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After FDA Objections, 23andMe Won't Offer Health Information

Posted by timothy on from the regulators-know-best dept.

sciencehabit writes "The company 23andMe will no longer provide health information to people who purchase its DNA testing kit, it announced last night.The change was 'to comply with the U.S. Food and Drug Administration's directive to discontinue new consumer access during our regulatory review process,' the statement said. While current customers will still have access to a 23andMe online database noting the health issues associated with their particular DNA, the company will not update that information, and customers who purchased its Personal Genome Service (PGS) on or after 22 November will receive only information about their ancestry and their raw genetic data without interpretation." It would be great to see a secondary market in this kind of analysis emerge.

96 of 146 comments (clear)

  1. There already is a secondary market already by PapayaSF · · Score: 4, Informative

    From snpedia.com:

    The easiest way to make a report is to visit promethease.com. This takes about 10 minutes and costs $5. [...] Promethease is a tool to build a personal DNA report based on SNPedia and a person's genotype (DNA) data. Customers of DNA testing services (23andMe, FamilyTreeDNA, Ancestry.com, Complete Genomics, ...) can use it to learn more about themselves completely independently of whichever company produced their data.

    --
    Q: What does the "B." in Benoit B. Mandelbrot stand for? A: Benoit B. Mandelbrot
    1. Re:There already is a secondary market already by jd · · Score: 1

      23&Me are very slow on updating ancestry information and weren't lightning fast on health data. Nonetheless, their data was clearly presented and had clearly stated confidence levels.

      Promethease are less well-known to me. I've used their service but I know nothing about the quality of their results, frequency of updates, reaction times when new studies are published, etc. If anyone could fill me in on that, that would be great.

      In fact, if 23&Me just moved their health system to an external website with import facility, you'd have the same configuration as with 23&Me + Promethease but with a data set that could evolve through self-reporting. Result - no change from b before, but legal because the DNA company just provides data.

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
  2. good riddance by ljw1004 · · Score: 4, Interesting

    Good.

    My family all had our genomes sequenced by 23andMe. The only area we have expertise in is Alzheimers, and (1) their Alzheimers explanations were misleading, (2) they made it REALLY hard to learn the raw data about what they found in our genomes, i.e. which SNPs they tested and what they found: instead they only boiled it down into a useless "you have 20% chance of getting Alzheimers" which was scientifically incorrect, lacked confidence levels, lacked context.

    I would love to get the raw data from their results, and I'd love to have someone better than them provide the tools to analyze & understand it.

    1. Re:good riddance by Paleolibertarian · · Score: 1

      Perhaps this is why the FDA put the kabosh on it. I am for the free market but providing misleading or wrong interpretation is not a good thing. Since they'll be providing the raw data perhaps a market for a better analysis will spring up. Hopefully in another country beyond the gentle protections of the FDA.

    2. Re:good riddance by Anonymous Coward · · Score: 1

      Uhh ... you are (and always have been) able to download the raw data from your 23andme account. Just click through to your profile, "browse raw data" and click the "DOWNLOAD" link in the upper right corner. And if you want to know the specifics about your DNA (which SNPs were tested and your results) click the "technical report" link on the Alzheimer's page: https://www.23andme.com/you/journal/alzheimers/overview/. Seems pretty clear to me.

    3. Re:good riddance by PCM2 · · Score: 5, Insightful

      Perhaps this is why the FDA put the kabosh on it

      The FDA was very clear about why they stopped it. It wasn't necessarily that the information was misleading, but that it would lead patients to make decisions about their own care without necessarily consulting a doctor, which the FDA thinks is not a good idea -- and I totally see their point, frankly.

      For example, one of the things that 23andMe can tell you is how well you might respond to one drug versus another, because of your specific genetic makeup. If you take that advice and change the dosage of your medication or switch to a different medication without discussing the issue with your doctor, you could cause yourself serious harm.

      On the far end of the scale, "false positives" for some diseases could be catastrophic -- say, if a woman was erroneously told she had a high chance of contracting a certain type of breast cancer and decided to have a double mastectomy, like Angelina Jolie had done.

      23andMe claimed that all it was doing was giving people information. But really, the way the information was structured and presented to the customer made it clear that it was designed to be diagnostically relevant and that they should use it to make decisions about how to proceed with health care. Any service that performs that function clearly falls under the jurisdiction of the FDA, IMHO.

      --
      Breakfast served all day!
    4. Re:good riddance by jd · · Score: 1

      If you looked, they would show that for each indicator, one or two SNPs were involved. These would be identified, along with the standard values and your values.

      To determine actual probability, you must multiply (not add) the probability for each indicator, remembering that not all indicators are known.

      In the case of Alzheimer's, where external chemicals (aluminium being one) are involved, the indicators mean nothing until you exceed toxic levels of the chemicals. There is nothing to trigger. 100% probability with no neurotoxin is the same as 0% with no neurotoxin. Don't blame me for poor schooling given to people.

      23&Me could have done a lot better, I don't consider it faultless, but when PEBKAC, there's nothing they can do.

      --
      It's a small world and it smells funny; I'd buy another if it wasn't for the money; Take back what I paid (SoM)
    5. Re:good riddance by E++99 · · Score: 2

      The FDA was very clear about why they stopped it. It wasn't necessarily that the information was misleading, but that it would lead patients to make decisions about their own care without necessarily consulting a doctor, which the FDA thinks is not a good idea -- and I totally see their point, frankly.

      For example, one of the things that 23andMe can tell you is how well you might respond to one drug versus another, because of your specific genetic makeup. If you take that advice and change the dosage of your medication or switch to a different medication without discussing the issue with your doctor, you could cause yourself serious harm.

      How could that possibly be within any legitimate government's domain? Using the same rational they could shut down wikipedia or rxlist. Clearly, people DO make medical decisions for themselves based on wikipedia and rxlist without talking to a doctor. The idea that some people believe it is the responsibility of the government to stop that sort of thing is terrifying to me. I should have autonomy over my own body, and the government should not stand in the way of me obtaining information for making my own rational decisions about how to exercise that autonomy.

    6. Re:good riddance by PCM2 · · Score: 3, Insightful

      How could that possibly be within any legitimate government's domain? Using the same rational they could shut down wikipedia or rxlist.

      They sure would shut down Wikipedia or RXList if those services allowed you to make an appointment to consult them for medical advice. Even campus health nurses have to be licensed.

      What Wikipedia offers now is pretty much the same thing as reading information out of a book. You can't stop people from doing that, and there's no law against it.

      What 23andMe does is market a product that you use to extract unique information about your own body, which is then presented to you in the form of suggestions about what health measures you should take -- in other words, medical advice. Very different.

      --
      Breakfast served all day!
    7. Re:good riddance by ceoyoyo · · Score: 1

      23andMe's marketing material explicitly claimed that they were giving medical advice that could help people make decisions and live longer. The FDA's letter specifically said they'd suggested some labelling changes that could bring them into compliance.

    8. Re:good riddance by E++99 · · Score: 4, Informative

      What 23andMe does is market a product that you use to extract unique information about your own body, which is then presented to you in the form of suggestions about what health measures you should take -- in other words, medical advice. Very different.

