Michael Joyner, MD, a physiologist and anesthesiologist at Rochester, Minn.-based Mayo Clinic, voiced skepticism regarding his colleagues' enthusiasm for precision medicine in a recent NPR report.
Here are three insights into why Dr. Joyner is questioning the growing trend.
1. Dr. Joyner, who runs a physiology lab focused on exercise at Mayo Clinic, told NPR that while DNA sequencing may help inform a few select medical treatments, the most widespread health problems — such as obesity, heart disease and diabetes — are best addressed by considering the whole patient rather than targeting individual biological pathways.
2. Dr. Joyner cited evidence concerning the importance that lifestyle choices, such as exercise, play in patient health, often surpassing the role of genetics. He said real-world studies of ordinary patients — rather than athletes — suggest walking and biking have a roughly five-fold influence on a person's body mass index as compared to their genetic profile.
When considering athletes, he told NPR, "People have looked at 3,000 elite endurance athletes — these are people who compete in the Tour de France and win Olympic medals in cross-country skiing and distance running — and [scientists] have been unable to find any genetic marker for superior performance."
3. Dr. Joyner is also concerned by recent studies that did not identify clinical benefits of precision medicine. NPR cited a 2015 study in The Lancet Oncology that found the use of cancer treatments informed by a patient's tumor DNA profile were no more effective than treatments assigned with traditional medical judgement.
For this reason, Dr. Joyner questions whether the rush to collect large-scale databases of patient information is misguided. "Is this just going to be a biological Tower of Babel?" he said, according to NPR.