New vs. Old: a Comparison of 23andMe's Health Reports and the Raw Data (enlis.com)

"With much fanfare," writes an anonymous reader, "last month 23andMe returned to reporting health information to their genetic service customers. How does their new service stack up?" According to the Enlis Genomics Blog, it's a good move but not perfect. The linked post explains that "the raw data from 23andMe contains significantly more health information than they are reporting in their health reports," and says "23andme has a long way to go to get back to reporting the same number of variants they were before the FDA ban. However – both the previous and new 23andMe reports pale in comparison to an analysis of the raw data. 23andMe’s new reports tell you about less that 1% of the health-related variants that are in their raw data." It's an interesting statistical blow-by-blow; the company making the comparison has a vested interest in you letting them run the numbers, but is not the only option.

Comments

Fuck the FDA

[shiftless]

Also, fuck Slashdot

Re:Fuck the FDA

[Anonymous Coward]

Says the man who's mother didn't take thalidomide. Thank you FDA!

Re:Fuck the FDA

[KGIII]

How do you know? They might be typing with their flippers.

What? It could happen.

Re:Fuck the FDA

[Anonymous Coward]

Says the man who's mother didn't take thalidomide. Thank you FDA!

Sometimes the FDA does good things and sometimes the FDA does bad things.

I've gone to a number of talks by experts in molecular genetics (i.e. experts in interpreting individual genome sequences to understand genetic disease) and I was a bit surprised that there's pretty much universal consensus that the FDA got it wrong when they shut down 23andMe's health reporting.

What you have to understand is that the quality of the underlying tests used by 23andMe was the same as what you'd get if you ordered the test through a medical doctor (i.e. both CLIA certified). And the interpretations that 23andMe were also as good as what you'd get from a medical doctor. The difference was that, in the case of 23andMe, the interpretations were provided by a website - as opposed to being provided in person by a medical doctor.

So there were a small number of genetic counselors who resented being cut out of the loop. The claim was that it was possible to explain the interpretations/results better in person than via a website. Now, there were actually a number of studies done which didn't show any real benefit to in-person explanations. And, as an aside, as someone who spent entire semesters trying to teach introductory biology to community college students, that makes a lot of sense to me: no matter how brilliant you are, there's a limit to how much biology you can explain to an average person in even face-to-face meeting that lasts an hour - and many medical doctors only meet with their patients for 5-10 minutes.

I don't have any problem with regulating things like brain surgery and even drugs where the wrong dose can kill you. And I'm even OK with regulating blatantly false or misleading information in certain limited contexts. But there's also the right to freedom of speech. When the FDA steps in an won't let a company post useful health information that represents the current expert consensus, that seems to me to be crossing a line.

In the ideal world, if the FDA disagreed with 23andMe's interpretation of any of the variants then they would have created their own website that explained the official government interpretation of each variant. A person could take their 23andMe data and upload it to the government website and get the official government interpretation.

Re: Fuck the FDA

[Anonymous Coward]

23andme got a warning saying they were making diagnosis without proper fda approval. They chose to outright ignore the fda. So they got shut down. The fda has a pretty clear and simple process and 23 could have probably just added a big warning that the data is not a diagnosis and one should talk to their Dr.

Re: Fuck the FDA

[Anonymous Coward]

Interesting anecdote but I work in a cap clia genetic testing lab setting and 23 and me was considered a bit of a joke at best and dangerous at worst. Pleiotropic effects, understanding stats enough ( most people don't) to make an informed decision on risk based on your background,qc, and the list goes on and on. Unless you have a very good background in the field you better get a genetic counselor and a proper interpretation to at least try to help. Otherwise you will be doing the same thing as self diagnosing on the internet when you have a small pain and think you have cancer. Ie think horses not unicorns when you hear hooves.

Re: Fuck the FDA

[Anonymous Coward]

...understanding stats enough ( most people don't) to make an informed decision on risk based on your background...

In what universe is a genetic counselor going to be able to teach an ordinary person statistics in a single one-hour meeting?

The people criticizing 23andMe assume god-like omniscience on the part of the licensed medical establishment. Do you have any idea how many possible variants there are? Do you somehow imagine that a genetic counselor, who typically has less training than a PhD molecular geneticist, is going to have memorized the interpretation of every possible variant - and be able to calculate in their head all possible interactions between the variants? The truth is that at the end of the day everyone is going to be reading from a computer generated report. And 23andMe's reports weren't any worse than what was available from the more mainstream test providers.

And the way things are set up, a person has to go through a medical doctor to take any concrete action anyway. All 23andMe was doing was offering information on a website. If a person looked at their 23andMe data and concluded that they needed a mastectomy they were still going to have to find a medical doctor to do it.

Re: Fuck the FDA

[Anonymous Coward]

i didnt say that. try to read.

Re:Fuck the FDA

[Hognoxious]

Sometimes the FDA does good things and sometimes the FDA does bad things.

But it never does anything out of the blue.

Genetically Blacks are dumber

[Anonymous Coward]

Every IQ tests proves it to the point where it is a statistical certainty.

Do you really believe skin color, bone shape, muscle mass etc can be determined by genetics but the brain is somehow immune?

Re:Genetically Blacks are dumber

[Anonymous Coward]

I've always found it interesting how physical characteristics like curly tails and floppy ears in dogs can be correlated to their (improved) behaviour, but in human populations it's considered apostasy to claim that behaviour and physical characteristics have anything to do with each other.

Re:Genetically Blacks are dumber

[fustakrakich]

Some people agree with you

Re:Genetically Blacks are dumber

[Anonymous Coward]

Every IQ tests proves it to the point where it is a statistical certainty.

Do you really believe skin color, bone shape, muscle mass etc can be determined by genetics but the brain is somehow immune?

Well on thing is a certainty , Trolls like you are even dumber by your logic, You're short and you smell bad.

Re:Genetically Blacks are dumber

[Anonymous Coward]

https://en.wikipedia.org/wiki/...

Ad hominem. If you're going to assert that all races are equal in intelligence, provide some evidence.

Re:Genetically Blacks are dumber

[Anonymous Coward]

Every IQ tests proves it to the point where it is a statistical certainty.

Do you really believe skin color, bone shape, muscle mass etc can be determined by genetics but the brain is somehow immune?