      Whoa, what? They have never been in the business of medical advice! What they did is to say, "you have genetic marker X which according to studies A and B are indicative of a 20% increased susceptibility to disease Y or and 50% increased likelihood to have an adverse reaction to drug Z." That is not medical advice! That is mere information, filtered by your genetic markers.

    9. Re:good riddance by biohazard123 · · Score: 2

      I would love to get the raw data from their results, and I'd love to have someone better than them provide the tools to analyze & understand it.

      Go to the dropdown link where your name is at top of left of the page. Click browse raw data, then click download...............

    10. Re:good riddance by tlambert · · Score: 4, Insightful

      The FDA was very clear about why they stopped it. It wasn't necessarily that the information was misleading, but that it would lead patients to make decisions about their own care without necessarily consulting a doctor, which the FDA thinks is not a good idea -- and I totally see their point, frankly.

      The FDA made them stop because doctors dislike being cut out of the loop, and insurance companies like being cut out of the loop even less than the doctors, and they would prefer to have you get the data through a disclosure mechanism which gives your insurance company better actuarial information. "Having a Dr. explain the information to the patients one on one" is just a place to hang that hat.

      For example, one of the things that 23andMe can tell you is how well you might respond to one drug versus another, because of your specific genetic makeup. If you take that advice and change the dosage of your medication or switch to a different medication without discussing the issue with your doctor, you could cause yourself serious harm.

      Yeah, in case you wondered, people can not self prescribe non-over the counter medications. So that excuse doesn't fly, either, since your doctor will be involved in writing the script for the new medication, and your insurance company will be paying for it, and like mine did, probably try to give you a cheaper generic version of a similar drug in place of the one your doctor actually wrote the script for, and then called it "equivalent". I've had that pulled on me, and been given "generic allergy medication" containing a cornstarch binder in place of the other one - when corn products were why I taking the damn stuff in the first place.

    11. Re:good riddance by Mashdar · · Score: 4, Insightful

      Does anyone else find it upsetting that the local CVS is packed with whole aisles of homeopathic "remedies" with no proven efficacy (or worse, disproven), but some company can't tell you what your genes might mean? Apparently the FDA is about protecting what goes in your eyes than what goes in you mouth?

    12. Re:good riddance by Frosty+Piss · · Score: 1

      Apparently the FDA is about protecting what goes in your eyes than what goes in you mouth?

      No, the FDA is about protecting the "rights" of doctors and insurance companies to make obscene amounts of money.

      --
      If you want news from today, you have to come back tomorrow.
    13. Re:good riddance by SchroedingersCat · · Score: 1

      FDA is fighting a fight it already lost. Just another outdated business model fighting something it struggles to embrace. Just like music industry was fighting Napster. Just like US government was fighting for encryption export controls. The information is out there. opensnp, promethease, even google. Anyone can connect the dots and they technically don't need 23andMe to do that. 23andMe makes it easier to consume that information but it is just a messenger.

      You say that "false positives" are catastrophic. I doubt that a woman would perform a double mastectomy on itself. She would get second or third opinion from doctors and surgeons. Consider the alternative for a second - what if a women never learned about this risk and died of cancer a few years later.

      Consumers will get the information they need one way or another. There is nothing FDA can do to stop it. Tests can be done offshore if needed. The beauty about genetic tests is that you only need to do it once in your lifetime.

    14. Re:good riddance by RightSaidFred99 · · Score: 1

      So let me get this straight. 23andme provided you with DNA sequencing and even provided a nice set of data (along with links to the original studies), and you're...mad that they didn't spoon feed it to you and tell you exactly what to do with it?

      You'll fit right in with the nanny state, congratulations. Fuck the FDA in this particular instance, their job is not to restrict me from information about myself.

    15. Re:good riddance by sumdumass · · Score: 1

      The FDA endorses false and misleading information all the time. For instance, look at their line on smoking in which they claim or support others making claims about the number of people with lung cancer who smoked showing you have a high risk of getting it if you do. They almost say it is a certainty that if you smoke or even be around people who smoke, you will get cancer and die. But the facts are that fewer then 10% of life long smokers will get lung cancer and to that, cancer deaths from smoking only make up 30% of all deaths from cancer (which is why it probably isn't outright banned). But when you look solely at lung cancer deaths, 87% smoked which gets turned into the you will get cancer and die claim.

    16. Re:good riddance by Wrath0fb0b · · Score: 1

      What 23andMe does is market a product that you use to extract unique information about your own body, which is then presented to you in the form of suggestions about what health measures you should take -- in other words, medical advice. Very different.

      So does the local palm-reader.

      The point appears to be that you can provide medical advice if you are completely unscientific about it, but as soon as you try to offer even a little bit (even of experimental or tenuous) fact, then you have to go whole hog.

    17. Re:good riddance by ljw1004 · · Score: 1

      When I was looked I was unable to find the SNPs. This might be because I did it as soon as 23andMe reduced prices to $200 for the first time, before they'd cleaned up their website.

      Turning "probability of alzheimers disease" into a single percentage is a meaningless project. Alzheimers has an age likelihood - so at age 50, some portion of the population will have the pre-clinical precursor, some portion will have mild symptoms, some moderate, some severe. By age 60, and 70, and 80 and 90, the proportions change again.

      So turning it into a single percentage number, as 23andMe did, is unable to capture what should be captured. It reeks of a company who did just enough research to put up a percentage number (because that's how their UI worked and that's what their UX designers thought users wanted to see), but didn't have the integrity to think through whether it was meaningful.

      Indeed, if you wanted a single numerical probability for whether you'll show clinical signs of Alzheimers before you die, you'd likely get a more accurate number by estimating when you'll die from other factors like cancer or heart disease -- will it be before the "numbers game" of alzheimers and old age catches up with you, or not?

    18. Re:good riddance by electroniceric · · Score: 2

      The FDA made them stop because doctors dislike being cut out of the loop, and insurance companies like being cut out of the loop even less than the doctors, and they would prefer to have you get the data through a disclosure mechanism which gives your insurance company better actuarial information.

      This sounds like one of those ads at the bottom of blogs "New service that doctors hate!!1". Seriously though, do you have any evidence for these claims?

      The FDA asked a 23andMe a simple question - show us the evidence that when you say that a person has an elevated risk of say, death, that that claim is true. Then they talked 23andMe 14 times over a couple years, then waited 11 months with no reply. Then they made them stop making those claims. So where is that the ravening hordes of doctors and insurers fit in there?

      Now imagine that 23andMe said the person was at low risk of death (like from heart disease) and that turned out to be ahem... mildly inaccurate. Was that the part the doctors hate?

      Notes that if 23andMe sticks to providing raw data, they are not making medical claims. Ravening hordes begone!

    19. Re:good riddance by electroniceric · · Score: 1

      Don't blame the FDA...
      Due to the structure of the 1938 Food Drug and Cosmetic act which established the FDA, it is not permitted to regulate homeopathic drugs in the same way as "normal" drugs. This is a registry of homeopathic drugs and if a drug is on there but is not a "normal" drug, the FDA can only regulate that it is manufactured safely, similar to food, not whether it is effective at treating disease. That is why you see this kind of labeling on such products:

      A product's compliance with requirements of the HPUS, USP, or NF does not establish that it has been shown by appropriate means to be safe, effective, and not misbranded for its intended use.

