精准的感伤

IF 1.3 4区 医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
J. Reardon
{"title":"精准的感伤","authors":"J. Reardon","doi":"10.1080/14636778.2022.2115352","DOIUrl":null,"url":null,"abstract":"The papers gathered in this special issue offer us an important, empirically rich glimpse at on-the-ground efforts in the United States to realize the promise of genomics in the clinic. What they make amply clear is that two decades after the completion of the Human Genome Project, for most the benefits of the much-touted precision medicine remain – at best – uncertain. Sara Ackerman, for example, reports on a molecular oncology program at a US medical center where “[f]or most patients, genetic testing produces information that is of uncertain clinical significance and does not lead to changes in treatment.” Jennifer James and Galen Joseph detail the concerns of clinicians and investigators who worry that a genomics-informed breast cancer prediction algorithm will produce “personalized” screening recommendations that may not be the best for an individual. Kate Weatherford Darling et al. describe clinicians who gain a renewed sense of purpose from the introduction of experimental genomic testing to rural Maine at the same time that they wonder if they are building a system that will ultimately “contribute to unsustainable patterns of over-testing in healthcare.” Even when genetic data can clearly help – as Deborah Gordon and Barbara Koenig report in the case of pancreatic cancer – people are denied benefits by legal systems that prevent the flow of data to family members. Yet despite the lack of few tangible benefits, it is striking that in each of these articles we meet clinicians, investigators, patients and family members who struggle mightily in the present to make good on the promise of genomics and precision medicine. They do so within systems that work against them in fundamental ways: introducing time-consuming and soul-draining layers of bureaucracy; New Genetics and Society, 2022 Vol. 41, No. 3, 187–195, https://doi.org/10.1080/14636778.2022.2115352","PeriodicalId":54724,"journal":{"name":"New Genetics and Society","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The pathos of precision\",\"authors\":\"J. Reardon\",\"doi\":\"10.1080/14636778.2022.2115352\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The papers gathered in this special issue offer us an important, empirically rich glimpse at on-the-ground efforts in the United States to realize the promise of genomics in the clinic. What they make amply clear is that two decades after the completion of the Human Genome Project, for most the benefits of the much-touted precision medicine remain – at best – uncertain. Sara Ackerman, for example, reports on a molecular oncology program at a US medical center where “[f]or most patients, genetic testing produces information that is of uncertain clinical significance and does not lead to changes in treatment.” Jennifer James and Galen Joseph detail the concerns of clinicians and investigators who worry that a genomics-informed breast cancer prediction algorithm will produce “personalized” screening recommendations that may not be the best for an individual. Kate Weatherford Darling et al. describe clinicians who gain a renewed sense of purpose from the introduction of experimental genomic testing to rural Maine at the same time that they wonder if they are building a system that will ultimately “contribute to unsustainable patterns of over-testing in healthcare.” Even when genetic data can clearly help – as Deborah Gordon and Barbara Koenig report in the case of pancreatic cancer – people are denied benefits by legal systems that prevent the flow of data to family members. Yet despite the lack of few tangible benefits, it is striking that in each of these articles we meet clinicians, investigators, patients and family members who struggle mightily in the present to make good on the promise of genomics and precision medicine. They do so within systems that work against them in fundamental ways: introducing time-consuming and soul-draining layers of bureaucracy; New Genetics and Society, 2022 Vol. 41, No. 3, 187–195, https://doi.org/10.1080/14636778.2022.2115352\",\"PeriodicalId\":54724,\"journal\":{\"name\":\"New Genetics and Society\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2022-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"New Genetics and Society\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14636778.2022.2115352\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"BIOTECHNOLOGY & APPLIED MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"New Genetics and Society","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14636778.2022.2115352","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