The range of IQ scores of blacks and whites overlap. Many blacks are smarter than the average white, and many whites are dumber than the average black.
You cannot take any random black person and know if that single individual's IQ score is lower, average or higher than the mean IQ score for whites.
You especially cannot know, if taking one random black and one random white, which has the higher score. You can know the probabilities for the groups, but you cannot know for any two individuals. I find that most people cannot understand this. Maybe people are dumb.

There are too many people who, when they hear that "The mean IQ score of blacks is less than the mean IQ score of whites", they believe that means "All blacks are dumber than any white person". Or, more likely, "I'm smarter than any black person".

You can define groups of humans based on almost any variable, test them, and you'll find the two groups have a different mean IQ score.
http://www.dailymail.co.uk/new...
These are people who are nearly identical genetically, but look at the differences in scores.

Re:Genetically Blacks are dumber

[AK Marc]

Every IQ test shows that you can alter the test to make any identifiable group "smarter" than another, if you choose. Yes, you could make an IQ test that would show Black people smarter than whites.

And yes, genetics is linked to physical characteristics, but there's been no proven link between race and those characteristics. Short Chinese people is a myth. It's mostly a product of their lower protein diet, and not genetics, but a racist glancing at them who believes in eugenics would try to breed the short out of them, when it's not in their genes.

It's that type of bigoted racism that people knee jerk against. Test the poorest poor whites in rural West Virginia against the top 10% (money, not IQ) of Blacks and you'll find a random selection from those groups shows Blacks smarter than whites. So, then what's the issue? Race? Or quality of life? But no, pointing out that poor people test worse gets the assertion that being dumb makes one poor, when the tests more closely show that being poor causes being dumb.

So yes, there is some genetics in the brain, but if you are looking at the wrong numbers, you'll get the wrong conclusion, and look like a racist bigot at the same time.

Re:Genetically Blacks are dumber

[Anonymous Coward]

You assume we compare poor impoverished blacks with everyone else.

Take the top 10% of every race and you will see blacks are always at the bottom, along with asians above whites and ashkenazi jews above all.

Would you mind explaining how an IQ test could be made to favor blacks above whites/asians/jews?

I can't see how that would work.

Re:Genetically Blacks are dumber

[KGIII]

Well, you could try going to live like the San people. I suspect you're probably not smart enough to do that. Point being, intelligence is a difficult thing to quantify and an IQ test isn't necessarily the best tool to determine such. It's just not a good quantifier. We could also argue the relevance of morality and situational ethics. We could also discuss the impact of poverty on intelligence or, more specifically, how it correlates to test results. I'd also submit that the IQ, as mentioned, is hardly a good metric. To have a standardized result then, if you insist, we can use that but it's up to you to demonstrate the importance.

All-in-all, it's rather subjective but I don't think we shouldn't talk about it. I just think we should talk about it like grownups.

So, how about you go ahead and tell us what your point is, what you think we should do about it, and how you feel it is relevant to the topic at hand. I'll be more than happy to have a mature and reasonable conversation with you.

Full disclosure: I'm mixed racially. I'm Native American (Micmac), Irish/English, and Black African (in order of percentage). I am not a geneticist. I do hold a Ph.D in Applied Mathematics and can understand statistics and have a reasonable grasp of logic.

So, sure... Let's have that discussion. What's your point? What do you think we should do? Why? How will it help? What's the goal? And how does it tie in with this research?

Re:Genetically Blacks are dumber

[Anonymous Coward]

Every IQ tests proves it to the point where it is a statistical certainty.

Given the rather large assumption that that's what IQ tests actually measure.

Re:Genetically Blacks are dumber

[Anonymous Coward]

Maybe people are dumb.

Most people are. Extremely.

Re:Genetically Blacks are dumber

[Anonymous Coward]

*one* thing
delete space after "certainty"
"trolls". Lowercase - not a proper noun
period after dumber, start new sentence with *B*y
*y*ou're

Were you drinking orange soda while you were typing that?

Re:Genetically Blacks are dumber

[Hognoxious]

Yes, you could make an IQ test that would show Black people smarter than whites.

That's trivially easy but it proves nothing. But would that test be a valid yardstick or predictor of ability & success within groups?

If you wrote the test in French, for example, it would make French people look a lot smarter than Americans. But would it be able to distinguish smart French people from their less intellectually gifted compatriots?

If the answer is no, you aren't testing what you claim to be testing. Some old tests did have this fault, which is perhaps why some people claim they're general knowledge tests. Modern tests don't have questions like "yacht is to ____ as chukka is to polo".

Re:Genetically Blacks are dumber

[AK Marc]

So if society has systemic racism and success is less likely in a Black person than a white person, the test should be rigged such that Blacks will score lower?

That's trivially easy but it proves nothing.

It proves the test is arbitrary, and not a measure of Racial Supremacy, as the OP suggested. You seem to be agreeing with my point, but disagreeing with my manner of presenting it.

Blacks are dumber than whites

[Anonymous Coward]

IQ tests provide overwhelming statistical evidence. It is unscientific to believe genetics determine skin color, bone shape, muscle mas etc but have no effects on brain development.

Re: Blacks are dumber than whites

[Anonymous Coward]

It's also unscientific to ignore peer-reviewed research that shows conclusively there is absolutely no difference in intelligence level or capability between black and white (or black and any other) races.

Plus, fuck you in your inbred face.

Re: Blacks are dumber than whites

[Anonymous Coward]

"It is an article of passionate faith among 'politically correct' biologists and anthropologists that brain size has no connection with intelligence; that intelligence has nothing to do with genes; and that genes are probably nasty fascist things anyway." -- Richard Dawkins.

Re: Blacks are dumber than whites

[Anonymous Coward]

The Bell Curve

Black-White Cognitive Gap

SAT Scores

But hey, keep telling yourself that evolution stops when it hits the brain despite overwhelming evidence to the contrary, just because it makes you feel better

Re: Blacks are dumber than whites

[Anonymous Coward]

It's an uncomfortable statement but just because you don't like the implications doesn't mean it isn't true.

Re: Blacks are dumber than whites

[tmosley]

"It's also unscientific to ignore peer-reviewed research that shows conclusively there is absolutely no difference in intelligence level "

That would be the case, were it true. But it isn't, sadly. It is so much easier to just wave your hands and claim that we are all the same, but we aren't. It might not even be genetic. I suspect that anyone who was born with dark skin would see a similar, if less pronounced effect as the sheep wearing the scary mask: https://www.youtube.com/watch?...

Human brains all work the same. Problem is that human brains interpret differing skin colors to have differing characteristics, something that might just be a self fulfilling prophesy. One that can only be solved by that most anti-liberal of solutions--segregation.