      All the FDA can do is go after companies that market non-homeopathic drugs (i.e. "normal" drugs) as homeopathic, like HCG.

    20. Re:good riddance by PCM2 · · Score: 1

      So does the local palm-reader.

      The point appears to be that you can provide medical advice if you are completely unscientific about it, but as soon as you try to offer even a little bit (even of experimental or tenuous) fact, then you have to go whole hog.

      Seriously? So in your book, a doctor who has spent years at medical school and practiced in the field for years more is a "palm reader," but whichever unlicensed, unregulated nobody who reads you your 23andMe test results is a "scientist"? I guess in the unmitigated bullshit stakes, that makes you a dean of medicine.

      --
      Breakfast served all day!
    21. Re:good riddance by im_thatoneguy · · Score: 1

      How is that different from your doctor saying "You most likely have Leukemia." All diagnosis and advice is based on a probability scale. If you have an 88% chance of developing cancer that's almost as good as saying you have cancer.

    22. Re:good riddance by heuermh · · Score: 1

      I wrote a java client for the 23andMe APIs available under LGPL version 3 or later here

      https://github.com/heuermh/personal-genome-client

      I am using it in several downstream variation analyses, please contact me if interested.

      For the record, I am not affiliated with 23andMe in any way, I'm just an free & open source bioinformatics developer.

    23. Re:good riddance by tjonnyc999 · · Score: 1

      Absolutely. It's "the tyranny of the moron over the intellectual" - because a few idiots might misinterpret/misuse/get hurt by something, let's BAN it for EVERYONE.

    24. Re:good riddance by tjonnyc999 · · Score: 1

      It wasn't necessarily that the information was misleading, but that it would lead patients to make decisions about their own care without necessarily consulting a doctor, which the FDA thinks is not a good idea -- and I totally see their point, frankly.

      So, by the same logic, let's shut down:

      • wikipedia.org - plenty of medical information there
      • RXList.com
      • WebMD.com
      • WrongDiagnosis.com
      • Healthatoz.com
      • DrKoop.com
      • Merck Manual at www.merck.com/pubs/mmanual/
      • ...and about 1000 more

      Oh noes! Medical information out in the open! How dare those peasants make decisions for themselves! We must protect them from themselves! ...etc.

      Yeah, let's deny information (however flawed it may be, it's better than nothing) to people with a capacity for independent thought, for the sake of coddling & protecting the morons.

  3. Re:smart by Albanach · · Score: 3, Informative

    There is a secondary market. Most large hospitals have genetic counselors who are trained and qualified to interpret and present the results of genetic testing.

  4. Re:smart by farble1670 · · Score: 2

    if it was that simple, wouldn't 23andMe have just hired some of these people? it might cost them, but probably cheaper than losing their entire business. how useful is it to the average person to gut a bunch of raw genetic data dumped on them?

  5. Outsmart The System by retroworks · · Score: 1

    I submitted someone else's DNA. Small price to pay for invisibility. It's flawed because I could be tagged with my pal's traits. But in the near future, we'll be buying/selling "prime DNA" for our test submittals, on street corners, like clean pee at La Tour de France.

    (OOps, I meant to submit anonymous coward, instead of this hacked 'retroworks' account).

    --
    Gently reply
    1. Re: Outsmart The System by Rujiel · · Score: 1

      Hacked account. Xfd. Why would someone joke about that? So much shitposting in this thread. I wonder who's paying?

  6. Re:smart by pepty · · Score: 4, Informative

    Those are the results of individual FDA approved genetic tests.

    A "secondary market" for running thousands of tests at once would run into the same problem that 23andMe did: if you are going to sell diagnostic services in the USA then you will need to get FDA approval. The options are to only provide raw data and let someone else generate the report for free (see Promethease, mentioned below) or move the whole company someplace where law enforcement won't bother it. I could see 23andMe spinning off an independent foundation that would generate free reports, thus allowing their core business (building up a database of peoples DNA and personal/family medical histories that they can rent out for medical research free from the normal regulatory hurdles) to proceed unhindered. They would just have to be very careful to make certain there was no linkage between the for profit and the free companies: the non-profit would have to generate reports from data of any source, not just SNPs from 23andMe, it couldn't share any board members or employees with 23andMe, Google, etc.

    Next legal challenge for 23andMe: doing medical research on people (gathering their DNA and medical histories, analyzing, allowing 3rd parties to analyze, etc) without getting IRB approvals first.

  7. Re:Canada by Anonymous Coward · · Score: 1

    You can not say the USA is the best country in north america. Or you have not been paying attention for the last 30 years here. Or you are very very rich and have almost no touch with reality anymore.

    Canada is number one. By pretty much any measure including common sense.

    And yes. i am in the usa. but quite realistic about where we currently are. (which we currently are fucking sad on pretty much every measure)

    Blind nationalism does not help anyone. But we do have alot of it. One of the reasons why we are not the number one country in north america....

    We need to fix it. Not continue to pretend we are the best. When we clearly are not anymore.

  8. Re:smart by Anonymous Coward · · Score: 1

    But why pay for people who are qualified to give medical advice, which would then have to be a lot more differentiated and have a lot more "maybe", "possibly" and "well okay the scientific basis for this is kinda sorta not very there" after it than it has already, when you can not do that and make more money?

  9. Too bad it's taken down... by sldunn · · Score: 3, Interesting
    As long as people understand that the results are only based on research/papers, 23andme is really awesome. It's best to discuss things with your doctor, and get things double checked, rather than to treat 23andme as some alternate to proper healthcare and checkups.

    I mean, really, who the hell would spit into a tube, pay $100 bucks and start a potentially harmful treatment regimen without seeing a doctor?

    Speaking from experience, 23andme did identify that one of her genes leaves her susceptible to having bad side effects of one of the medications she was taking (and she was suffering from this side effect). Taking the 23andme health report to her doctor let her move onto an alternate treatment, which is working *much* better.

    I hope that a revisited health report/traits thing comes back soon. Or maybe put it behind a test wall, and make sure people to understand exactly what they are getting.

    1. Re:Too bad it's taken down... by ceoyoyo · · Score: 1

      All the people who spend hundreds of billions on "supplements" every year? There are a LOT of people who self medicate. There are even more who go to doctors and tell them what they're going to prescribe.

    2. Re:Too bad it's taken down... by RightSaidFred99 · · Score: 1

      So what, fuck them.

    3. Re:Too bad it's taken down... by ceoyoyo · · Score: 1

      That is one approach. You might change your mind when some unregulated company sells you bad heart medication though. Or contaminated ibuprofen.

  10. just do an endrun around the system... by jinchoung · · Score: 1

    "for entertainment purposes only" seems to be the necessary language. right?

  11. Re:smart by ColdWetDog · · Score: 2

    The problem is that 23andme was trying to make it 'that simple' and beyond. Their recent literature downplayed the (difficult) part about relative risk, probabilities and how to analyze the data in a rationale way and played up the 'we can make you live longer' aspect. Taking the information to a qualified genetic counselor would be the best way to evaluate the subject for the vast majority of people. But that is time consuming, expensive and you have to really think about stuff.

