“Did I give this condition to my child?”
Clinicians often hear this question from families after giving them a child’s diagnosis. This means that many families understand the importance that genetics plays in family health history.
But few are likely to know the term “genomics” or how it can help a clinician tailor the best possible treatment for a child. And, it turns out, that even clinicians aren’t always sure how to best integrate genomics into clinical care.
The Center for Pediatric Genomics (CpG) wants to change that. That’s why it has launched an initiative called “Grassroots Genomics” designed to help everyone – from our staff and clinicians to the community – understand the genome’s influence on health.
To understand the difference between genetics and genomics, think of a pocket watch. If a single gear is a gene, all the gears working together represents the genome. So, while genetics is the study of single genes – and is an important part of health – genomics examines how a person’s genes work together and interact with each other and the environment. When everything is working smoothly, a person is healthy.
CpG believes that now is the time to build trust and knowledge in the community for the day when a patient’s genome is used more commonly to treat, cure or even prevent disease. For example, the use of pharmacogenomics – choosing medications based on a patient’s genome– is growing in some specialties, such as psychiatry.
But that means getting true buy-in across all levels of the medical center to help our own staff and clinicians – many who graduated from medical school long before the sequencing of the first human genome in 2003 – to understand the many aspects of genomics.
“Grassroots Genomics will help us better understand what education and resources are needed to ultimately build a positive culture that integrates genomics and can transform child health,” says Kristen Sund, PhD, point person for Institutional Genomics, who leads the initiative, along with CpG co-directors Peter White, PhD, director, Biomedical Informatics, and John Harley, MD, PhD, director, Center for Autoimmune Genomics and Etiology.
“Through genomics, we have two big opportunities—to understand the molecular basis of disease from infancy throughout the human lifespan and to use this information to improve ways to help children even before they get a disease,” says White.
At the heart of Grassroots Genomics is a quick 10-minute presentation and 30-question survey that assesses if clinicians and researchers are currently using genomics in any way; what and how they might want to learn about genomics; and if their patients are asking about genomics or genetics.
The survey has revealed that about 42 percent of Cincinnati Children’s clinicians have patients who ask questions about genomics/genetics but only about half feel comfortable talking about the subject with families.
“Genomics provides information that help guide clinical practice,” says White. “When combined with other findings, we’ll be able to predict whether a patient will have a disease or have a good or bad reaction to a specific drug. This helps us to create patient care solutions that are tailored to each individual, which is really the basis of precision medicine.”
Initial Grassroots Genomics efforts have already shaped some great partnerships and helped answer, “What does genomics have to do with it?”
Critical Care and the Center for Pediatric Genomics found common ground surrounding genomics-supported research in sepsis, a life-threatening illness caused by the body’s response to an infection. Sports Medicine connected on research to understand the underlying gene expression that drives motor performance and resultant injury-risk biomechanics.
“By incorporating genomic discovery into the already exceptional clinical care provided at Cincinnati Children’s, we will be leading the progress for healthcare in children into a future that will provide better more accurate, personalized diagnosis and more effective treatment,” says Harley. Grassroots Genomics is just another step in unraveling the mystery and explaining the power behind the data that will help us be more proactive in treating or preventing diseases.