The Risks and Rewards of Genetic Information
As a researcher, UW Bothell assistant professor Chris Wade studies the intersection between genomics and everyday health care practices. “It is a really exciting time to be studying genomics because the overall goal of personalized prevention and treatment of disease is rapidly becoming a reality,” he says. “I like to point out to my students that in 2003 it cost about $3 billion to sequence a genome. Now, you can do it for $4,000, and get your results back in less than 50 hours.”
But while the technology may be at our fingertips, Wade says doctors don’t know yet how best to use it. “We have this amazing new technological capacity, but for the most part, we don’t have any idea of how to use it effectively,” he says. “Just because whole-genome sequencing can tell us information about health doesn’t mean that using it will actually benefit people.”
The possibilities however, are promising. In the realm of public health interventions, Wade says that genomics could be used to help prevent diseases before they occur. “For example, could telling someone that they are at higher genetic risk for Type 2 diabetes help motivate them to change their diet and exercise behaviors?” he says. “This remains an open question, and certainly one worth exploring.”
The main project Wade has worked on to answer these questions is the Multiplex Initiative, which was a collaboration study between the National Human Genome Research Institute, the Henry Ford Health System, and Group Health Cooperative. In the study researchers offered a genetic test to about 2,000 insured adults for eight common health conditions. “This gave us some fascinating insights into why people decided to get tested, whether people understood the information, and how they used their genetic risks in their health care.”
His current research looks at how genetic testing can influence children. “From a public health perspective, it would make sense to do testing early,” he says. “However, this would mean that many children would grow up knowing about their genetic risks.” Wade is looking for data that clarifies how children respond to this information so researchers can design testing strategies that avoid pitfalls and maximize benefits.
On campus, Wade teaches classes on genomics for nursing students. “During the class, we talk about a wide range of issues one would need to think about before implementing a new medical technology, such as the health risks and benefits, the impact on patients, and key policy issues,” he says. During the class, the students put together proposals for how they would use genomics in a public health intervention, which they present at the end of the course.
Wade says clinicians need to be thoughtful in their approach to genetic testing. “The truth is, there are historical cases where we started using genetic tests prematurely,” he says. “Unsurprisingly, it didn’t work out so well. There were major clinical mistakes; patients were often misinformed, and the delivery approach contributed to social stigmas. With a technology as powerful as whole-genome sequencing, it is really important that we get it right.”