    Not a very good way to make money these days. The FDA put a kabosh to that.

    --
    Faster! Faster! Faster would be better!
  12. Re: Oh Canada by rmdingler · · Score: 1, Offtopic

    Maple syrup is a huge plus. But really and truly, nationalized health care>entrenched government corruption.... hell, I could even learn to yell at hockey games.

    --
    Happiness in intelligent people is the rarest thing I know.

    Ernest Hemingway

  13. Re:smart by russotto · · Score: 1

    If they simply take the raw 23&me test results and provide the analysis, there's no "device" for the FCC to use to assert jurisdiction.

  14. Re:smart by ceoyoyo · · Score: 2

    The problem is, if a random person gets a genetic test done their report is along the lines of "such and such a variant has been associated with a 0.000000028% chance of developing such and such", etc. That's not very sexy marketing.

  15. The FDA's mission to save idiots from themselves by jwbales · · Score: 1

    Although 99.9% of us have the common sense to get a professional opinion if some test bought on the internet delivers bad news, the FDA denies us access to such tests on the off chance that some idiot will take rash action without consulting a physician. Were that to happen, which I seriously doubt, the worst result would be a slight improvement in the gene pool.

  16. The science is open.. by xtal · · Score: 3, Insightful

    Just need to link the science (published) and the genotype. It's all open.

    Next up is banning people from sequencing their own genomes without a MD.

    The real story here is who's the loser - it's not you; your DNA is your DNA, and the sequences are there or they aren't. The insurance industry are the ones who are actually worried about these tests - all of a sudden you have data they don't, and they can't apply their actuarial models anymore. Hilarity ensures.

    May we all live in interesting times.

    --
    ..don't panic
  17. Re:Canada by Anonymous Coward · · Score: 1

    Or you are very very rich and have almost no touch with reality anymore. ...We need to fix it.

    I agree with your statements, above.

    But the problem is, the people you mention above ( "the very rich who have almost no touch with reality" ) ARE the
    people who are in control of the US. Can you see how that is not going to lead to any change ? They are quite
    comfortable, and they have absolutely no incentive to change. Change is not going to happen unless those in control
    perceive a real threat to their comfortable positions, and it's doubtful any such threat will appear from within the US.
    As for any threats from outside the US, the rich can and will rely on the working classes to provide expendable young
    men and women who are ready to enlist in the armed forces because it might be their only chance for a job. I could go on,
    but I am enjoying my evening and no one here is going to care what I say anyway, so fuck it. //

  18. From a 2010 Cell paper by sat1308 · · Score: 5, Informative

    One company, for example, offers 166 tests in one of its testing packages where approximately 60% of the tests (99) are categorized as âpreliminary researchâ(TM) because the genetic-association data have not yet been replicated (www.23andme.com/health/all/). These tests are given 1, 2, or 3 stars based on the size of the study that supports the genetic association for which they test. Information for each of these tests cites references for the original ïnding of the genetic association, including the journal where it was published and the study size. It also provides the number of attempted replications and the number of contrary studies that have been published. Although transparent, examination of the scientiïc evidence provided for many of the genetic associations in this category raises the question of whether these tests should even be included in a genetic-testing package. Two of the ïve genetic tests with 1-star status (those for âavoidance of errorâ(TM) and âobsessive compulsive disorderâ(TM)) are based on single studies with fewer than 100 participants (https://www.23andme.com/you/health/). In both cases the variants map to the D2 dopamine receptor, a gene that has repeatedly been associated with human behavioral traits and attracted newspaper headlines, only to have the associations refuted in later studies [8]. Eight of the 37 (22%) available 2-star-rated genetic associations (originating from a single study with less than 750 participants) have a âcontrary studyâ(TM) indicated. Two different 3-star tests, one for Lou Gehrigâ(TM)s Disease (ALS) and another for obesity, utilize variants that have been positively associated with disease in one or two studies, respectively. However, both these variants have failed replication in four additional studies (https://www.23andme.com/you/health/). Although, the company boasts of its 'systematic vetting processâ(TM) used to determine which research ïndings to include in its genetic-testing package, a number of highly questionable tests continue to be offered to consumers.

    http://www.ncbi.nlm.nih.gov/pubmed/20828856

    1. Re:From a 2010 Cell paper by tjonnyc999 · · Score: 1

      So they're new, unproven, and questionable. The alternative is not knowing at all. Given the choice of "incomplete data" vs "NO data", I'll take the 1st, thank you very much.

  19. Re:smart by Belial6 · · Score: 2

    I don't know if I would go that far. U.C. Davis does genetic testing for pregnant women, and I got the joy of talking to one when my wife was pregnant. The 'Genetic Counselor' had no idea what the data meant. Every question I asked was met with a blank stare and the repeating of the line from the script she was given. It was awfully similar to calling an Indian tech support line.

  20. Absolutely! by no-body · · Score: 1

    "It would be great to see a secondary market in this kind of analysis emerge"

    Health/Life insurance Co's need to increase profit margins, employers figure out whom to fire first, police departments preventative arrests, - Minority Report-Style, paradise for extortionists getting their hand on those data worth a fortune.

  21. Meanwhile, in America by Rujiel · · Score: 1

    The FDA can't guarantee it'll get dangerous foods off the shelves within even a few years. It couldn't halt BP from ditching millions of gallons of neurotoxic, carcinogenic dispersants into the gulf after Deepwater Horizon. But it's sure as sin make sure your life isn't ruined by an unclear genetics report--as if there were any way people could imperil theirselves with the information.

    1. Re:Meanwhile, in America by fluffy99 · · Score: 1

      The FDA can't guarantee it'll get dangerous foods off the shelves within even a few years. It couldn't halt BP from ditching millions of gallons of neurotoxic, carcinogenic dispersants into the gulf after Deepwater Horizon./quote>

      Um, you seem to have EPA and FDA confused. But I agree that there are bigger issues out there with the food supply chain that should be a higher priority.

    2. Re:Meanwhile, in America by Rujiel · · Score: 1

      sorry drunk post

  22. Re:smart by ColdWetDog · · Score: 1

    You should ask for a refund.... Good genetic counselors are hard to find. It's not a very sexy field and it's hard work explaining complicated subjects - including the most dreaded subject of all - statistics - to lay people of varying degrees of sophistication.

    The Accreditation Council for Genetic Counseling (ACGC) is the specialized program accreditation board for educational training programs granting master’s degrees or higher in genetic counseling. I wonder if your counselor had gone through an approved program.

    --
    Faster! Faster! Faster would be better!
  23. 23andMe is just plain bogus by quixote9 · · Score: 2

    They can't do analysis, a secondary market can't do it, nobody can. The science just isn't there yet to draw useful conclusions for an individual on the basis of DNA in isolation.

    Note that: in isolation. That's what 23and Me was peddling. Hospitals and genetic counselors and doctors are doing something else. They have the whole medical history. They have, or should have, enough training to understand population genetics, statistics, and where somebody's DNA data fits in to all that. (Although a comment lower down this thread talks about a blank-brained counselor. They happen. Run, do not walk, out of their offices.)

    So, no, it would not be "great to see a secondary market in this kind of analysis emerge." It would be just as bogus as 23andMe, given our current state of knowledge.

