Wednesday, March 18, 2009

If genetic causation is complex, why should risk factors be any less so?

Every day, it seems, the forces of biological simplism -- the hunger for, and vested interest in simple answers to complex questions -- suffer a setback. Today, it's large-study results that show that screening for a simple marker for early prostate cancer detection seems to be ineffective ( New York Times prostate cancer article ). It may be harmful in the sense of leading to the detection of benign cases, and then some intervention with its associated risk of morbidity. Earlier this year somewhat similar results appeared for mammographic screening for breast cancer. The point is not to coldly denigrate attempts at early detection, but to show the importance of recognizing nature's complexity. Those who suffer from cancer--and we all know such people, and many of us will be such people--deserve all the care and concern that can be mustered. But can we think of better ways to approach this genetically complex problem? Is standard reductionism, trying to identify individual risk factors, or even single risk factors, the way to go? Or will some smart young researcher give us the benefit of conceptually innovative ideas?

For most risk factors, genetic or otherwise, the situation is similar: cholesterol, blood pressure, even obesity have complex and poorly understood associations with subsequent disease outcomes, and with prior genetic risk factors. It is already known, however, that the most effective way to head off chronic diseases is not to smoke, get exercise, and eat a moderate, balanced diet (including even to have a drink now and then!).

But, that conceptually innovative idea is not going to come anytime in the next month or so -- biology is on holiday. This is not like France, where everyone goes to the seaside in August. No, it's because of our 'stimulus' package's ad hoc grants program. Like lemmings to the sea, or hogs to the trough, every scientist and his relatives (living or deceased) is charging headlong for the new money. Whether this is a moral way to spend these funds is an open question. But everyone's now too busy putting together their hoped-for bonanza grants to do any actual scientific work. Ironically, the stimulus package's 'challenge grants' may turn out to be a NON-work initiative for science!

Presumably, the crush will end and we'll all get back to work. One can predict that, due to the gold rush the funding percentages won't be any better, and they may be worse for this 'easy money'. Time will tell.


Sam said...

Hey, some of us lemmings/hogs have to keep working. I guess that's because I don't get to be an official hog. I just anonymously toil trying to build the trough, or maybe it's the cliff.

Anne Buchanan said...

Ok, true, everyone's still at work -- the lesser lemmings generating data and the greater lemmings turning it over into grants.

Ken Weiss said...

The problem is that Deans and administrators everywhere are pushing their faculty to rush to the trough. Many if not most of the projects could be called 'pork'. They are not mainly ensuring employment for those given cold shock by the economic downturn, but mainly business as usual (or, for example, more equipment quickly justified). Or salaries for faculty members who already have most if not all their salaries covered on grants or who are making large amounts of money already. So this is, to me, not in the spirit of the thing that's so desperately important for many people today.