The general practitioner and the "new genetics"

Measuring the chronology of the translational process of molecular genetic discoveries

Background

The process of technology validation and transfer of new molecular diagnostic tests towards the clinic faces challenges and needs to be improved. There is no empirical measure of the chronology and pace of technology transfer of molecular genetic discoveries.

Methods

We studied these for 29 molecular genetic test discoveries in order to (1) provide estimates of the timeframe between discovery of a clinical application and complete clinical implementation, and (2) compare the trajectories between different new tests to identify common patterns. We identified 11 publicly available “timestamps” for the technology transfer process ranging from discovery of the marker to use in a clinical setting. For each test selected, we searched public databases to identify available timestamps and dates. We plotted and compared trajectories of individual tests, including chronology.

Results

We show that there is much variability in the chronology of transfer between biomarkers. The median time between discovery of the marker and availability of the clinical test was 9.5 years (minimum 1). There was a median time of 18 years between test discovery and FDA approval (minimum 7 years), and it took a median of 17 years between discovery and the availability of a certified reference material for the 10 assays that have one (minimum 9 years).

Conclusions

We conclude that new molecular genetic tests take significant time between discovery and clinical implementation, and that further work is needed to pinpoint key factors, including policy and organization factors, that may allow for improving and streamlining this process.

Practice of personalized primary prevention of lifestyle diseases: associated problems and issues in Japan

This article explores the current situation of personalized primary prevention of lifestyle diseases based on individuals' genome information in Japan. The Japanese healthcare system and regulatory framework of genetic testing have been reviewed because they relate to the issue. From our perspective, clinics and health check-up centers in Japan are appropriate centers for implementing measures for primary prevention of lifestyle diseases. For example, we researched a predictive genetic testing program for diabetic complications and metabolic syndrome. Based on our interviews with physicians and experts, we identified the following factors that are critical to the effective use of genetic testing for primary prevention of lifestyle diseases: an institutional framework for evaluating the credibility of predictive genetic testing; psychological effects (both positive and negative) of predictive genetic testing; and education of physicians and other health professionals in lifestyle disease genetics and effective communication with patients.