    1. Re:23andMe is just plain bogus by Anonymous Coward · · Score: 3, Insightful

      What's your definition of "useful conclusion"? Because I'm pretty sure it's different than what 23andMe was peddling and what all of us satisfied customers expected. Most 23andMe reports are equivocal on their face, in a good way. Some, like markers for Parkinson's or Alzheimer's, are also pretty clear. They tell you in plain English that the lack of a marker does not mean you're free from risk. If a marker is present, they give you a risk factor. But in no way did they diagnose you with Parkinson's.

      Everybody thinks that they're smarter than most other people, and people like you just assume that most other people can't comprehend this stuff. Well, 1) we can and 2) it doesn't matter because 23andMe reports are of a different type entirely than what a professional genetic counselor would possess.

      Show me one person who was duped by 23andMe? Even my own mother, who is quite naive about science-related topics, consumed her reports with a grain of salt, and without needing any warnings from me. Everybody understood that 23andMe is to professional genetic counseling as Walgreens is to The Mayo Clinic. In other words, professional and trustworthy in so far as a commercial vendor can be, but not in the same league as a real healthcare provider.

      In an age where people obsess over stuff like HFCS and juice fasts, 23andMe cut through all the crap with hard data and reports which, despite all the inherent limitations, were damn interesting, if not in the rare case positively life changing. People understood the limitations, even the science-deficient anti-HFCS and organics crowd.

      What the FDA did was pounce on some lofty marketing language. Big whip. The FDA just wants to shutdown the commoditization of genetic counseling, period. And it's ultimately going to cost all of us a ton of money.

  24. Thord party analysis by n6kuy · · Score: 4, Informative

    > It would be great to see a secondary market
    > in this kind of analysis emerge.

    There are already companies (livewello.com, for instance) that will take your 23andme raw data and analyze it for certain traits and risk factors.

    --
    If you disagree with me on social issues, then it's pretty clear that you are a narrow-minded bigot.
    1. Re:Thord party analysis by n6kuy · · Score: 1

      "Thord", LOL.

      Guess I should proofread before hitting Return...

      --
      If you disagree with me on social issues, then it's pretty clear that you are a narrow-minded bigot.
  25. Re:smart by nitehawk214 · · Score: 2

    The problem is that 23andme was trying to make it 'that simple' and beyond. Their recent literature downplayed the (difficult) part about relative risk, probabilities and how to analyze the data in a rationale way and played up the 'we can make you live longer' aspect. Taking the information to a qualified genetic counselor would be the best way to evaluate the subject for the vast majority of people. But that is time consuming, expensive and you have to really think about stuff.

    Not a very good way to make money these days. The FDA put a kabosh to that.

    How did they plan on making people live longer if they did not have anyone analyze the results? Or was their entire business plan to get people to pay top dollar for information they cannot understand?

    --
    I'm a good cook. I'm a fantastic eater. - Steven Brust
  26. DOn't need IRB always by Anonymous Coward · · Score: 1

    I don't think there's any law that requires you to have IRB approval for anything you do. If you receive government funds, then sure, a condition of the grant or contract will be "you need to have an IRB". You can also hire an IRB. That is, there's no objective standard for approval. You sign up to the Belmont principles, etc, but it's not like there's some certification process for IRBs.

    1. Re:DOn't need IRB always by pepty · · Score: 1

      Actually if the research involves human subjects and is intended to support a product that would require FDA approval an IRB is required even if the funding is all private. The FDA has rules about how IRBs must be formed, but I dont' think they certify them. 23andMe and the companies it sells data/research services to might be exempt though since they could claim the data wasn't collected for any particular study: the data just happened to be available after customers plonked down their $99.

  27. Re:smart by JWSmythe · · Score: 4, Informative

    That quote isn't quite complete. They've only discontinued new user access to health related tests. They're still providing ancestry information.

    The majority of the really useful information is genetic. The health information was secondary. Really, the whole health thing was vague at best, and it didn't take a rocket scientist to figure it out.

    For example, gallstones. My risk is 6.2%, where avg risk is 7.0%. Not bad, I have a lower chance.

    I had to have my gallbladder removed a year ago, because I had two golf ball size stones. Yup, anything greater than a 0.0% chance means there is a chance. Lucky me.

    Anyways, here's the full email they just sent out to 23andMe customers today.

    Dear 23andMe Customers,

    I'm writing to update you on our conversation with the U.S. Food and Drug Administration and how it impacts you.

    If you are a customer whose kit was purchased before November 22, 2013, your 23andMe experience will not change. You will be able to access both ancestry and health-related information as you always have.

    23andMe has complied with the FDA's directive and stopped offering new consumers access to health-related genetic results while the company moves forward with the agency's regulatory review processes. Be sure to refer to our 23andMe blog for updates.

    We stand behind the data we have generated for customers. Our lab partner adheres to strict quality standards that are part of the Clinical Laboratory Improvement Amendments of 1988 - known as CLIA. These are the same standards used in the majority of other health and disease-related tests.

    You are among the first people in the world to ever get access to their genomes. You are genetic pioneers. Thank you for your ongoing support and we look forward to continuing to serve you.

    Anne Wojcicki
    Co-founder and CEO, 23andMe

    --
    Serious? Seriousness is well above my pay grade.
  28. Re:smart by pepty · · Score: 1

    Ask for a refund - but first give them a quick quiz on conditional probability.

  29. Re:smart by swillden · · Score: 1

    if you are going to sell diagnostic services in the USA then you will need to get FDA approval

    I don't think so. I don't think there's any requirement that people have FDA approval in order to issue opinions on medical issues. You have to be an MD to call yourself a doctor, but if you just want to tell people stuff and aren't claiming to be a doctor and aren't doing any sort of medical procedures on them, go nuts. Likewise, if you're producing medical devices or performing medical tests (like 23andme), then you need approval but if you're not, do what you like.

    --
    Note to ACs: I usually delete AC replies without reading them. If you want to talk to me, log in.
  30. Re:Canada by sumdumass · · Score: 1

    But they didn't imprison the German Americans or the Italian Americans. So maybe, just maybe, there was something about the Japanese Americans and Japanese born legal residents that the armed forces saw differently. Just maybe there was something different about the US back then. "race prejudice, war hysteria, and a failure of political leadership" comes to mind but I'm not sure how loudly it gets said when it is talking about FDR.

    And that is not to mention that Japanese Americans were in the armed forces during the same time period too.

  31. Re:Canada by BlueStrat · · Score: 1

    But they didn't imprison the German Americans or the Italian Americans.

    Sorry, guy. That's incorrect.

    Well, the Italians were treated with a bit more discretion, but many innocent Italians were interned.

