In Reply: We agree with Dr Khoury and colleagues that a number of different types of efforts, including public health research, will be needed to explore fully the promise of genomics-based healthcare and to make that promise a reality. Clearly, health is determined by neither genes nor environment alone, but by the interaction of both. Thus, epidemiologic research that examines the complex interactions among multiple genes and their interaction with environmental factors will be key to unraveling the mysteries of health and disease. In addition, as Khoury et al indicate, policy and communication research and health services research will be critical if the benefits of genomics are to be realized in an effective, economical, and impartial way.
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