NHS should use genome testing and predictive algorithms for personalised prevention – Wired.co.uk

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The NHS should embrace genomic testing for cancer patients and those with rare diseases, the UK's chief medical officer has said.

In her annual report, Dame Sally Davies, says that the ability to create personalised prevention methods is "now with us" and the health service should attempt to make the most of genomics and predictive algorithms.

"The importance of moving from a generalised top down model of health promotion to a more specific and personalised model is predicated on the reality that societal changes now pay much greater importance to individual autonomy," the annual report says.

Davies, who spoke at this year's WIRED Health conference, says health systems in the future must have a greater deal of individual autonomy.

In part, this can be achieved by genomic sequencing. The genome is the collection of a person's 20,000 genes and includes 3.2 billion letters of DNA. By sequencing the genome, it is possible to read every letter of a person's DNA and it is hoped doing so will allows clinicians to understand the origins of diseases.

The first complete human genome was sequenced in 2006 and since then the cost to do so has rapidly decreased. Genomics England, which is running a project to sequence 100,000 genomes, says sequencing now costs 1,000 to read every letter and takes two days.

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So far, proving its worth, the 100,000 genomes project has diagnosed three British men and two children with rare diseases based on their genomes. Davies says this approach should be expanded within the NHS going forward. Around 30,000 genomes have been sequenced so far.

"Personalised prevention must take place through the agency of the individual," the annual report says. "He or she is expected to change behaviour, or undergo screening, or in some other way to respond behaviourally to information".

Davies told The Guardian this approach has the potential to change the NHS and "has the potential to change medicine forever".

Davies says that rare inherited disorders should be tackled using a "combination of genomic, environmental and other biological markers". These could be inserted into a "risk prediction algorithm". When this can be achieved, it will be possible to enhance public health at a large scale, the report says.

There are obvious data protection considerations that need to be completed for the development of health tools that use a large number of people's data. A pioneering trial to create a prediction app between the NHS' Royal Free Trust and Google's DeepMind was found to have unlawfully used patient data. The test, which has since been altered, saw 1.6 million patients' data being used without proper authorisation.

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NHS should use genome testing and predictive algorithms for personalised prevention - Wired.co.uk