    "The laws regarding "enemy aliens" did not make ideological distinctionsâ"treating as legally the same pro-Fascist Italian businessmen living for a short time in the U.S. and trapped there when war broke out, anti-Fascist refugees from Italy who arrived a few years earlier intending to become U.S. citizens but who had not completed the process of naturalization, and those who had emigrated from Italy at the turn of the 20th century and raised entire families of native-born Italian Americans but who were not naturalized themselves. They were all considered enemy aliens."

    http://en.wikipedia.org/wiki/Italian-American_internment

    The Germans had it a bit rougher, but neither compared to the scale or extent of the Japanese internment.

    http://en.wikipedia.org/wiki/German-American_internment

    Strat

    --
    Progressivism (aka US 'Liberalism'): Ideas so good they need a police/surveillance-state to enforce.
  32. open source analysis by stenvar · · Score: 1

    There are plenty of tools and sources that help you analyze the data. Long term, the FDA decision will simply mean that people who are skilled and/or rich enough to go abroad will get the benefit of this analysis, while everybody else will be screwed. Congratulations, FDA, for doing your part in increasing health disparities.

  33. offensive arrogance by stenvar · · Score: 1

    Whether you have a variant dopamine receptor is certainly a reasonable thing to include in a genetic testing package like 23andMe: even if current studies don't have clear results about what that means, there is a good chance that there will be meaningful associations in the future. If 23andMe only included those tests for which absolutely clearcut associations had been worked out, people would have to get retested constantly.

    The company did what it should have done: it picked a large number of important markers and disclosed things correctly and properly.

    Fortunately, this kind of FDA stupidity is not going to work long term: people are simply going to get their entire genomes sequenced, and there will be a huge number of free tools and web sites for searching for disease associations, ancestry, and relatives.

    1. Re:offensive arrogance by electroniceric · · Score: 1

      Fortunately, this kind of FDA stupidity is not going to work long term: people are simply going to get their entire genomes sequenced, and there will be a huge number of free tools and web sites for searching for disease associations, ancestry, and relatives.

      Let me recast this just a bit to illustrate the problem:

      Fortunately, in the long term, 3D printing will allow people to create their own CT scanners, and there will be a huge number of free tools and websites for searching for tumors, heart defects, and bone density.

      Are you at all worried about what people will do with their homemade CT scanners?
      Perhaps doctors know a little bit about reacting to that kind of data (and the uncertainties in it) and making good decisions about it?

    2. Re:offensive arrogance by stenvar · · Score: 1

      Are you at all worried about what people will do with their homemade CT scanners?

      Are you being serious? No, of course I'm not worried, I think it would be great. How could you possibly think it wouldn't be great?

      What's next? Are you going to try to pass laws against skin, testicle, and breast self-exams because people might be confused by the lumps and spots they might discover?

      Perhaps doctors know a little bit about reacting to that kind of data (and the uncertainties in it) and making good decisions about it?

      Some doctors do, others are dumber as dirt. Ultimately, the decision belongs to the patient, not the doctor, and the doctor's only job is to give advice if the patient wants it. On the other hand, if the patient discovers something about his body that concerns him, it's the doctor's job to look and explain.

    3. Re:offensive arrogance by electroniceric · · Score: 1

      No, of course I'm not worried, I think it would be great....

      I am truly stunned by this. A self-interpreted home-made CT scan is an unalloyed good? Notwithstanding the radiation to get there, without serious testing, you have no idea how accurate the thing is (back to the FDA's repeated requests to 23andMe).

      Allowing the heroic assumption that the Garage-scan-o-matic things actually give accurate results, are you also saying you think the majority of people have the education and knowledge to make heads or tails of what might a slightly larger appearance of the brachiocephalic artery might mean for them? Or that they have any idea what to do about it?

      Are you going to try to pass laws against skin, testicle, and breast self-exams because people might be confused by the lumps and spots they might discover?

      That's not what I propose nor what the FDA is doing. If someone tries to sell an automated system to tell people what those lumps and spots mean (particularly if they use the term "risk") you'd better believe I would demand enforcement of the existing laws that say that the seller must prove that their system works in order to sell it.

      Some doctors do, others are dumber as dirt.

      Sure, doctors are people and there are all kinds of them. But at the very least they have had a rigorous education, and following that a series of experiences in trying to understand the confusing mishmash of information about people's health conditions and make judgments about a course of action to follow.

      Since this post is entitled "offensive arrogance", let me just ask if you really think that education and experience means nothing. And if so, does it mean nothing when an engineer used his or experience to say a piece of software is poorly architected, or that car can be hacked, or there is inadequate review of security? After all, I can read Slashdot to get the answers I need or check something out from github to fix the problem...

      There is a role for experts and there are some things that are dangerous enough that an expert's opinion should be required, whether that's a doctor, an engineer, or policeman.

    4. Re:offensive arrogance by stenvar · · Score: 1

      I am truly stunned by this. A self-interpreted home-made CT scan is an unalloyed good?

      The "good" is that the diagnostic equipment becomes so cheap that people can make it themselves. They can then decide for themselves whether to use it for good or for bad. People are smarter than you give them credit for: far more people will use it responsibly and benefit from it than people who will misuse it and harm themselves. The only people who would really suffer would be doctors and corporations, who see a lucrative source of revenue disappear.

      There is a role for experts and there are some things that are dangerous enough that an expert's opinion should be required

      You are deliberately obfuscating and confusing two very different situations: harm to others and harm to myself. Some sort of arbiter is required when person A does something that may directly harm person B; that's when we should require people to get involved based on criteria that we can agree on as a society. Since such positions are frequently responsible for abuse of power, we should also minimize such situations. But an expert's opinion should never be required, let alone their judgment or permission, for things I want to do to myself.

      23andMe should be required to be clear and truthful about their results, but they obviously are. Offering an unreliable test with clear disclosure should not be grounds for banning a test.

      Since this post is entitled "offensive arrogance", let me just ask if you really think that education and experience means nothing.

      A used car salesman is an expert on cars and their faults. Does that mean you should trust him? Would you want to pass laws that let used car salesmen decide on your behalf which car to buy? Of course not. Yet, that's what you advocate for medicine.

      you'd better believe I would demand enforcement of the existing laws that say that the seller must prove that their system works in order to sell it.

      One can reasonably talk about disclosure requirements for services like 23andMe. But the restrictions you advocate oh services are nothing more than a handout to the medical and insurance industry. In the guise of worrying about consumer safety, you effectively advocate harmful corporatism and privacy intrusions. People like you are responsible for the spiraling health care costs and the inability to deliver good and effective health care to the poorest in our nation.

    5. Re:offensive arrogance by stenvar · · Score: 1

      That's not what I propose nor what the FDA is doing. If someone tries to sell an automated system to tell people what those lumps and spots mean (particularly if they use the term "risk") you'd better believe I would demand enforcement of the existing laws that say that the seller must prove that their system works in order to sell it.

      The problem is that you and the FDA define "working" as "high precision and recall", instead of simply a truthful disclosure of what the test result means. 23andMe is saying "here is the genetic marker, and there is one study that suggests that this marker may indicate...". The test works as advertised. But you think everybody else is illiterate and stupid and is going to make bad decisions, so you want to keep such results from them. And although people like you insist on "risk quantification" and perfection for everybody else, you never show that the stringent regulatory policies you advocate are effective or even necessary. Apply your own criteria to your policy advocacy.

  34. Re:smart by aurizon · · Score: 1

    Someone in another country can easily setup a multivariate look-up grid of the kind 23andMe uses to show how various genetic patterns correlate to various aspects of your health or intelligence.. In fact 23andMe can open source their method and many people will provide this service, some for free, some for fee.