Re: Blacks are dumber than whites

[C0R1D4N]

It isn't physical. It is a result of culture and education. In places where blacks are generally equal to white (such as England) there's no difference.

Re: Blacks are dumber than whites

[BarbaraHudson]

So, human skin color determines other characteristics? Guess that explains "Black is beautiful," "Once you go black you never go back," "White boys can't jump," etc. Too bad IQ tests are a poor indicator of overall intelligence. There is a negative correlation, though. The more faith you put in these tests, the dumber you are.

Re: Blacks are dumber than whites

[Anonymous Coward]

It also explains why Africa is a shithole where people still live in mud huts while whites went to the moon.

Re: Blacks are dumber than whites

[tmosley]

"So, human skin color determines other characteristics?"

If you don't believe that, then you don't believe in racial discrimination. Skin color doesn't directly dictate characteristics. IE an all white or an all black society can and have historically been equally barbarous or ascendant. But mix the two together and something strange happens. The society stratifies according to skin tone. This has happened in many entirely separate cultures (India being a good examples--dark skinned South Indians have rarely ruled over light skinned North Indians). This is clearly not due to some inherent mental defect caused by increased melanin production, but by societal interaction. Placing more trust in light skinned people, and less trust in dark skinned people. Even the Incas were said to be ruled by light skinned (and even blond headed) people, where the Aztecs worshipped some ancient whites they may have encountered as gods (and thus perhaps mistook blond haired, blue-eyed Spaniards for Gods). White skin is bad for you, in that it increases skin cancer. Light colored eyes are bad for you as well, as you more quickly lose your sight in old age. Yet these characteristics have been strongly preserved. There must be a reason for that.

" Too bad IQ tests are a poor indicator of overall intelligence"

No, it is a very good indicator of that. It's just that it correlates almost exactly with skin color, more precisely than with genetics (ie Australian aboriginals and Southern Indians have very low IQs on average, not just Africans, or some certain subset of Africans, as would otherwise be predicted by genetic theory).

It seems to me that skin color causes other people to behave differently towards you. As shown in studies of the perceptions of young children (http://abcnews.go.com/GMA/story?id=2553348&page=1), dark skin is perceived as "bad", "ugly", "masculine", "dishonest" where white skin was perceived as the opposite. Think about how interactions with people who have such genetically defined prejudice against you would effect your development. This is what we call a "self fulfilling prophesy". Kids who aren't trusted tend to be more anti-social--period. This is well known, as kids, including white kids, who get caught in the system tend to remain in it and become ever more criminal. IE they are treated like criminals, so they become criminals.

Failing to recognize these features/biases in human cognition doesn't help anyone. It only hurts us. ALL of us. Most especially the disadvantaged groups we claim that we are trying to help. Fact is: they need to be isolated from white people, because they trust them more than they should, at the expense of their own who are trusted less than they should be, based on individual merit. Communities like Greenwood prospered, until they ran afoul of whites. Then they were annihilated. The current system certainly seems to have failed blacks. Seems like it is time for a change.

Re: Blacks are dumber than whites

[tmosley]

White people lived in mud huts until not that long ago. And only a few of the most traditional societies in Africa still live like that, or those in the most oppressed, anti-capitalistic societies. Capitalist nations, like Botswana, boast GDPs that rival first world nations, and are really only called anything other than first world because they have crappy neighbors.

Re: Blacks are dumber than whites

[Anonymous Coward]

How are blacks not equal, if not superior to whites in the U.S.?

Diversity quotas, lower requirements for entering the same college, more scholarships, etc.

Re: Blacks are dumber than whites

[Anonymous Coward]

Capitalist nations, like Botswana, boast GDPs that rival first world nations

Botswana's GDP is of $15.8 billion. That ranks them at 120th. Per capita, that's $7,123 per year. They're nowhere close to first world. And most of Africa is Capitalist. All of it if you exclude tribes that have little notion of property.

Re: Blacks are dumber than whites

[AK Marc]

So, human skin color determines other characteristics?

Human skin certainly determines the susceptibility to certain kinds of cancer. And skin color correlates well with incidence of sickle cell anemia. And skin color correlates well with salt sensitivity (for heart disease, not taste). Skin matters for lots. But it hasn't been shown to correlate for many other things. It seems reasonable to assume it will correlate with some physical characteristics (like gender and height), and mental characteristics. But so far, no conclusive links have been found. And lots of people have looked really hard.

Re: Blacks are dumber than whites

[Richard_at_work]

I've traveled a lot in Africa (Botswana, Uganda, Kenya, Namibia to name a few) and mud constructions are still pretty much the norm for most villages - concrete or modern construction is sometimes utilised, but oftentimes a family simply cannot afford those construction methods - so they resort to mud bricks which have been kiln dried. The only consistent modern material used is corrugated metal for the roof.

Re: Blacks are dumber than whites

[Anonymous Coward]

This comment, more than any of your others, reveals how little you know about how culture and environment affects outcome. Nurture is as important as Nature.

You just failed your own IQ test.

Re: Blacks are dumber than whites

[BarbaraHudson]

Your arguments are flawed. There is no genetically defined prejudice against people with different skin color. There is a socially-inclined prejudice, but change the societal environment, and it disappears. Hint: we grew up too poor to afford the *luxury* of being racist. We had more important things to worry about than the color of our friends skin.

Re: Blacks are dumber than whites

[tmosley]

"There is no genetically defined prejudice against people with different skin color"

Nope, sorry. This is shown in videos of the youngest children. Babies focus more on white dolls than black ones. Facts won't go away just because they are uncomfortable.

Also, just waving your hands around and saying "that isn't so" isn't proof.

"we grew up too poor to afford the *luxury* of being racist. We had more important things to worry about than the color of our friends skin"

You act as if that is some kind of point. This has nothing to do with being friends with anyone. Most white people have black friends. I do and have since I was a little boy. That doesn't change the fact that blacks are perceived as being more masculine and less trustworthy based solely on skin color (as shown with the same effect occurring in India), and that this occurs in all human societies, including those populated entirely by black people.

Re: Blacks are dumber than whites

[tmosley]

Purchasing power parity (PPP). That $7000 a year buys the equivalent of a middle class lifestyle there.

Re: Blacks are dumber than whites

[tmosley]

Villages. Try towns and cities.

And kiln-fired mud bricks are NOT the components used to make a mud hut. That would be sticks and mud.

