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Health Aff (Millwood). 2008 Nov-Dec;27(6):1600-11. doi: 10.1377/hlthaff.27.6.1600.

The evidence dilemma in genomic medicine.

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Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia, USA.


An ongoing dilemma in genomic medicine is balancing the need for scientific innovation with appropriate evidence thresholds for moving technology into practice. The current low threshold allows unsubstantiated technologies to enter into practice, with the potential to overwhelm the health system. Alternatively, establishing an excessively high threshold for evidence could slow the integration of genomics into practice and present disincentives for investing in research and development. Also, variable coverage and reimbursement policies can lead to differential access to technology, exacerbating health disparities. There is an urgent need for a collaborative process for appropriate transition of genomic discoveries from research to practice.

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