  35. Re:smart by citizenr · · Score: 1

    How did they plan on making people live longer if they did not have anyone analyze the results? Or was their entire business plan to get people to pay top dollar for information they cannot understand?

    Doh, In a true and tested spirit of google they replaced humans with an algorithm. PGM PGM on the wall, tell me who will live the longest of them all?

    --
    Who logs in to gdm? Not I, said the duck.
  36. Thank you for the problematic example. by Kludge · · Score: 1

    For example, gallstones. My risk is 6.2%, where avg risk is 7.0%. Not bad, I have a lower chance.

    If you think that "23andMe" can detect a 0.008 difference in the probability of your getting gallstones based on a genetic test, then you have been duped. The studies that 23andMe use to estimate these values are not nearly accurate enough to make these kinds of statements. That sort of statement has not been validated, and that is part of the FDA's problem with these scams.

    1. Re:Thank you for the problematic example. by JWSmythe · · Score: 1

      I wasn't saying that the indication was anything.

      Yes, I do believe they can tell the difference. They aren't determining the risk factor. They are passing on information based on scientific studies. The doctors who ran the studies make the determinations on risk. They provide the links to that research, and even specifically discuss other things you should do if you are concerned, including contacting a genetic counselor.

      I didn't believe or not believe, I had gallstones based on the 23andMe report. I believed based on symptoms and a diagnostic ultrasound that showed two golf ball size stones where there should have been none.

      Here's the study information they provide with this particular one. There's a lot of information on the page. I don't want to make this post huge by quoting the whole thing. It does include information on the lab that does the testing.

      The FDA is pissed that 23andMe is making this information available, where you should normally spend a fortune with doctors, if you can get them to agree to doing genetic testing, to give you the same information.

      ABCG8
      Marker:rs11887534

      This SNP is in a gene called ABCG8, which encodes a cholesterol transporter protein. The version of this SNP associated with increased risk for gallstones (C) causes a physical change in the protein that is thought to result in increased cholesterol transport into the biliary ducts and the gallbladder. This may precipitate the formation of gallstones; however, additional studies are needed to elucidate the mechanisms by which this SNP affects gallstone formation. Having two copies of the C version of this SNP confers higher risk than having just one.

      Research suggests that the C version of this SNP is also associated with slightly earlier onset of gallstones. There is also some evidence that this SNP may be associated with gallbladder cancer (gallstones are a risk factor for gallbladder cancer), but larger studies are required to verify this.

      Multiple studies have confirmed this association in populations with European ancestry. A small Chinese study examined this SNP and found suggestive evidence for the association with gallstones and biliary tract cancer, but more studies are needed to confirm the association in Asian populations. This association has not been studied in populations with African ancestry.
      Citations

      Buch S et al. (2007). "A genome-wide association scan identifies the hepatic cholesterol transporter ABCG8 as a susceptibility factor for human gallstone disease." Nat. Genet. 39(8):995-9.

      Stender S et al. (2011) . "Sterol transporter adenosine triphosphate-binding cassette transporter G8, gallstones, and biliary cancer in 62,000 individuals from the general population." Hepatology 53(2):640-8.

      Xu HL et al. (2011). "Cholesterol metabolism gene polymorphisms and the risk of biliary tract cancers and stones: a population-based case-control study in Shanghai, China." Carcinogenesis 32(1):58-62.

      The genotyping services of 23andMe are performed in LabCorp's CLIA-certified laboratory. The tests have not been cleared or approved by the FDA but have been analytically validated according to CLIA standards. The information on this page is intended for research and educational purposes only, and is not for diagnostic use.

      --
      Serious? Seriousness is well above my pay grade.
  37. Re: smart by pegr · · Score: 1

    Nope. This is a clear FDA overreach. They were not involved in any process designed to diagnose, treat, or prevent illness. They were involved only in protected speech. And because of the FDA, we now have prior restraint on protected speech. 23andme should have released the lawyers on the FDA.

  38. Re:The FDA's mission to save idiots from themselve by Lawrence_Bird · · Score: 2

    Let me go rah rah for you. If 23andme is so shitty at providing accurate medical information to aid the lay person in evaluating their results then the MARKET will put them out of business as consumers will a) stop using them and b) competitors who provide better service will emerge.

    There is no need for government intervention here. Please go control your own person and family and leave the rest of us the fuck alone.

  39. This is shocking news by Lawrence_Bird · · Score: 1

    I really figured that all these dna testing outfits were either fronts for DHS or at least in cahoots. Shocking the FDA did not get the memo. Has Rudi Guilliani been on Fox yet to lament the loss of info for the DNA databse?

  40. Re: Oh Canada by PopeRatzo · · Score: 1

    But really and truly, nationalized health care>entrenched government corruption.... hell, I could even learn to yell at hockey games.

    Just because the US is in third place is no reason to gloat.

    --
    You are welcome on my lawn.
  41. Re:smart by couchslug · · Score: 1

    After the Snowden releases, how dare anyone mod my post "flamebait"?

    The choice for the rest of the world is to submit to the US government, or not. That doesn't mean there are not other toxic governments in the world, but you can defy them too. Americans are sheep and there is no hope for change, but those of you who don't live here have more choices than being indirectly ruled by our politicians.

    You didn't elect American masters, and you don't have to elect American puppets.

    --
    "This post is an artistic work of fiction and falsehood. Only a fool would take anything posted here as fact."
  42. Herbal supplements have congresscritters. by Behrooz · · Score: 2

    Sen. Orrin Hatch (R-UT) would like to speak with you about how your health can enjoy the benefits of herbal supplements!

    --
    "We have to go forth and crush every world view that doesn't believe in tolerance and free speech." - David Brin
  43. Statistics.. by BeckyGrz · · Score: 1

    I had taken a 23andme test out of curiosity about ancestry and a type of cancer that ran in the family that is known to have a very strong genetic link. Before taking it though I read reviews/commentary from all over the web and I noticed one glaringly obvious reality. People don’t get statistics very well, and even those that do have a blind spot when it comes to odds that affect them. (lottery methods anyone?)

    All over you see negative comments saying that the test is garbage because it said I had reduced chance of getting this and I already have it, or the opposite. There’s some cognitive dissonance there that might just be a part of human nature, nowhere on 23andme or other sites that I have looked at do they every say you will get this or you won’t get that. Heck even on the cosmetic results such as what hair or eye color it’s a likely will/likely won’t statement.

    Sadly I can see one area which might be one of 23andme’s problems was something that I saw as a strength. In the initial presentation of results it dumbs it down to just numbers and a confidence—simplifies in some cases a half dozen tests into one percentage. If you dug down into where the numbers came from they provide links to the studies, sample sizes, dates, and all the scientific info one could ever want. But if you stopped at just those initial numbers and acted on them due to what you feel you know of statistics? Yeah it could cause some trouble/confusion—though still imho much less than those who go and start taking all matter of homeopathic snake oil for that twinge in their back they are sure is cancer.

    My test for the most part came back with what I expected: some cool info on where some of my family likely came from and with the regards to the cancer gene I didn’t come up snake eyes. That doesn’t mean I won’t have to go in for regular testing and be vigilant, and it doesn’t really change the way I do manage my health, it just makes me a little bit more knowledgeable about what’s in me and much more curious about what future research holds. If it came back that I have that “bad” gene what would have happened? Likely the same, though I probably would have shared my results with my GP to see what she thought, I’m not a doctor after all.