Re: Blacks are dumber than whites

[tmosley]

"And most of Africa is Capitalist"

I see you, like the vast majority of people, have no idea what that term means. HINT: If you have a central bank, you aren't capitalist. HINT 2: If you have corrupt, thieving government officials, then you aren't anywhere NEAR capitalist. The role of government in a capitalist society is to prevent and punish aggression from within and without. Not to rob the people and enrich those in power.

Re: Blacks are dumber than whites

[Megol]

What you are saying is that there are no capitalist countries? If that's true in the same way there are no communist countries nor fascist ones. But that says little about anything.

Re: Blacks are dumber than whites

[Megol]

Bricks? That's not what most of us call mud. :P

Claiming that mud huts is some indicator of intelligence (as the clueless fuck above tries to do) is in itself laughable - if anything it is an indication of intelligence. There are less complex huts that can be made but mud is cheap, ecologic, easy to work with and (if used correctly) a near perfect match to the climate. Why build western style houses when they would be much more expensive and much harder to maintain where the weather is extremely wet for long periods followed by extreme heat for long periods, not to mention that in many places in Africa there is very little wood usable for construction - heck in some places there aren't enough to cook on.

Re: Blacks are dumber than whites

[Anonymous Coward]

Yes, there's NO true scotsman.

Re: Blacks are dumber than whites

[BarbaraHudson]

That can still be attributed to other factors. Show me the etiology, the genes that you just claim genetically defines prejudice against people with skin color. You claim they exist, so where are they already? Or, as you say, 'Waving your hands around and saying "that IS so" isn't proof either.

Re: Blacks are dumber than whites

[GuB-42]

So, human skin color determines other characteristics?

Usually not, but it often correlates with other characteristics. For example, white skin tend to correlate with long nose although AFAIK they are completely separate traits. There are other indisputable correlations between skin color and other biological traits. So I don't think it is much of a stretch to assume that there are correlations with higher functions too.
Interracial procreation can blur these differences but we need both a change of mindset and a few generations to get there. Sexual preference still goes towards the same race group.

Culture matters too, but guess what, there are also correlations between culture and skin color too, and despite all the good talk about the "melting pot", the line may be a little bit blurry but it is still there.

Oh and sorry for beating the dead horse but you don't believe that correlation implies causation, do you?

Re: Blacks are dumber than whites

[GuB-42]

White skin is bad for you, in that it increases skin cancer. Light colored eyes are bad for you as well, as you more quickly lose your sight in old age. Yet these characteristics have been strongly preserved. There must be a reason for that.

Yes, that's called vitamin D.
UV light do two things to the skin : damage it, which is bad, and give vitamin D, which is good. You can't separate the two.
As a result, people from the north, where there is very little sunlight especially during the winter, have light skin as a way to get as much vitamin D as possible, whereas people from near the tropics where there is plenty of sunlight have dark skin as a natural sunscreen to prevent UV-related skin damage.
The eye color is related to the skin color because melanin is what makes both skin and eyes dark.

Another thing is 80 year life spans are a new thing. Traits that may prove an advantage passed 50 didn't matter that much from an evolutionary point of view when few people even got to that age, and if they could, probably didn't reproduce passed it.

Re: Blacks are dumber than whites

[BarbaraHudson]

No, I don't believe that correlation necessarily implies causation. I also don't think that IQ tests correlate with intelligence. If the IQ tests were designed by the Inuit, we'd mostly be classified as severely retarded.

Re: Blacks are dumber than whites

[tmosley]

There is a continuum. Currently every "capitalist" country actually has a mixed market (ie they have a central bank and thus the centrally plan the price of money, the foundation of free exchange) rapidly sliding into one form of socialism or another. Those that adhere most closely to the capitalist ideal do the best (think Singapore), while those that stray the furthest inevitably collapse (think Zimbabwe--and note that we have the exact same monetary policy as they did leading up to their hyperinflation).

Everyone submit your DNA!

[hsmith]

It will make building a national database that much easier for police to scour.

Re:Everyone submit your DNA!

[Anonymous Coward]

If you're worried about this, you spend too much time jizzing in places you shouldn't.

Re:Everyone submit your DNA!

[Cederic]

Or you're aware of how easily mistakes are made, how flawed the testing is and how the statistics are misunderstood and misrepresented.

I'm far less likely to be prosecuted for a crime I didn't commit if my DNA isn't available to be wrongly matched with that of a criminal.

can't deal with that Elephant in the Room

[turkeydance]

c'mon, man.

Predictive testing

[PopeRatzo]

According to the data, one can predict the stupidity of a Slashdot comment by whether the poster is an Anonymous Coward. Studies have proven this time and time again.

Data, like hips, don't lie.

Re:Predictive testing

[Anonymous Coward]

And it takes an AC to make a stupid comment? Think your comment proved otherwise...

Re:Predictive testing

[Anonymous Coward]

According to the data, one can predict the stupidity of a Slashdot comment by whether the poster is an Anonymous Coward. Studies have proven this time and time again.

Data, like hips, don't lie.

Fuck you. Ben Carson would be a great president.

Re:Predictive testing

[Anonymous Coward]

According to the data, one can predict the stupidity of a Slashdot comment by whether the poster is an Anonymous Coward. Studies have proven this time and time again.

And it takes an AC to make a stupid comment? Think your comment proved otherwise...

PopeRatzo's claim does not imply that "an AC" was a necessary condition to make a stupid comment.

Re:Predictive testing

[Anonymous Coward]

I figured it was half- a-troll to imply that indeed, AC's are ignorant posters, but then I realized that of course that is not the case. AC's are the only one capable of making a post that isn't dependent on the fragile ego of a neckbeard basement-troll.

Re:Predictive testing

[Anonymous Coward]

That makes sense. Nothing on slashdot has ever been posted by an AC. Oh, wait...

Open Source Personal Analysis Tool

[kromozone]

Instead of opening your data up to yet another corporation by trusting someone else to analyze your raw data, why not create an open source application that you can download to analyze your raw genetic data? I'm sure the molecular biologists out there would be more than willing to help contribute.

Re:Open Source Personal Analysis Tool

[Anonymous Coward]

DNA.LAND is moving in that direction. The people at Genes for Good might have similar aspirations as well.

Re: Open Source Personal Analysis Tool

[BarbaraHudson]

They would still have the data.

