perplexed by. It is called Iris BioTechnologies. They have a "magical" product called BioWindows. I say magical because obviously they have not disclosed who in the hell they came up with their technology. They are going to beta this month and launch in the late spring. What is BioWindows? From the site:BioWindows is a very sophisticated artificial intelligence program that analyzes the genomic information from our nano-biochips. Comparing this information with a central repository of genomic profiles, patient survey profiles and reference data provides appropriate treatment scenarios for a variety of patholo... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1208084 Tue, 05 Feb 2008 13:43:00 +0100 1208084 http://www.medworm.com/index.php?rid=1200751&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fgenome-boy-friday-scienceroll-hits-yale.html After listening to a great lecture by Berci this afternoon I got so amp'd that I decided to submit my rebuttal to the Nature Genetics editorial. At the same time I was doing that I read an email from a good friend of mine Dr Colby.He tells me about a little known company called Psynomics.From the site:"Our first two products:Psynome™ – tests for two mutations of the GRK3 gene that are associated with bipolar disorder.Psynome2™ –tests for gene mutations in the Promoter L allele gene that predicts patient response to serotonin-based drugs, the most commonly prescribed drug therapies in psychiatry today. These tests are useful to your doctor in making a timely and accurate diagnosis of your condition and prescribing the right medication. The tests can be ordered individually or combin... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1200751 Mon, 04 Feb 2008 20:05:00 +0100 1200751 http://www.medworm.com/index.php?rid=1198081&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F02%2Fof-slelling-and-men.html Way back in 2004 I was bouncing off the ideas of Helix Health. My ex-partner and I even spoke of how great it would be to have datasets with genomes, biomarkers, physical exam and medical history data. We posited how great it would be to sell these datasets to pharma.....We even thought about creating a CRO to carry out the genetic integration of pharma testing creating PGx specialized research.I only mention this because I got a little blasted for tying 23andME with Tuskegee. Well, not really blasting, just a blog post from a really great new blog called Genetic Future.First, we said "Is this a viable business model?" The answer, a resounding yesSecond we said "Will patients be ok with us giving their data to Pharma companies?" The answer, maybe...but only if they received something back.... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1198081 Sun, 03 Feb 2008 14:51:00 +0100 1198081 http://www.medworm.com/index.php?rid=1159581&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2008%2F01%2Fdont-be-evil-devil-to-ben.html An old post.......interesting that I seemed to be right on track....In reading through my RSS feeder I stumbled across an interesting video at Testing Hiatus. It comes from the website Master Plan the Movie. Before you watch this YouTube video I first would like you to take a gander at an excerpt from "The Google Story"Sergey Brin and Larry Page have ambitious long-term plans for Google's expansion into the fields of biology and genetics through the fusion of science, medicine, and technology. . . .One of the most exciting Google projects involves biological and genetic research that could foster important medical and scientific breakthroughs. Through this effort, Google may help accelerate the era of personalized medicine, in which understanding an individual's precise genetic makeup can ... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1159581 Fri, 18 Jan 2008 03:16:00 +0100 1159581 http://www.medworm.com/index.php?rid=1113492&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F12%2Fblog-post.html The Sherpa Says: Thanks to Megan for publishing this to the web. I am certainly interested in the medical aspects of these companies. Being pragmatic is different than being skeptical. I am both. Thanks to my other pragmatic skeptic Dr. Colby for pointing this video out for me. (Source: Gene Sherpas: Personalized Medicine and You) Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1113492 Sat, 22 Dec 2007 15:06:00 +0100 1113492 http://www.medworm.com/index.php?rid=1080505&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F12%2Fgenetics-depression-and-pgx.html In case you have missed it. There will be an excellent talk given at the National Press Club in D.C. I will be sending members of my team to these lectures on the broad policy issues emerging from growing understanding of the genetic basis of depression and other mental conditions, the ability to detect genes responsible for these conditions and offer therapy based on genetic tests, and the policy questions raised more generally by genetic testing for personalized medical treatment.To register for the talks check out the Genetics and Public Policy website. Which brings me to my next topic. Genelex now has a blog. For those who do not know who Genelex is.....From their website:DNA testing industry leader since 1987, we provide accurate, convenient, affordable, confidential DNA testing and t... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1080505 Sat, 08 Dec 2007 01:54:00 +0100 1080505 http://www.medworm.com/index.php?rid=1075129&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F12%2Fdelaware-reducing-gap.html As I had talked about in prior posts Coriell has now officially launched the Delaware Personalized Medicine Project. For all of those genome seekers out there, I suggest that you check out this project. Who is Coriell? Well in case you have never heard of the HapMap before today....The Coriell Institute for Medical Research is an internationally known not-for-profit, basic biomedical research institution. The Institute's founder, Lewis L. Coriell, M.D., Ph.D., played a major role in bringing the Salk polio vaccine to the public by using cell cultures to study human viral diseases. The Coriell Institute was founded in 1953.I initially had contact with the people from Coriell in 2005 at ASHG. This is an amazing group of dedicated individuals who are always carrying genetics forward. The Repo... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1075129 Thu, 06 Dec 2007 00:53:00 +0100 1075129 http://www.medworm.com/index.php?rid=1067895&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F12%2Fwe-need-me-samples.html Genetic Research is a hard business. You have to fight and IRB to get your I's Dotted and Your T's crossed. You have to write and write and write grants to get funding for your ideas. You have to manage the project and work to keep everything on track. But what will the rate limiting step be in genomic research?Perhaps it is the lack of samples?From Medical News Today, an exciting announcement regarding Lupus. Lupus is a terrible disease where the immune system attacks the body's DNA. It can cause horrible things including, stroke, skin disease, kidney disease, brain inflammation. In fact a whole host of persons who have this disease are unable to function in society.A new finding includes the discovery (Not Validation) of a gene implicated in Lupus' pathogenesis (disease cause) OX40L. The... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1067895 Mon, 03 Dec 2007 20:16:00 +0100 1067895 http://www.medworm.com/index.php?rid=1061209&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F11%2Flittle-knome-fact.html Well, after fighting to keep the name Helix Health. I have realized that just because you have a catchy name does not mean someone else doesn't have it too.Thus is the case with Knome. I could ramble on about how whole genome sequencing is superior to the limited SNP analyses currently available. This superiority is very important for personalized medicine, but not quite important for a cocktail party. I could have posted some of the press release, but Hsien, Berci and the rest of the DNANetwork do a great job of covering this sort-of new entry to corporate genomics. Instead, I wanted to focus on the fact that another Knome exists. In fact several Knomes exist. Some even have vice-presidents. Well it turns out Knome has been around a little while before this. In fact a company called Cambr... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1061209 Fri, 30 Nov 2007 01:49:00 +0100 1061209 http://www.medworm.com/index.php?rid=1037059&cid=t_157250_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F11%2Fstaying-positive.html I was showered with a host of emails from my readers today. The GTO highlight, The Issue feature, Scienceroll's commentary all the readers had to say one thing. Sherpa, take it easy. You beat up on DNADirect and their questionable questionnaires, You picked on Forbes giving hype to deCODE, You pointed out that Navigenics had some sketchy ethics, Slammed Salugen, Attacked Myriad, and Now little 'ol 23 and Me. Did you have to sink this low?Sink this low?Wow! Ok, so I have been known to blow my top a time or 2. Can you blame me? Have I stated any incorrect facts? Maybe some, which I have quickly amended. Including the fact that DNADirect does not "mark up" test costs. Even though I am still unsure of how a company who sells tests at cost and charges 75 USD for phone consultation (even less th... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=1037059 Mon, 19 Nov 2007 23:53:00 +0100 1037059