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DNA? — an exploration of 23andMe for health
PF Anderson, Emerging Technologies Informationist, Taubman Health Sciences Library, University of Michigan
November 11, 2016
My personal genomics story in 25 words or less
BEFORE
● Doctor(s): Tell me where it hurts. ● Me: EVERYWHERE. And ...● Doctor(s): How long have you hurt? ● Me: 20 years? Forever? ● Doctor(s): It’s probably in your head.
AFTER
What worked? gluten-free diet + new vitamins + exercise
<http://www.slideshare.net/perplexity/celiac-hidden-stories-invisible-disabilities>
What is personal
genomics?
What is personal genomics?
Individual vs. population <http://www.nature.com/gim/journal/v11/n8/full/gim200978a.html>
Genetics (heredity) vs genomics (functions & interactions) <http://www.who.int/genomics/geneticsVSgenomics/en/>
Image credits: <https://openclipart.org/detail/181150/shadow-of-person-standing-leg-cross-and-put-hands-in-the-pockets> | <https://openclipart.org/detail/46141/group-of-people>
Personal genomic services
List of personal genomics companies (International
Society of Genetic Genealogy: <http://isogg.org/wiki/List_of_personal_genomics_companies>
Personal genomic services logos
The “Big” (Well Known) Ones
And then there’s UM’s “Genes for Good” (FREE!)
● “Genes for Good is a research study conducted at the University of Michigan.
● The major goal of the study is to engage tens of thousands of individuals in genetic research.
● The primary tool to accomplish this is the Genes for Good Facebook App.”
<https://genesforgood.sph.umich.edu/> | <https://genesforgood.sph.umich.edu/facebook_app>
How does personal
genomics work?
Basics: what you do, what you get
What personal genomics CAN’T
do
“*Our tests can be used to determine carrier status in adults from saliva collected using an FDA-cleared collection device (Oragene DX model
OGD.500.001), but cannot determine if you
have two copies of the genetic variant. Each test is most relevant for people of certain ethnicities.
The tests are not intended to diagnose a
disease, or tell you anything about your risk for developing a disease in the future. On their own,
carrier status tests are not intended to tell you
anything about the health of your fetus, or your newborn child’s risk of developing a particular disease later in life.” 23andMe, <https://customercare.23andme.com/hc/en-us/articles/212194308-Health-Reports-and-Ethnicity>
Why not? Personal genomics tends to “cherry pick” genes to examines throughout the entire “orchard” of the genome.
Clinical genomics take more of an “apple harvesting” comprehensive deep dive into the products of a single “tree.”
Image credits: <https://commons.wikimedia.org/wiki/File:Cherry_picking_201127_(5991855207).jpg> | <https://commons.wikimedia.org/wiki/File:Apple_Harvest_by_Camille_Pissarro.jpg>
A personal genomics analogy
Image credits: <https://commons.wikimedia.org/wiki/File:ATCG.jpg>
Our genes are like a score … They tell us what notes are intended.
Image credits: <https://commons.wikimedia.org/wiki/File:Codons_aminoacids_table.png> | <https://commons.wikimedia.org/wiki/File:Johann_Sebastian_Bach_-_BWV_Anh._117a_-_Polonaise_in_F_major.pdf>
… but they can’t tell us how good the piano is, or how recently it was tuned, …
Image credits: <https://commons.wikimedia.org/wiki/File:The_Honky_Tonk_Blues_-_geograph.org.uk_-_1625960.jpg> | <https://commons.wikimedia.org/wiki/File:Steinway_%26_Sons_concert_grand_piano,_model_D-274,_manufactured_at_Steinway%27s_factory_in_Hamburg,_Germany.png>
… or who is playing, or where, or …
Image credits: <https://commons.wikimedia.org/wiki/File:Student_of_House_of_Piano_Music_Academy.JPG> | Hans Bernhard (Schnobby): Oscar Peterson Plays Piano <https://commons.wikimedia.org/wiki/Oscar_Peterson#/media/File:Oscar_Peterson_1.JPG> | <https://commons.wikimedia.org/wiki/File:Arthur_Rubinstein_1906.jpg>
What CAN personal
genomics do?