Re: Open Source Personal Analysis Tool

[KGIII]

It would be awesome to have a small finger sticker and analytics device, like used for diabetes blood sugar testing kits, that, maybe, hooked into a USB port and did the work there and was able to spit the data out. Then you could do all sorts of things, up to and including things like removing any easily identified PII and sharing the results with the research communities of your own volition.

They took a bunch of blood when I joined the military. While this was, indeed, many years ago (mid 1980s when I went back in to get more funding for school) - I'm not naive enough to think that they don't still have that vial on ice somewhere or haven't already run it through the various machines to get a copy of my DNA. So, I no longer have control of that data. In hindsight, well, I guess I'm okay with it - the rewards were worth the loss, currently. However, I wish I'd a choice in the matter as to them keeping the data after I left. I'm quite certain that they did.

If I could do the test locally and then opt to strip it of 'exif' data (for wont of a better word) then I'd probably be willing to donate it to a responsible research party provided they gave me something in return - like a markup that indicated my heritage and whatnot. There's a bit of Black African in me and we can't trace the history back beyond the Revolutionary War and I'm curious about that. There are also heritage aspects that I'd like to know more about. I'd give up my data, to a responsible research group, for that benefit.

No way in hell would I give it to this company or to any other commercial enterprise. Not willingly, at least. With my luck someone in the government's already sold it to them. Or, rather, given them access in quid pro quo for campaign donations or for employing a few friends from within their district.

Re:Open Source Personal Analysis Tool

[ponos]

The data is quite simple. At the most basic level it's just a photo of bright spots on a chip, as read by the machine. Knowing that spot A corresponds to variant A and spot B to variant B, an algorithm then decides ("calls"), depending on the relative brightness whether the person has variants AA, AB or BB (or impossible to tell). This is the only real processing and there IS open source software for that (packages for R, most famously CRLMM).

So, the whole point is getting the variant calls, ie what sort of nucleotide the person has at specific positions, for example rs314159 --- yes I chose that based on pi, but it does exist. If you have the variant calls, you can then try to decide, based on available literature, what this means for your health.

The not-so-obvious reason why SNP genotyping has not yet made it to the clinic is that polymorphisms (the stuff that genotyping arrays discover) are either frequent or associated with significant effect, but rarely both. Some rare variants (for example BRCA1/2) have important consequences and some variants are very frequent (for example, for hair color) but don't have important health consequences. This is the result of natural selection: bad genetics tend to get thrown away and become rare.

Simply put, most of the information associated with frequent polymorphisms only modifies risk by a relatively weak amount (relative risk 1.2-2, for example) and may also depend on other polymorphisms or entire haplotypes (a whole bloc of DNA) or even the environment. The resulting information is NOT of sufficient quality to dictate anything beyond things that we already know, ie don't smoke, eat healthy, moderate exercise etc. There are a few exceptions, for example in pharmacogenetics, where some people react differently to drugs, especially important or highly toxic drugs (clopidogrel, 5-fluorouracil, irinotecan etc). In these cases, there is some interest in genotyping and the FDA does mention cases where it could matter. Nevertheless, genetic testing for pharmacogenetics is not universally performed and is not generally required.

In the end, at the current state of affairs, the information provided by 23andme is most useful for ancestry but not particularly useful for health-related decisions. Which is why the FDA stopped them in the past.

Anyway, don't underestimate the interest 23andme has in farming your data (like Google). Even anonymized data without phenotype correlations can be scientifically very interesting. This is not necessarily a problem, but is likely to be the case with all similar genotyping offers.

Re:Open Source Personal Analysis Tool

[Anonymous Coward]

...why not create an open source application that you can download to analyze your raw genetic data?

Many, if not most of the major analysis tools are already freely available (usually even fully open source).

Let's say your raw data is a full genome sequence reads from an Illumina sequencer (which costs about $1,000 from a few drops of saliva at the going rate). Well, first thing you're going to do is map your raw reads to a reference genome. The most common reference genome in use is freely available from the NCBI ftp site that is provided by the US NIH. And there are plenty of free read mappers available - many people like BWA, for example, which is, of course, freely available. And then the next thing you're going to do is call your variants. Again, there are plenty of free variant callers available. If you don't care about fancy statistics and corner cases then you could even just write yourself a simple Perl script. Many people like GATK, though, which is, of course, free and does all kinds of fancy thing like realigning indels and calling variants on multiple individuals simultaneously. Then you're going to need to map your variants to predicted effects. Again, there are lots of freely available tools for this. Or you could download the raw data from various free ftp sites around the world and write yourself a couple custom Perl scripts. Historically many people have used Annovar for this - which is freely available but a pain to install because of all the underlying data that is needed. There are also a number of up-and-coming websites such as the Ensembl Variant Effect Predictor (VEP) that are, of course, free and will spare you the pain of installing all the underlying biological databases locally. And then when you have a variant of interest, you'll want to look at it more closely in a genome browser. Again there are lots of free choices: IGV out of the Broad Institute is a nice standalone browser written in Java. But then UCSC has a nice genome browser written in JavaScript that you can access with any modern web browser. There's also all kinds of (free) specialized tools to look for structural variants such as large regions of loss of heterozygosity (LOH) or structural breakpoints.

The problem is that it takes quite a bit of expertise to use all of these tools. It's a lot like Linux in the early days before easy to install Linux "Distributions", with easy to use package management systems, became common. No doubt we'll get there soon. Google even seems to be putting together it's own little cloud-based genome analysis environment. But making it easy for ordinary people to understand their genomes is not easy. You can't just tell an ordinary person that they have a ten megabase loss of heterozygosity out on the p-arm of chromosome 13 and expect them to know what you're talking about.

And getting back on topic, 23andMe was focused on just that problem: putting together a website that could help ordinary people understand their genomes. And the FDA shut them down. Certain medical doctors and genetic counselors thought people should only get information about their genomes from in-person face-to-face meetings. They didn't like the idea that they could be replaced with a slick website. So, not only is it a hard problem, but the FDA might shut you down if you try to develop software tools / website that help people understand their genomes.

Re:Open Source Personal Analysis Tool

[Anonymous Coward]

The not-so-obvious reason why SNP genotyping has not yet made it to the clinic is...

At this point, SNP genotyping is pretty much obsolete for health-related uses because you can now get a full genome sequence for about $1,000 from just a few drop of saliva - well the raw data, at least - a custom interpretation for a suspected genetic condition might easily run you $20K. SNP genotyping can still be useful for detecting losses or duplications of large parts of a chromosome ("structural" variations) - but mainly because the analysis software is more mature.

