-Steve
http://www.thegenesherpa.blogspot.com

Do you see how confusing the data is? I sure do.
The jury’s still out. At least in my mind.
-Steve
http://www.thegenesherpa.blogspot.com

The “possibility” is not strong enough to state it as fact. But luckily in this case exercise and diet is not as risky as a drug eluting stent or Vioxx……..
-Steve
http://www.thegenesherpa.blogspot.com

Barry: Actually I agree with you – I don’t want people to waste money on genetic tests that won’t help them, either. It’s all about useful testing, for the right people, through the right venue.

At DNA Direct, I strive to present detailed information about test results, risk, current research and preventive measures — BEFORE people purchase a test. As a prelude to the purchase process, there’s an interactive questionnaire the provides response about appropriateness of testing, just in case people don’t read the rest of the site. I’d love your feedback, too, on whether we’ve adequately addressed your concerns.

(To clarify “feedback” since Steve misunderstood — I’m always looking for readers reactions to our content — whether patient, health wonk, clinician, etc. What I care about is not just that we provide accurate info, but that how people READ and understand it is also accurate. All too often, medical-speak is accurate but misunderstood by laypeople, and that can be very dangerous.)

Everyone might be interested in knowing that all DNA Direct’s website and individual, Personalized Reports that testers receive undergo a minimum 3-step clinical review process: a subject matter (in this case of the deCODE test, an MD diabetes expert and physician educator), our clinical director (CGC) and our medical director (MD, PhD geneticist). In the case of deCODE, because it is a new area without medical guidelines, we also worked with deCODE’s clinical team and medical advisors to really dig into the research in addition to our own experts and advisors.

At the end of the day, I guess I fall in line with Hsien’s perspective. We all have to take responsibility. As healthcare consumers, we are agents who should make educated decisions. As healthcare providers, it’s imperative that we provide sound, ethical services. I chose to work for DNA Direct because of the diligence with which the people and company were approaching this new model of providing genetic counseling, education and testing services. (See my interview with Hsien’s for more, or DNA Direct’s Standards & Guideline for Company and Consumers)

On Hemochromatosis: DNA Direct provides counseling and testing for HFE. See here. Let me know if you don’t find the info you need Also, the Iron Disorders Institute has great resources.

Steve: regarding P values and the DPP trial (NEJM 2006), see the researchers conclusions: “Finally, we did not detect significant interactions between genotypes at either SNP and the DPP interventions. The absence of an effect may not be surprising, since these interventions succeeded primarily by improving insulin sensitivity and these variants affect insulin secretion. However, we did not observe any effect of genotype at these loci in the lifestyle-intervention group, raising the possibility that a behavioral intervention can mitigate the risk conferred by genetic background.” Looking at the graphs in the article gives a pretty strong visual for this argument. All the clinicians I’ve spoken with concur with this interpretation.