Today’s market leader may be rapidly replaced by another temporary leader. To be able to cover the necessary investments and improve the efficiency of the services, the chances are that larger reference centres with appropriate diversified technological platforms will be set up responsible for the high throughput analysis of thousands of samples a year. Local clinical services would then mainly serve as entry point for the patient and interpretation of his/her testing results. In fact this is somehow what the direct to consumer (DTC) services tried to set up. We should actually be grateful to the DTC companies that we were forced to review this new

approach as well as its potential impact on our services and on the

population. The questions to be answered in this regard will be: what service provision will be optimal in the future? What will www.selleckchem.com/products/r428.html be the role of the geneticists in this? How can we convince the policy makers to follow our suggestions? Should we plan an orderly introduction of these services or wait and see what happens, let market forces decide? Impressive efforts are underway to identify tissue-, organ- and individual-specific networks CHIR98014 in vitro of interacting proteins (Barabasi et al 2011). Rather than the symptom-based approach we have today, they will undoubtedly become the basis on which diseases and ‘diseasomes’ will be identified in the future. Moreover, they will allow one to measure the effect of genetic polymorphisms and of epigenetic and environmental influences on the function of these networks and give a solid scientific basis for ‘personalized (stratified groups) medicine’. In addition, they will be the basis on which new

treatments will be designed. The available knowledge about these networks can in most oxyclozanide cases not yet be used in medical practice. Also in model organisms the role of the ‘dark genome’—the non-coding part of our genome—is being successfully unraveled and opportunities to do the same for humans are becoming available (Blaxter 2010, Davidson 2010). More information—time and research—is needed before the knowledge will be applicable in the clinic, but will we be able to wait? In this regard, as stated in the report, proven clinical validity and utility of the research findings as well as the ethical, legal and societal aspects will be evaluated before their clinical application can be considered. This will require a fundamental change in the regulations about genetic/medical testing. The IVD directive of the EU is under revision. Even in its new formulation, it may not provide sufficient regulation to guarantee that all tests done in academic or private settings in the EU are done under appropriate quality criteria. Moreover, it will probably not be able to regulate tests offered over the internet.