There are a few exceptions, for example in pharmacogenetics, where some people react differently to drugs, especially important or highly toxic drugs (clopidogrel, 5-fluorouracil, irinotecan etc).

Based on the presentations at the American Society for Human Genetics (ASHG) in Baltimore last month, many of the major healthcare organization in the USA are making plans to implement genetic testing for adverse reactions to these drugs. It may be a few more years before it all actually gets rolled out universally (there are currently a number of large pilot studies ongoing) - and it may just be full genome sequencing rather than SNP genotyping - but this is coming. It's a question of "when" rather than "if".

In the end, at the current state of affairs, the information provided by 23andme is most useful for ancestry but not particularly useful for health-related decisions.

There were quite a few people who found out through 23andMe that they were carriers for dangerous BRCA variants. 23andMe almost certainly saved some people from dying of breast cancer. Personally, I'd say that not dying of breast cancer is useful.

Which is why the FDA stopped them in the past.

I've encountered an almost universal consensus among the top molecular geneticists that the FDA made the wrong decision. So, in certain sense, the FDA stopped 23andMe because the FDA was stupid.

But, anyway, the real motivation behind the FDA's actions was that certain medical doctors and genetic counselors didn't want to be replaced by a slick website. They argued that 10 minutes of face time with a certified professional was better than unlimited time on a carefully crafted website. There were scientific studies about conveying information to patients that didn't support this contention. But the head of the FDA at the time was a medical doctor herself - so she was sympathetic to that view point even if it was not supported by the science.

Re:Open Source Personal Analysis Tool

[Anonymous Coward]

Anyway, don't underestimate the interest 23andme has in farming your data (like Google). Even anonymized data without phenotype correlations can be scientifically very interesting.

I like 23andMe. I even applied to work there (never heard back at all) a few months ago. And their booth at the American Society of Human Genetics meeting in Baltimore last month was hugely popular.

But it was interesting that when I stopped by their booth and asked a slightly rude question: "Do you have any plans to transition from SNP genotyping data to full genome sequencing?" The person I asked had this fleeting look of sadness and despair - and then said no, they were just going to stick with SNP genotyping.

The more I think about it, the more I think that's very telling. Because even Barack Obama who has been way behind the curve on the personal genomics revolution is planning a "precision medicine initiative" that will almost certainly sequence a million genomes over the next few years. In 5-10 years, all that painstakingly collected 23andMe SNP genotyping data is going to be obsolete.

That's not to say that 23andMe can't reinvent itself in one way or another. But their current "goldmine" of genomic data is rapidly becoming obsolete. They are facing some huge challenges.

Re:Open Source Personal Analysis Tool

[RDW]

23andMe use SNP arrays (custom Illumina BeadChips) rather than NGS at the moment. The 'raw' data they supply isn't really raw at all, but a processed list of several hundred thousand variant calls:

http://www.snpedia.com/index.p...

You can convert this into something standard like VCF, which most tools that deal with variants will read.

Re: Open Source Personal Analysis Tool

[Anonymous Coward]

Uh, they probably tested your blood for STDs and contagious diseases and then threw it out.

There actually isn't much DNA in blood. Hemoglobin does not have a nucleus. 23andme use a sample of your cheek cells for sequencing.

Re:Open Source Personal Analysis Tool

[Anonymous Coward]

Yes, the 23andMe SNP data is rapidly becoming obsolete. But, even if you start with the list of called variants from 23andMe, there are still a lot of steps needed to get to a final interpretation. And, even though most of the tools are freely available, very few people have the expertise that is needed to know how to use them.

Re: Open Source Personal Analysis Tool

[Anonymous Coward]

Not all blood cells are red blood cells - i.e. there's the white blood cells (the immune system cells) which do have DNA. It's now possible to sequence most of the genome of a single cell so not much DNA is needed. There are even "NIPT" tests you can get now that sequence the genome of a fetus using a sample of blood from the mother (bits of cell-free fetal DNA end up in the mother's blood stream).

But, yes, you can also use cheek cells or saliva. If you're doing something like next-gen sequencing, a fraction of your reads won't be human (they'll map to the various species of bacteria in your mouth). But asking people to send a saliva sample is much easier than asking people to send a blood sample - when you're in the DTC (direct-to-consumer) market.

Re: Open Source Personal Analysis Tool

[BarbaraHudson]

Now you can get glucometers with BluTooth data sharing :-)

Re:Open Source Personal Analysis Tool

[Rutulian]

At this point, SNP genotyping is pretty much obsolete for health-related uses because you can now get a full genome sequence for about $1,000 from just a few drop of saliva

No way. Two lanes of HiSeq (the most economical method) will net you about 10X coverage (assuming uniform coverage, which you won't get) for about $3000 at academic prices. For SNP calling, 20-30X is usually considered the minimum, with 50-60X being preferred. And then there is still the cost of DNA isolation, library prep, QC to factor in. The $1000 (human) genome is still quite a ways away.

SNP genotyping can still be useful for detecting losses or duplications of large parts of a chromosome ("structural" variations)

Maybe you are just being lazy with your terminology, but SNP genotyping, by definition, does not look for structural variations. SNP == single nucleotide polymorphism. There are separate arrays to look for these variations, but they are not SNP arrays. That said, while whole genome data might be better suited for this type of analysis, it is far from trivial. Usually targeted amplification of specific loci is used, not whole genome data. There is a tendency to believe that more data is always better, but genome data is not easy to understand. If you ever thought pharmaceutical research was sloppy due to poor statistical analyses and over interpretation of results, multiply this by 1000 for genome studies.

 

But the head of the FDA at the time was a medical doctor herself - so she was sympathetic to that view point even if it was not supported by the science.

I partially agree, but there is quite a bit of disagreement in the field about how significant these associations are and how meaningful they are with respect to medicine. It is easy to scare people and then use that to sell medications or treatments that may or may not work, so going through experts that have studied extensively and remain up-to-date in the field is good, in my opinion. Lots of people try to self-diagnose from websites already. I don't think that is leading to better healthcare outcomes. If you are worried about people who just want to make some quick cash, I would worry more about all of the companies selling tests and devices than I would about the doctors themselves.

Re:Open Source Personal Analysis Tool

[Rutulian]

The 'raw' data they supply isn't really raw at all, but a processed list of several hundred thousand variant calls:

No, but it is cheap, which is not to be underestimated. If we want affordable healthcare, we have to care about cost and not just the new shiny. The other thing is, focusing on select variants allows them to do a targeted analysis. In a world plagued by systems biology, people like to think a "global picture" is always better, but having some idea what you are looking for before you start collecting data makes your statistical analysis, you know...meaningful.

