The dream of transforming medical practice by measuring individualized actionable medical and lifestyle data for all common conditions from a single blood test has not been realized. Genetic approaches alone can never accomplish this promise despite the billions spent. Obstacles to accomplishing it are technical, human and economic.
Technical obstacles include poor productivity in multiplexed technologies for new biomarker discovery, poor management of false discovery in highly dimensional data and inadequate large scale biobanking of multi-year samples.
Human obstacles include a jaded view of new technologies because of failures in the past, intellectual snobbishness about the higher value of making predictions in the future over measurements of what is happening now, lack of agreement about performance standards and validation, inadequate decision support for patients and physicians and precautionary regulatory approval processes based on one test at a time.
Economic obstacles include reimbursement processes geared towards a single a-priori diagnosis rather than multi-disease screening, an intellectual property thicket which may be impenetrable to highly dimensional tests and the cost and time of discovery and validation.
Nonetheless there is a glimmer of hope; new techniques such as SomaLogic’s 850-plex proteomic assay can overcome some of these obstacles with the potential that early versions of the wellness chip could be 5 years away.
Susana Martinez-Conde // 02.09.2016
Ted Kaptchuk // 02.08.2016
Caldwell Esselstyn // 02.04.2016