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To the Editor: In their Commentary, Dr Kohane and colleagues¹ present the sound general principle that the current wave of enthusiasm for genomic medicine must be tempered by an awareness of the inherent limitations of the field. The potential for false-positives to cloud clinical decision making is certainly present. However, there is an important converse to this idea.

In the practice of medicine, clinical findings frequently go unexplained. These may take the forms of congenital malformations, encephalopathies, or constellations of multiple disease entities, superficially unrelated to one another, that nevertheless occur in an individual patient. In such cases where the clinical picture does not fall into a well-understood realm, all that may be done is to attach a descriptive label or the noninformative label "idiopathic." This may lead to a reactive practice of medicine in which clinicians, unable to anticipate problems, simply try to respond to them when they occur. . . . [Full Text of this Article]

Michael Kruer, MD
mkruer@phoenixchildrens.com
Department of Pediatrics
Phoenix Children's Hospital
Phoenix, Ariz

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