  44. Re:smart by pepty · · Score: 1

    but if you just want to tell people stuff

    Telling people stuff is fine, but once you charge for the service you open yourself up to regulation. For years I've thought that the direct-to-consumer genetic testing industry would end up split into companies that charged to sequence your DNA on the one hand and free software that interpreted the data on the other. Originally I thought this would be the way to avoid infringing the thousands of patents on DNA tests a paid service would run afoul of, but now that DNA patents have been sharply limited I think this shift might still happen in order to escape FDA problems.

  45. On Getting a second opinion... by coolsnowmen · · Score: 1

    There are a lot of posts here already saying, "it's 23&me.com, of course you should get a second opinion before: {getting a double mastectomy, getting your balls cut off, ...}". But, that is always the case in the face of a life changing diagnosis. If your local doctor diagnosis you with anything you consider life changing, for me it was an allergy to a common food, you should always get a second opinion. And if it is something major like major surgery, then consider getting a 3rd opinion too.

    I trust my doctor, I've been with him long enough to know he doesn't just try to get me random expensive procedures, but I've learned to listen more carefully. The more it seems something is "probably", and less definitely, the more I consider what else it could be, what else I could do, do some reading myself, and consider getting a second opinion.

    1. Re:On Getting a second opinion... by tjonnyc999 · · Score: 1

      Keywords: "learned", "listen", "consider", "reading myself". You're not a moron, so you think about things before making a decision. But, the FDA is not basing their decision on you - they're basing it on the possibility of some idiot doing something rash because they've heard they have a possibility of getting some disease. And, because we live in the age of "tyranny of the moron over the intellectual", their decision is "protect the moron, deny the intellectual".

  46. The last place I look for health information is by ToddInSF · · Score: 1

    The FDA and the CDC.

    Unless I want a good, bitter, laugh.

  47. Re:good riddance - Not by PCM2 · · Score: 1

    Exactly, IMO the FDA is shutting down a useful service in order to protect a few idiots out there would would act on the results as gospel.

    Bullshit. The FDA isn't "shutting 23andMe down." Nobody woke up yesterday morning and was told 23andMe had to shut down. 23andMe had YEARS to get in compliance with FDA regulations, but instead it chose to say "we don't agree that we fall under the jurisdiction of the FDA" and do nothing. And then, golly gosh, it turns out that we do actually live in a society of laws after all. If I was an investor in 23andMe, I would be steaming pissed.

    --
    Breakfast served all day!
  48. Re:The FDA's mission to save idiots from themselve by tlhIngan · · Score: 1

    Let me go rah rah for you. If 23andme is so shitty at providing accurate medical information to aid the lay person in evaluating their results then the MARKET will put them out of business as consumers will a) stop using them and b) competitors who provide better service will emerge.

    If you believe that, I have some snake oil to sell you. In fact, that's why the FDA was created - people were making tons of money selling hokey products that claim to improve your life, from poisons to strange electro-stimulator devices. Chances are, they didn't work, and if you were lucky, you weren't worse off for it (if not, death, chronic disease (more sales!) was your fate). But enough people did get sick and die that people wanted "something to be done".

    The problem is the market cannot decide - because the chances and everything is so vague and time delayed that how do you really know? It's like predicting the weather.

    So you have a "greater than normal chance" of some disease. What do you do? Do you change your lifestyle? What if you got it anyways? (The big problem is genetics just tells you how prone you are to something. The environment contributes significantly to whether or not you actually get it).

    Or take cancer. Perhaps the genetic test says you're less likely to get melanoma. Does it mean you can avoid sunscreen and tan yourself until you're completely charred safe in knowing you probably won't get melanoma?

    And hell, fake medical information is bad. See anti-vaccination groups bringing back diseases that were well under control or even eradicated (e.g., smallpox) only a couple of decades earlier.

  49. Re:The FDA's mission to save idiots from themselve by im_thatoneguy · · Score: 1

    the MARKET will put them out of business as consumers will a) stop using them and b) competitors who provide better service will emerge.

    Just like the MARKET will put all of those herbal supplements, homeopathic water solutions and penis enlargers out of business?

  50. Re:The FDA's mission to save idiots from themselve by Lawrence_Bird · · Score: 1

    The problem is the market cannot decide - because the chances and everything is so vague and time delayed that how do you really know? It's like predicting the weather.

    Have you heard of this thing they call the internet? Or global commerce? Nothing stays undiscovered for very long and if it is a big enough deal people will hear about it and competitors take advantage.

  51. Re:You are STUPID by ceoyoyo · · Score: 1

    I see you've gone with the "vehemence" method of trying to convince people you're right. Normally you wouldn't be worth replying to, but someone else reading this thread might get some benefit.

    Two of those "regulations" that makes a company "regulated' is that they a) have to very carefully specify exactly how they're making whatever-it-is, including precisely what's in it, and b) have to demonstrate in scientifically rigorous trials that it actually does more good than harm. So the chances of a REGULATED company selling you bad heart medication are vastly lower than those of an unregulated company doing it. A regulated drug producer can kill you if there's some accident, like a tainted batch. An unregulated one can kill you that way, or if they decided it would be cheaper to put a bit less of the active ingredient in, or change the process, or didn't have a reliable process in the first place, or were wrong about the drug working, or just made up the whole thing in the first place.

    Don't think someone would make up imaginary treatments? Google "snake oil" and "homeopathy."

  52. Re:The FDA's mission to save idiots from themselve by Lawrence_Bird · · Score: 1

    And those people are harmed how? There is a huge body of infomation readily available on all of those things. If somebody wants to believe that stuff is helping them WTF is it your business or the goverments? Are they harming you?

  53. Screwing the many to protect the few... by tjonnyc999 · · Score: 1

    ...seems to be the ongoing policy of US Government in general, and of the FDA in particular.

    Just as they've held up the approval of 15-minute DIY HIV test kits (Orasure et al), now they're blocking access to this information. Same principle: "Because we're worried that a few morons can't understand the data, we're going to screw EVERYONE indiscriminately".

    Same result: 100,000's of potentially preventable HIV infections occurred in the years the quicktests were delayed, now 100,000's of people will be denied the knowledge of potentially life-threatening illnesses and the possibility of preventative maintenance.

    Way to go, FDA. Let more people get sick & die so Big Pharma profits. Motive couldn't be more transparent of it was made from Trivex.

    On a larger scale, I wonder if the age of "tyranny of the moron over the intellectual" will ever come to an end.

  54. Re:The FDA's mission to save idiots from themselve by tjonnyc999 · · Score: 1

    OK, so they screw up once in a while. It's your responsibility to take ANY medical advice with a grain of salt, and to seek a 2nd opinion. Which is why there's that entire concept of a "2nd opinion", that's been around for centuries.

    But noooo, we can't have that, let's shut down the information for EVERYONE because SOME people might misinterpret, or because there's a TINY error chance in the testing process.

    Typical American attitude - "this might annoy/damage some morons, so let's shut it down for everyone".