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Genome Medicine | Full text | How behavioral economics can help to avoid `The last mile problem¿ in whole genome sequencing

Genome Medicine | Full text | How behavioral economics can help to avoid `The last mile problem¿ in whole genome sequencing

How behavioral economics can help to avoid ‘The last mile problem’ in whole genome sequencing

Jennifer S Blumenthal-Barby1*Amy L McGuire1Robert C Green2 and Peter A Ubel3
1Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza MS 420, Houston 77030, TX, USA
2Division of Genetics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Avenue Louis Pasteur, Boston 02115, MA, USA
3Fuqua School of Business and Sanford School of Public Policy, Duke University, Fuqua Drive, Durham 27708, NC, USA
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Genome Medicine 2015, 7:3  doi:10.1186/s13073-015-0132-8
The electronic version of this article is the complete one and can be found online at:

Published:22 January 2015
© 2015 Blumenthal-Barby et al.; licensee BioMed Central. 
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Editorial summary

Failure to consider lessons from behavioral economics in the case of whole genome sequencing may cause us to run into the ‘last mile problem’ - the failure to integrate newly developed technology, on which billions of dollars have been invested, into society in a way that improves human behavior and decision-making.


Much energy and other resources are being invested in efforts to integrate whole genome sequencing (WGS) and whole exome sequencing (WES) into clinical care. For example, the National institutes of Health (NIH) plans to invest $400 million into translational genomic projects over the next few years. Already, millions of dollars have been committed to exploring the clinical integration of genomics through programs such as the Clinical Sequencing Exploratory Research (CSER) Consortium. This consortium funds nine centers to study the generation of genomic sequence data, methods to translate and interpret those data, and the ethics and psychosocial impact of those data in a variety of pediatric and adult clinical settings. As members of one of the funded centers, we are optimistic about the future of clinical genomics. Nevertheless, in addition to well-recognized technical and translational challenges that are associated with the clinical integration of WGS or WES, the field of behavioral economics suggests that there will be equally daunting behavioral challenges.

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