本期特刊中收集的论文为我们提供了一个重要的、经验丰富的机会,让我们得以一窥美国为实现基因组学在临床中的应用所做的实际努力。他们非常清楚的是,在人类基因组计划完成二十年后,对大多数被大肆吹捧的精准医疗的好处来说,充其量是不确定的。例如,萨拉·阿克曼(Sara Ackerman)报告了美国一家医疗中心的一个分子肿瘤学项目,在该项目中,“对大多数患者来说,基因检测产生的信息没有不确定的临床意义,也不会导致治疗的改变。”Jennifer James和Galen Joseph详细描述了临床医生和研究人员的担忧,他们担心基于基因组学的乳腺癌预测算法将产生“个性化”的筛查建议,这可能不是对个人最好的。Kate Weatherford Darling等人描述了临床医生,他们从将实验性基因组检测引入缅因州农村地区获得了一种新的目标感,同时他们怀疑他们正在建立一个最终将“导致医疗保健中不可持续的过度检测模式”的系统。即使基因数据能够提供明显的帮助——正如Deborah Gordon和Barbara Koenig在胰腺癌案例中所报道的那样——人们也被阻止数据流向家庭成员的法律体系剥夺了利益。然而,尽管没有什么切实的好处,但令人惊讶的是,在每一篇文章中,我们都能看到临床医生、研究人员、患者和家属,他们目前正在努力实现基因组学和精准医学的承诺。他们是在与他们背道而驰的体制内这样做的:引入耗时且耗费灵魂的官僚机构;新遗传与社会,2022 Vol. 41, No. 3, 187-195, https://doi.org/10.1080/14636778.2022.2115352
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The pathos of precision
The papers gathered in this special issue offer us an important, empirically rich glimpse at on-the-ground efforts in the United States to realize the promise of genomics in the clinic. What they make amply clear is that two decades after the completion of the Human Genome Project, for most the benefits of the much-touted precision medicine remain – at best – uncertain. Sara Ackerman, for example, reports on a molecular oncology program at a US medical center where “[f]or most patients, genetic testing produces information that is of uncertain clinical significance and does not lead to changes in treatment.” Jennifer James and Galen Joseph detail the concerns of clinicians and investigators who worry that a genomics-informed breast cancer prediction algorithm will produce “personalized” screening recommendations that may not be the best for an individual. Kate Weatherford Darling et al. describe clinicians who gain a renewed sense of purpose from the introduction of experimental genomic testing to rural Maine at the same time that they wonder if they are building a system that will ultimately “contribute to unsustainable patterns of over-testing in healthcare.” Even when genetic data can clearly help – as Deborah Gordon and Barbara Koenig report in the case of pancreatic cancer – people are denied benefits by legal systems that prevent the flow of data to family members. Yet despite the lack of few tangible benefits, it is striking that in each of these articles we meet clinicians, investigators, patients and family members who struggle mightily in the present to make good on the promise of genomics and precision medicine. They do so within systems that work against them in fundamental ways: introducing time-consuming and soul-draining layers of bureaucracy; New Genetics and Society, 2022 Vol. 41, No. 3, 187–195, https://doi.org/10.1080/14636778.2022.2115352
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
New Genetics and Society
New Genetics and Society 生物-生物工程与应用微生物
CiteScore
4.30
自引率
16.70%
发文量
19
审稿时长
>12 weeks
期刊介绍: New Genetics and Society: Critical Studies of Contemporary Biosciences is a world-leading journal which: -Provides a focus for interdisciplinary and multi-disciplinary, leading-edge social science research on the new genetics and related biosciences; -Publishes theoretical and empirical contributions reflecting its multi-faceted development; -Provides an international platform for critical reflection and debate; -Is an invaluable research resource for the many related professions, including health, medicine and the law, wishing to keep abreast of fast changing developments in contemporary biosciences. New Genetics and Society publishes papers on the social aspects of the new genetics (widely defined), including gene editing, genomics, proteomics, epigenetics and systems biology; and the rapidly developing biosciences such as biomedical and reproductive therapies and technologies, xenotransplantation, stem cell research and neuroscience. Our focus is on developing a better understanding of the social, legal, ethical and policy aspects, including their local and global management and organisation.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信