Re:Open Source Personal Analysis Tool

[Rutulian]

And getting back on topic, 23andMe was focused on just that problem: putting together a website that could help ordinary people understand their genomes. And the FDA shut them down

The FDA requires analytical verification ( does the test or service accurately and reproducibly provide the data that you are saying within acceptable margins of error? ) and clinical validation ( can the results of the test or service be reliably associated with specific health outcomes, after accounting for statistical significance and effect sizes? ) for medical devices and services sold in the USA. 23andMe has to go through this process as does every medical services company. This is not a conspiracy. The interpretation of medical data is not completely straightforward and requires a fair amount of expertise. Drug companies and device manufacturers like to whine about the FDA because they want the freedom to sell their snake oil to the public, but if you want medical decisions based on the careful consideration of the available science and not emotional manipulation, what the FDA does is essential.

The problem is that it takes quite a bit of expertise to use all of these tools. It's a lot like Linux in the early days before easy to install Linux "Distributions"

No, it is not like that at all. If it were a simple matter of an easy to execute set of programs, those tools would have been written a long time ago. There are, in fact, plenty of easy to use tools out there already. The challenging part is the nuance and interpretation of the data: understanding the error rates and data biases, knowing how to look for things like structural variation, understanding different types of mutation and how they may affect downstream processes, knowing how to verify your data and determine whether the result is trustworthy. With genetic data there is the additional aspect of inheritance. Probability is inherent to the interpretation of most of analyses; a straightforward yes or no is much less common. It takes many years of study and experience to get to this level. Some analyses are straightforward enough to be automated, but not all of them. Which is why we aren't going to get rid of doctors any time soon.

Re:Open Source Personal Analysis Tool

[RDW]

That was really just a comment for biology geeks about the kind of data they provide. With a true raw file, you can get more out of SNP array data (e.g. genomic copy number). The 23andMe pricing is pretty keen, though, perhaps only about double what what you'd pay an academic service provider to run a SNP array of similar size (you'd get full raw data, but would have to do the DNA extraction and data interpretation yourself). An exome costs about 10x the price of the cheapest SNP array, and a whole genome maybe double the exome price (more if you want high depth of coverage), so I agree that SNP arrays still look good for some applications. There's more than enough data on the 600k 23andMe array to run into the multiple testing problem if you aren't careful with the stats! 23andMe themselves only report on a very small fraction of the variants, but the rest of the calls are available in the 'raw' output.

Re:Open Source Personal Analysis Tool

[RDW]

SNP genotyping can still be useful for detecting losses or duplications of large parts of a chromosome ("structural" variations)

Maybe you are just being lazy with your terminology, but SNP genotyping, by definition, does not look for structural variations. SNP == single nucleotide polymorphism. There are separate arrays to look for these variations, but they are not SNP arrays.

You can certainly use SNP arrays to look at losses, duplications, and copy number changes in general - this is done routinely. Full SNP array data gives you not just variant calls, but also signal intensity etc. for each probe. You can't look directly at other forms of structural variation like translocations and inversions, although it may be possible to pick up focal copy number changes at the breakpoints.

Re:Open Source Personal Analysis Tool

[Anonymous Coward]

No way. Two lanes of HiSeq (the most economical method) will net you about 10X coverage (assuming uniform coverage, which you won't get) for about $3000 at academic prices. For SNP calling, 20-30X is usually considered the minimum, with 50-60X being preferred. And then there is still the cost of DNA isolation, library prep, QC to factor in. The $1000 (human) genome is still quite a ways away.

Macrogen up in Korea has the highest certifications available - better than CLIA in terms of raw data quality - guaranteed to be as good as if Illumina did the sequencing for you itself. And they offer 30X whole genome for $1,000 (an extra $100 to extract the DNA from saliva). They also offer combined whole genome and 100X exome for $1,500.

Maybe you are just being lazy with your terminology, but SNP genotyping, by definition, does not look for structural variations.

As others have pointed out, in practice that's one of the main things it's used for.

It is easy to scare people and then use that to sell medications or treatments that may or may not work...

I agree that if you're doing something physical - selling a drug, performing a surgery, etc. - then it's OK to place some limits on freedom of speech associated with that activity. But 23andMe was pure speech - there weren't offering anything physical - only information.

Re:Open Source Personal Analysis Tool

[Rutulian]

Macrogen up in Korea has the highest certifications available - better than CLIA in terms of raw data quality - guaranteed to be as good as if Illumina did the sequencing for you itself. And they offer 30X whole genome for $1,000 (an extra $100 to extract the DNA from saliva). They also offer combined whole genome and 100X exome for $1,500.

Right, sure, go ahead and send your sequencing to Korea. What is the cost to have it done by MacrogenUSA, the subsidiary that can actually do FDA-approved work? $1000 doesn't even cover the cost of the materials, so who knows what they are pulling to advertise that.

But 23andMe was pure speech - there weren't offering anything physical - only information.

The issue is, what do people do with that information? If they run out and start seeking a bunch of new age remedies for perceived ailments because they don't understand enough about genetics to know what they are looking at, then it can be a real public health problem. Just look at vaccines. Jenny McCarthy wasn't even selling information, she was just giving it away for free, and it panicked enough people that they made some really dangerous decisions affecting their children and other people around them.

There is no tangible difference between "doing something physical" and "doing something on the internet." A genetic counselor doesn't do anything physical. They just talk to you. But they still have to be licensed to operate in their official capacity.

Re: Open Source Personal Analysis Tool

[Agripa]

It would be awesome to have a small finger sticker and analytics device, like used for diabetes blood sugar testing kits, that, maybe, hooked into a USB port and did the work there and was able to spit the data out.

You do not think such a device would be used by the authorities like in GATTACA?

Re: Open Source Personal Analysis Tool

[KGIII]

Well then I'd be on the lookout for agents with little stabby pens. Just because it can be abused doesn't make me not want it.

Re:Open Source Personal Analysis Tool

[ponos]

At this point, SNP genotyping is pretty much obsolete for health-related uses because you can now get a full genome sequence for about $1,000 from just a few drop of saliva - well the raw data, at least - a custom interpretation for a suspected genetic condition might easily run you $20K. SNP genotyping can still be useful for detecting losses or duplications of large parts of a chromosome ("structural" variations) - but mainly because the analysis software is more mature.

