title: Why personalized medicine will fail if we stay the course.
abstract: Genomic science and associated technologies are providing scientists and clinicians with novel insights that are transforming the delivery of healthcare and the overall well-being of society. However, these insights inform us that historical population sampling approaches for investigating rare and common genetic variations are not representative of the complex ancestral backgrounds of today's patients. In order for personalized medicine to be meaningful and applicable to the global populations, we will need to know how common and rare genetic variants found in different parts of the world influence health and drug response. This article demonstrates the importance of increasing ethnic and racial diversity among participants in genomic research, highlights areas of opportunity for improving our understanding of genomic diversity among populations, and provides examples of successful models that help to resolve these concerns.
authors.affiliation: Center for Research on Genomics & Global Health, National Human Genome Research Institute, NIH, Bethesda, MD, 20892-5635, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Ramos
authors.forename: Shawneequa L
authors.initials: SL
authors.lastname: Callier
authors.forename: Charles N
authors.initials: CN
authors.lastname: Rotimi
keywords: diversity; ethnicity; genomic medicine; global populations; personalized medicine
references.citation: Ann Epidemiol. 2001 Jan;11(1):51-8
references.pmid: 11164120
references.citation: BMC Med Ethics. 2009 Aug 22;10:13
references.pmid: 19698115
references.citation: Nature. 2010 Sep 2;467(7311):52-8
references.pmid: 20811451
references.citation: Proc Natl Acad Sci U S A. 2009 Jun 9;106(23):9362-7
references.pmid: 19474294
references.citation: N Engl J Med. 2012 Mar 29;366(13):1200-8
references.pmid: 22455414
references.citation: Pharmacogenomics. 2010 Aug;11(8):1077-94
references.pmid: 20712526
references.citation: N Engl J Med. 2011 Mar 24;364(12):1144-53
references.pmid: 21428770
references.citation: Hum Genet. 2012 Oct;131(10):1615-26
references.pmid: 22923055
references.citation: Prog Community Health Partnersh. 2008 Winter;2(4):321-7
references.pmid: 20208312
references.citation: Annu Rev Genomics Hum Genet. 2011;12:217-44
references.pmid: 21721939
references.citation: Ann Hum Biol. 2008 Mar-Apr;35(2):121-44
references.pmid: 18428008
references.citation: N Engl J Med. 2010 Oct 14;363(16):1551-8
references.pmid: 20942671
references.citation: Nature. 2011 Feb 10;470(7333):204-13
references.pmid: 21307933
references.citation: Genome Biol. 2011;12(5):223
references.pmid: 21635713
references.citation: Science. 2012 Jul 6;337(6090):100-4
references.pmid: 22604722
references.citation: Per Med. 2010 Nov;7(6):633-642
references.pmid: 29788561
references.citation: Pharmacogenomics. 2003 Jan;4(1):91-5
references.pmid: 12517289
references.citation: Nat Rev Genet. 2010 May;11(5):356-66
references.pmid: 20395969
references.citation: Curr Opin Mol Ther. 2009 Jun;11(3):260-8
references.pmid: 19479659
references.citation: Per Med. 2012 Jan;9(1):93-97
references.pmid: 29783288
references.citation: Nat Genet. 2010 Sep;42(9):739-741
references.pmid: 20694014
references.citation: Kennedy Inst Ethics J. 2002 Mar;12(1):1-15
references.pmid: 12211263
references.citation: J Law Med Ethics. 2008 Fall;36(3):585-8
references.pmid: 18840252
references.citation: Diabetologia. 2011 Apr;54(4):783-8
references.pmid: 21188353
references.citation: Public Health Genomics. 2010;13(2):72-9
references.pmid: 19439916
references.citation: JAMA. 2001 Nov 14;286(18):2270-9
references.pmid: 11710893
references.citation: Nat Genet. 2007 Feb;39(2):218-25
references.pmid: 17206141
references.citation: Per Med. 2005 Aug;2(3):225-237
references.pmid: 29793265
references.citation: Nature. 2004 May 27;429(6990):464-8
references.pmid: 15164072
references.citation: Am J Bioeth. 2006 Sep-Oct;6(5):W1-5
references.pmid: 16997802
references.citation: Trends Genet. 2009 Nov;25(11):489-94
references.pmid: 19836853
references.citation: PLoS Genet. 2009 Jul;5(7):e1000564
references.pmid: 19609347
references.citation: Nature. 1950 Aug 12;166(4215):247-9
references.pmid: 15439261
references.citation: Nat Rev Drug Discov. 2002 Apr;1(4):300-8
references.pmid: 12120281
references.citation: Nat Genet. 2008 Sep;40(9):1039-40
references.pmid: 19165915
references.citation: Am J Pharmacogenomics. 2003;3(6):393-8
references.pmid: 14672520
references.citation: JAMA. 2007 Oct 10;298(14):1682-4
references.pmid: 17925520
references.citation: Nat Genet. 2012 Feb 05;44(3):257-9
references.pmid: 22306650
references.citation: Nat Genet. 2009 Jun;41(6):657-65
references.pmid: 19465909
references.citation: Nat Genet. 2004 Nov;36(11 Suppl):S34-42
references.pmid: 15508001
references.citation: Clin Pharmacol Ther. 2008 Sep;84(3):306-9
references.pmid: 18714319
references.citation: PLoS One. 2011;6(11):e27162
references.pmid: 22073278
references.citation: J Empir Res Hum Res Ethics. 2012 Feb;7(1):37-52
references.pmid: 22378133
references.citation: BMC Med Genomics. 2011 Feb 04;4:17
references.pmid: 21294900
references.citation: Science. 2012 Jul 6;337(6090):64-9
references.pmid: 22604720
references.citation: Nature. 2009 Oct 8;461(7265):747-53
references.pmid: 19812666
references.citation: N Engl J Med. 2010 May 27;362(21):2001-11
references.pmid: 20505179
references.citation: J Law Med Ethics. 2010 Fall;38(3):684-96
references.pmid: 20880250
references.citation: N Engl J Med. 2003 Feb 6;348(6):529-37
references.pmid: 12571261
references.citation: Genome Med. 2010 Mar 24;2(3):20
references.pmid: 20346094
references.citation: Pharmacogenomics. 2012 May;13(7):771-7
references.pmid: 22594509
references.citation: Pharmacogenomics J. 2003;3(1):14-6
references.pmid: 12629579
references.citation: Genome Med. 2012 Aug 28;4(8):65
references.pmid: 22929582
references.citation: Diabetes. 2004 Mar;53(3):838-41
references.pmid: 14988271
references.citation: Nat Genet. 2007 Jun;39(6):770-5
references.pmid: 17460697
references.citation: Pharmacogenomics. 2011 Dec;12(12):1717-28
references.pmid: 22118054
references.citation: Clin Pharmacol Ther. 2011 Mar;89(3):343-5
references.pmid: 21326261
references.citation: Eur J Hum Genet. 2012 Apr;20(4):463-8
references.pmid: 22085899
references.citation: Diabetes. 2010 Jun;59(6):1549-54
references.pmid: 20299471