Will Investments in Large-Scale Prospective Cohorts and Biobanks Limit Our Ability to Discover Weaker, Less Common Genetic and Environmental Contributors to Complex Diseases? Morris W. Foster1 and Richard R. Sharp2
1Department of Anthropology, University of Oklahoma, Norman, Oklahoma, USA; 2Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA Abstract Increasing the size of prospective cohorts and biobanks is one approach to discovering previously unknown contributors to complex diseases, but it may come at the price of concealing contributors that are less common across all the participants in those larger studies and of limiting hypothesis generation. Prospective cohorts and biobanks constitute significant, long-term investments in research infrastructure that will have ongoing consequences for opportunities in biomedical research for the foreseeable future. Thus, it is important to think about how these major additions to research infrastructure can be designed to be more productive in generating hypotheses for novel environmental contributors to complex diseases and to help identify genetic and environmental contributors that may not be common across the larger samples but are more frequent within local or ancestral subsets. Incorporating open-ended inquiries and qualitative information about local communal and ecologic contexts and the political, economic, and other social structures that affect health status and outcome will enable qualitative hypothesis generation in those localized contexts, as well as the collection of more detailed genealogic and family health history information that may be useful in designing future studies. Using communities as building blocks for larger cohorts and biobanks presents some practical and ethical challenges but also enhances opportunities for interdisciplinary, multilevel investigations of the multifactorial contributors to complex diseases. Key words: biobanks, communities, complex disease, gene-environment interaction, prospective cohorts, qualitative methods, research design. Environ Health Perspect 113:119-122 (2005) . doi:10.1289/ehp.7343 available via http://dx.doi.org/ [Online 4 November 2004] Address correspondence to M.W. Foster, Department of Anthropology, 455 W. Lindsey, Room 505C, University of Oklahoma, Norman, OK 73019 USA. Telephone: (405) 325-2491. Fax: (405) 325-7386. E-mail: morris.w.foster-1@ou.edu This publication was made possible by grant ES11174 from the National Institute of Environmental Health Sciences (NIEHS) and grant HG02691 from the National Human Genome Research Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIEHS, National Human Genome Research Institute, or National Institutes of Health. The authors declare they have no competing financial interests. Received 22 June 2004 ; accepted 3 November 2004. The full version of this article is available for free in HTML or PDF formats. |