ABSTRACT:This article traces the emergence of lean principles in genomics research and connects this new way of doing science with many of the current pitfalls of precision medicine in its attempts at improving population health outcomes. Precision medicine has a history of public funding, yet the benefits in clinical settings are very slowly being realized due to a variety of factors, such as uncertainty regarding relevant treatments after identifying disease risk, lack of cost-effectiveness studies for general population-level interventions, and letting a culture of "over promise and under deliver" permeate some areas of genomics research. The article concludes with insights into the challenges and opportunities that will need careful consideration and consultation with the wider society in order to decide whether to turn off the "tap" for investment of public funds in research on genomics and other "omics." Ultimately, this article argues for a moderate course correction in how public funds are invested to truly improve the health of all of us, and not just some of us.

中文翻译：

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基因组学公共资金和投资回报：公共卫生视角

摘要：本文追溯了基因组学研究中精益原则的出现，并将这种新的科学研究方式与精准医学在改善人口健康结果的尝试中的许多当前陷阱联系起来。精准医疗有公共资助的历史，但由于多种因素，例如确定疾病风险后相关治疗的不确定性，缺乏针对一般人群干预的成本效益研究，临床环境中的益处实现起来非常缓慢，并让“过度承诺和交付不足”的文化渗透到基因组学研究的某些领域。文章最后深入探讨了需要仔细考虑并与更广泛的社会协商以决定是否关闭“