The new Presidential initiative on precision medicine in the United States
The new Presidential initiative on precision medicine in the United States [1]. It is obvious to the readers of BioData Mining that this will require careful analyses of large and often complex data sets to best translate information into increasingly individualized risk. Here we ask why improved and appropriate data mining is not only positive but a vast improvement on most current analyses of EPZ004777 price genomic data. The answer lies to some extent in elucidating the present practice of -omic analyses and how we will need to expand it. Many current -omic approaches rely on univariate and linear analyses that can often miss the underlying architecture of complex traits. For example, univariate analyses of single genetic markers for association with disease risk, prognosis, or drug response that are the analytical standards for genetic analyses of human disease, and have been promoted as a means to develop personalized or more recently precision medicine, make many assumptions about architecture. Given the interest in precision medicine, it is important to ask explicitly what is being assayed in these types of studies that have been argued, incorrectly we believe, as the precursors to precision medicine. Most human geneticists study the association of genetic variants, be they common or rare, assessed across moderate to large samples of cases and controls. The effect of each allelic substitution is then measured as it associates with a particular phenotype. These estimates can provide useful population level risks; however, they are simply the average effect of an allelic substitution across the population, not necessarily predictive of results in an individual or a subgroup. The concept of average allelic effect is one that is well developed in quantitative genetics, but by its very name is suggestive not of precision medicine but of average medicine. Hence, it is possible in a large outbreeding?2015 Williams and Moore. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Williams and Moore BioData Mining (2015) 8:Page 2 ofpopulation with multiple types and levels of environmental exposure that an average odds ratio can have large variances, which are often reported as 95 confidence intervals. However, some people with a “risk allele, as defined by the population average, will not have an increased risk. At the extreme it is even possible to have opposite effects. For example, it is well recognized that increasing PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/28298493 levels of salt intake can on average result in higher blood pressure and subsequent sequelae, including end stage organ disease. But as much as 10 of some populations may have inverse salt sensitivity or an increase in blood pressure with decreasing salt intake. This illustrates that lowering salt is not a universal good [2]. On top of this there is some evidence that different genes associate with inverse salt sensitivity than those that associate with canonical salt sensitivity, making direct comparisons impossible [3]. Of course, this limitation is not unique to genetic analyses as environmental exposures are also usually dealt with.
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