You get clues, to take to a detective
Clues or hints to health puzzles or mysteries
Image credits: <https://commons.wikimedia.org/wiki/Sherlock_Holmes#/media/File:Basil_Rathbone_Sherlock_Holmes.jpeg> | <https://commons.wikimedia.org/wiki/File:Cluedo_Game_Board.jpeg>
Finding Your Detectives!Family Physicians: <http://familydoctor.org/familydoctor/en.html>
Genetic Counselors: <http://www.nsgc.org/>
Genetics Home Reference <https://ghr.nlm.nih.gov/>
And (with caution) patient or public forums like Patients Like Me and 23andMe, as well as disease-specific patient forums.
Are there any risks?
Image credits: <https://openclipart.org/detail/10970/prohibition1> | <https://openclipart.org/detail/10972/prohibition2> | <https://openclipart.org/detail/10974/prohibition3> | <https://openclipart.org/detail/10976/prohibition4> | <https://openclipart.org/detail/10978/fire-forbidden-sign> | <https://openclipart.org/detail/10980/prohibition6> | <https://openclipart.org/detail/10982/prohibition7> | <https://openclipart.org/detail/10984/prohibition8>
Risks of personal genomicsFinding out something you don’t want to know
Misunderstanding / misinterpreting what you find out
Other people finding out something you don’t want them to know (employers, insurance, friends, family)
Discovering relatives you don’t know about
Being discovered BY relatives you don’t know about
Genetics, a double-edged sword <https://raceandtechnology.wordpress.com/2014/12/10/genetics-a-double-edged-sword-2/>
GINA - Genetic Information Nondiscrimination Act <https://www.eeoc.gov/laws/types/genetic.cfm>
How to get started with
your 23andMe data
23andMe: Start at the homepage
23andMe: Check your health reports first
23andMe: Then, if you want more, select “TOOLS”
23andMe: Under “TOOLS,” choose “Browse Raw Data”
23andMe: You found the Raw Data … Almost
23andMe: After “Opt In”
23andMe: You may also download the data
23andMe: Options prior to download
Tools to analyze your 23andMe
data
23andMe > 23andYOU: 3rd Party Tools
<http://www.23andyou.com/3rdparty>
23andMe: 3rd Party Tools
23and You: <http://www.23andyou.com/3rdparty>
ISOGG: Autosomal DNA Tools: <http://isogg.org/wiki/Autosomal_DNA_tools>
A few of my (FREE) favorites: ● GEDmatch: <http://gedmatch.com/> ● Genetic Genie: <http://geneticgenie.org/> ● Promethease: <http://snpedia.com/index.php/Promethease> ● David Pike's DNA Comparison Utilities:
<http://www.math.mun.ca/~dapike/FF23utils/> ● Interpretome: <http://esquilax.stanford.edu/>
Not free: ● Strategene <http://go.strategene.org/genetic-analysis/>
Talking with your doctor about your
results
Image credits: <https://openclipart.org/detail/261044/doctor-holding-clipboard>
Doctors can react in different ways … OMG, it’s a real genetic test! Wow! Let’s change all your meds!
OMG, it’s a personal genomic test. Not another one! I don’t have time for this.
Image credits: <https://openclipart.org/detail/242102/surprised> | <https://openclipart.org/detail/213625/facepalm-as-gesture>
OMG, it’s a real genetic test! Wow! Let’s change all your meds!
OMG, it’s a personal genomic test. Not another one! I don’t have time for this.
Best is something
like this —>Not this —> OMG! (too much action, too little data)
Or this —> OMG! (not enough action, not enough conversation about why it’s important to you)
Hmmmm. Well, this is interesting, and while it really doesn’t tell us anything definitive yet, it does suggest some areas we might want to explore. Let’s talk more. Would you be willing to have some more tests? Or see a genetic counselor? I’m thinking of …
Image credits: <https://openclipart.org/detail/242102/surprised> | <https://openclipart.org/detail/245805/Doctors-and-nurses-and-hospital-staff> | <https://openclipart.org/detail/213625/facepalm-as-gesture>
More information &
resources ● DIYgenomics: <http://www.diygenomics.org/index.php> ● DNA.Land: <https://dna.land/> ● Genetics Home Reference (NIH):
<https://ghr.nlm.nih.gov/> ● GeneKnot: <https://geneknot.com/> ● Genomes Unzipped: <http://genomesunzipped.org/> ● Infinome: <https://www.infino.me/welcome> ● Patients Like Me: <https://www.patientslikeme.com/> ● Your Genome: <http://www.yourgenome.org/>
Next, the microbiome?