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IGSP, DCRI stress preventive medicine

Call them mystics - physicians at Duke University Medical Center want to tell the future. In today's scientific age, researchers are honing in on genes as tools for predicting risks for future diseases.

The identification of genetic risk factors for specific disorders is at the core of the broad ambitions of preventive medicine, which is a major goal of the Medical Center leadership. By identifying genetic risks, doctors can eventually alert people to the diseases they could likely develop and help prevent them.

The route to developing such a technology is a daunting challenge, however, combining varied problems in genetics, clinical study and biology. With the Medical Center's existing strengths and the establishment of the Institute for Genome Sciences and Policy - capped by Monday's grand opening of the Center for Human Genetics - Duke medical leaders believe that they have put together a model structure for the difficult task.

Duke Clinical Research Institute Director Dr. Robert Califf envisions a broad-based model for how genetic risk identification would ideally operate at Duke: clinical physicians could identify problematic diseases; IGSP researchers could then try to find the genetic cause, along with potential methods for blocking it; and DCRI workers, experts at developing and analyzing clinical trials, could help test the methods on humans.

"As we work with [medical] faculty interested in a particular disease, the IGSP needs to be available to that faculty, and DCRI needs to be available for when the work extends into humans," Califf said. "For prospective health care to be real, it's got to cut across the whole spectrum."

IGSP Director Huntington Willard points to this collaboration as a major reason for coming to Duke.

"Genomic medicine must go hand in glove with personalized health care," he said. "You have to understand how impressive it is that a health system the size of [Duke University Health System] is thinking about developing new models of health care. Most health systems are just holding on for dear life [financially]."

Willard agreed with Califf about the need for partnering in the development of genetic technologies. "Duke presents a real opportunity for that kind of partnering with them and others. You're better off partnering with people than going it alone," he said.

Health System Chief Executive Officer Dr. Ralph Snyderman has become a nationally recognized supporter of preventive medicine, and he noted he would help organize the Medical Center's efforts to integrate genetic research with prospective care.

Snyderman hinted that the Medical Center's support of preventive care will eventually extend beyond the laboratory and into the classroom.

"We think the sciences are going to be heavily embellished by genomics and proteomics, but the main impact that it's going to have on health is it allows the doctor to anticipate risk," he said. "We need to teach students to be thinking along those lines."

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