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Meyer MN, Papageorge NW, Parens E, Regenberg A, Sugarman J, Thom K. Potential corporate uses of polygenic indexes: Starting a conversation about the associated ethics and policy issues. Am J Hum Genet 2024; 111:833-840. [PMID: 38701744 PMCID: PMC11080274 DOI: 10.1016/j.ajhg.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Some commercial firms currently sell polygenic indexes (PGIs) to individual consumers, despite their relatively low predictive power. It might be tempting to assume that because the predictive power of many PGIs is so modest, other sorts of firms-such as those selling insurance and financial services-will not be interested in using PGIs for their own purposes. We argue to the contrary. We build this argument in two ways. First, we offer a very simple model, rooted in economic theory, of a profit-maximizing firm that can gain information about a single consumer's genome. We use the model to show that, depending on the specific economic environment, a firm would be willing to pay for statistically noisy PGIs, even if they allow for only a small reduction in uncertainty. Second, we describe two plausible scenarios in which these different kinds of firms could conceivably use PGIs to maximize profits. Finally, we briefly discuss some of the associated ethics and policy issues. They deserve more attention, which is unlikely to be given until it is first recognized that firms whose services affect a large swath of the public will indeed have incentives to use PGIs.
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Affiliation(s)
- Michelle N Meyer
- Department of Bioethics and Decision Sciences, Geisinger College of Health Sciences, Danville, PA, USA.
| | | | | | - Alan Regenberg
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kevin Thom
- Department of Economics, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Snowling M, Hulme C. Do we really need a new definition of dyslexia? A commentary. Ann Dyslexia 2024:10.1007/s11881-024-00305-y. [PMID: 38526759 DOI: 10.1007/s11881-024-00305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 03/27/2024]
Abstract
We provide a commentary on current debates about the definition of dyslexia. We agree with others that dyslexia is best thought of as a dimensional disorder with the best established causal risk factor being a deficit in phonological processing. Dyslexia is particularly common in children from families with a history of dyslexia and in children with preschool language difficulties. We argue that definitions may differ depending upon their purpose. Traditional discrepancy definitions may be useful for research purposes, but when considering the provision of educational services discrepancy definitions are not useful since all children with reading difficulties require reading intervention regardless of their level of IQ.
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Affiliation(s)
- Maggie Snowling
- University of Oxford and St. John's College, Oxford, England.
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Sear R, Townsend C. 'Dysgenic fertility' is an ideological, not a scientific, concept. A Comment on: 'Stability and change in male fertility patterns by cognitive ability across 32 birth cohorts' (2023), by Bratsberg & Rogeberg. Biol Lett 2023; 19:20230390. [PMID: 37909106 PMCID: PMC10618866 DOI: 10.1098/rsbl.2023.0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
Recently Bratsberg & Rogeberg (2023) presented an analysis in Biology Letters of how cognitive ability is associated with fertility in Norwegian men. Our concern relates to the theoretical framework of this paper. The analysis is framed around the concept of 'dysgenic fertility', which is treated throughout as a scientific theory, but 'dysgenic fertility' is not science, it is an ideological concept.
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Affiliation(s)
- Rebecca Sear
- Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Bland HT, Gilmore MJ, Andujar J, Martin MA, Celaya-Cobbs N, Edwards C, Gerhart M, Hooker GW, Kraft SA, Marshall DR, Orlando LA, Paul NA, Pratap S, Rosenbloom ST, Wiesner GL, Mittendorf KF. Conducting inclusive research in genetics for transgender, gender-diverse, and sex-diverse individuals: Case analyses and recommendations from a clinical genomics study. J Genet Couns 2023:10.1002/jgc4.1785. [PMID: 37667436 PMCID: PMC10909936 DOI: 10.1002/jgc4.1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/26/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
A person's phenotypic sex (i.e., endogenous expression of primary, secondary, and endocrinological sex characteristics) can impact crucial aspects of genetic assessment and resulting clinical care recommendations. In studies with genetics components, it is critical to collect phenotypic sex, information about current organ/tissue inventory and hormonal milieu, and gender identity. If researchers do not carefully construct data models, transgender, gender diverse, and sex diverse (TGSD) individuals may be given inappropriate care recommendations and/or be subjected to misgendering, inflicting medical and psychosocial harms. The recognized need for an inclusive care experience should not be limited to clinical practice but should extend to the research setting, where researchers must build an inclusive experience for TGSD participants. Here, we review three TGSD participants in the Family History and Cancer Risk Study (FOREST) to critically evaluate sex- and gender-related survey measures and associated data models in a study seeking to identify patients at risk for hereditary cancer syndromes. Furthermore, we leverage these participants' responses to sex- and gender identity-related questions in FOREST to inform needed changes to the FOREST data model and to make recommendations for TGSD-inclusive genetics research design, data models, and processes.
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Affiliation(s)
- Harris T. Bland
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Marian J. Gilmore
- Department of Translational and Applied Genomics, Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Justin Andujar
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Makenna A. Martin
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Natasha Celaya-Cobbs
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Clasherrol Edwards
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville TN
| | - Meredith Gerhart
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Gillian W. Hooker
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
- Concert Genetics, Nashville TN
| | - Stephanie A. Kraft
- Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, WA 98101
- Department of Pediatrics, Bioethics and Palliative Care, University of Washington School of Medicine, Seattle, WA
| | - Dana R. Marshall
- Department of Pathology, Anatomy and Cell Biology, Meharry Medical College, Nashville TN
| | - Lori A. Orlando
- Duke University, Center for Applied Genomics and Precision Medicine, Durham, NC
| | - Natalie A. Paul
- Rainbow Advocacy Inclusion and Networking Services, Longview, WA
- Lavender Spectrum Health, Vancouver, WA
| | - Siddharth Pratap
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville TN
| | - S. Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Georgia L. Wiesner
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
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Saylor KW, Klein WM, Calancie L, Lewis KL, Biesecker LG, Turbitt E, Roberts MC. Genetic Testing and Other Healthcare Use by Black and White Individuals in a Genomic Sequencing Study. Public Health Genomics 2023; 26:90-102. [PMID: 37544304 PMCID: PMC10614486 DOI: 10.1159/000533356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Early adopters play a critical role in the diffusion of medical innovations by spreading awareness, increasing acceptability, and driving demand. Understanding the role of race in the context of other characteristics of potential early adopters can shed light on disparities seen in the early implementation of genomic medicine. We aimed to understand the association between self-identified race and individual experience with genetic testing outside of the research context. METHODS We assessed factors associated with the odds of having ever received genetic testing prior to enrollment in a genomic sequencing study among 674 self-identified white and 407 self-identified African, African American, or Afro-Caribbean ("Black") individuals. RESULTS Controlling for individual determinants of healthcare use (demographics, personality traits, knowledge and attitudes, and health status), identifying as Black was associated with lower odds of prior genetic testing (OR = 0.43, 95% CI [0.27-0.68], p < 0.001). In contrast, self-identified race was not associated with the use of non-genetic clinical screening tests (e.g., echocardiogram, colonoscopy). Black and white individuals were similar on self-reported personality traits tied to early adoption but differed by sociodemographic and resource facilitators of early adoption. CONCLUSION Persistent racial disparities among early adopters may represent especially-entrenched disparities in access to and knowledge of genomic technologies in clinical settings.
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Affiliation(s)
- Katherine W. Saylor
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - William M.P. Klein
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Larissa Calancie
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Katie L. Lewis
- Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Leslie G. Biesecker
- Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erin Turbitt
- Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Megan C. Roberts
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
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