I am aware of the difference between the cost of data and the cost of healthcare resulting from said data, but the poster was explicitly asking about the relevance of "open source" raw data so that he could do the interpretation himself. I am also explicitly mentioning arrays, because this is the cheapest technology and the one used by 23andme. Nevertheless, this kind of technology (and yes, the genome too!) has not made a very meaningful impact in clinical practice, with the obvious exception of clinical genetics. Now, you probably already know that today it's much easier to get a diagnosis of some rare muscular dystrophy or some weird anomaly of metabolism thanks to genome sequencing. However, with the exception of some genetic conditions (BRCA1/2, Lynch syndrome, Cystic fibrosis), clinical genetics are only useful for a small percentage of the population. That is exactly what I am saying: there is great progress for a small percentage of the population with rare, high-penetrance, devastating diseases, but there is not meaningful genetic test for type 2 diabetes, hypertension, cardiovascular disease, COPD and other frequent conditions. I already explained the reason above but you can also read more about it elsewhere (for example: http://www.nature.com/nrg/jour..., frequent diseas)

Based on the presentations at the American Society for Human Genetics (ASHG) in Baltimore last month, many of the major healthcare organization in the USA are making plans to implement genetic testing for adverse reactions to these drugs. It may be a few more years before it all actually gets rolled out universally (there are currently a number of large pilot studies ongoing) - and it may just be full genome sequencing rather than SNP genotyping - but this is coming. It's a question of "when" rather than "if".

I agree, which is why I said that this kind of application is more mature and that's why I called it an "exception". I already occasionally ask for DPYD or UGT1A1 genotyping for my patients, so certainly this is not a very remote scenario. Nevertheless, some kind of HARD data will have to justify the expense: reduction of hospitalisations, chemotherapy mortality or something similar. Just showing that universal genotyping predicts ... genotype is not enough. There has to be a meaningful clinical advantage for a significant number of patients.

There were quite a few people who found out through 23andMe that they were carriers for dangerous BRCA variants. 23andMe almost certainly saved some people from dying of breast cancer. Personally, I'd say that not dying of breast cancer is useful.

Well, that is an interesting byproduct of chance and certainly these people were lucky. However, you are certainly aware that SNP genotyping is NOT a valid test for BRCA variants for many different reasons. So, I would counter argue that some people were also falsely reassured by a negative result of a suboptimal test.
If people need to know their BRCA status, they need a proper test (=sequencing with sufficient depth at an accredited lab), a proper interpretation of variants (especially class 2-3!) and discussion of the family tree by a medical geneticist. I understand that cheap DIY healthcare is appreciated in the US, but you can't seriously consider 23andme results as sufficient in this context.

At least you aren't using a pseudonym, "PopeRatzo"

[Anonymous Coward]

Whew, I'm relieved to see that you're using your full legal name here, and not some sort of a pseudonym, "PopeRatzo"! Otherwise we'd have to think that you're posting anonymously, like some sort of a coward.

Slashvertising

[goodmanj]

Clearly nobody read the link, because it's one big fat ad for a third-party genome-analysis tool and nobody's complained yet. Come on, people, keep up!

Re:Slashvertising

[Sperbels]

So are we allowed to mention any company names in a slashdot news article? Or is it all Slashvertisement? As one who is a user of 23andme, this is actually fairly significant news for me. It also has enormous privacy implications and is seems quite news-for-nerds worthy.

Re:Slashvertising

[ArchieBunker]

I thought about trying their service but for $199 I'll pass.

Re:Slashvertising

[drinkypoo]

I thought about trying their service but for $199 I'll pass.

I thought about trying their service but for the ultimate invasion of privacy and an open door to future violations of human rights, I'll pass. I really want to know what they have to tell me but I certainly am not willing to find out under these terms. Now, when I can do it anonymously...

Re:Slashvertising

[Anonymous Coward]

On top of it, they simply claim that they detect more variants without checking false positive rate. Reporting a major disease-associated variant like BRCA1 without having enough data (coverage) to make a confident call is not a good idea!

Re:At least you aren't using a pseudonym, "PopeRat

[KGIII]

You can call him Pontiff and his last name is Ratzo, he'd not make this up. They can't tell lies on the internet, you know.

medical information is regulated

[Goldsmith]

Ok, this is very simple, and something all the developers here need to know.

If you're reporting medical information in the US, you need all of the processes you use to generate that health information to go through the FDA before you ADVERTISE you can do it (yes, your website is an advertisement). Fitness is fine any time, go crazy with that. Medical information, only after FDA approval. If you think you may be doing something health related, go find a regulatory consultant and find out what you need to do before you get a shut down letter from the FDA!

For Enlis to write up a document essentially kicking 23andme for adhering to the law, after witnessing what happened to 23andme (and now Theranos) is the height of stupidity. 23andme was shut down, and it's executives were headed toward fraud indictments when the heroic efforts of their regulatory team saved them. That's what's coming for Enlis after this article.

It may be a year or two before the FDA gets to them, but this will be a black mark that will be extraordinarily hard for them to escape. They have just screwed themselves and their investors. The FDA-23andme saga has provided the biotech space with crystal clear instructions on what is necessary to report medical info from genetic data, and Enlis just danced right over those regulations. Very, very, stupid for them to post this article.

Need a geneticist to understand the Enlis results

[Anonymous Coward]

I've had my DNA analysed with 23andme and was pleased with the way the results were presented. Genetic "problems" were highlighted and I could see genetic reasons for a medical condition I've been diagnosed with. The information was presented in a way that was simple to understand with the option to see the more technical information and the research that supports the results.

After seeing this article I paid the $40 to have the results interpreted by Enlis in case there was some things that were 23andme were required to hold back. I uploaded my 23andme results and rather than being able to look at the results on their website or download a PDF, I was emailed a link to download the same data, reformatted. I then had to download a 900MB executable to "interpret" this file. The way the information is presented by this software is only of use to a geneticist or medical doctor. Even knowing the medical name of the genetic variance that affects my blood clotting it took me 20-minutes to find the report on that part of my DNA and even then I can't tell from the Enlis software whether I have the "bad" variant of the gene or not.

Until the data is presented in a way a layman can understand save yourself $40 and don't bother.

Some have p-souls, some have q-souls, but ...

[Hognoxious]

Humans are different because they have souls.

You are quite simply a moron

[shiftless]

Yes you did. Try to think.