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Could gene tests tell if kids can be sports stars?

Rating

4 Star

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Could gene tests tell if kids can be sports stars?

Our Review Summary

 A recent commentary published in the Journal of the American Medical Association (JAMA) calls attention to the potential harms associated with testing children for genes associated with sports performance.

What differentiates the results reported in this study of genes associated with athletic performance from other association studies appears to be the lack of strong evidence supporting this association with athletic performance. This means that unlike certain genes that really have been associated with, say heart disease, at the level of a population, the jury is still out on the evidence for genes associated with athletic performance. So if we’re not sure at the population level, it means that this test is of no practical value for any individual (or as this article mentions – the hopeful parent of an indifferent child) who wishes to predict the future likelihood of being a professional athlete.

 

Why This Matters

Since the entire human genome was sequenced and reported over a decade ago to great fanfare, the public has been waiting to see the practical benefits of applying this knowledge. So far, there has been little for them to see. A number of commercial enterprises have arisen that sequence an individual’s DNA and report on which versions of a number of genes the person has. These genes have been associated with risk of cancer, heart disease, diabetes, rarer genetic conditions, but all suffer from the fact that while the specific gene variants may be predictive at a population level, they so far offer little to the individual patient. In this context, one can now add genes associated with athletic performance.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

 According to the story, the testing kit costs about $170.  

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story does not present any data from the research on this topic.  It would have been helpful had it included some of the data from the JAMA commentary to illustrate the variability in the evidence. For example, smaller studies have found that between 31% and 73% of elite power/sprint athletes express the ACTN3 gene compared to a range of 26% to 45% in control groups. Again, finding the probability that the individual tested would be a professional athlete before and after testing would be ideal.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

Throughout the story, the writer touches on the ethical and psychological implications of this test; however, it would have been useful had it mentioned other potential harms outlined by the authors of the commentary in JAMA.  For example, specialization in a sport at a young age may lead to injury and/or burnout.  In contrast, children who test negative for the gene may be discouraged and limit their participation in sports. This decrease of physical activity could lead to health issues in the future. In addition, there is the potential that the ACTN3 gene may later be associated with disease risk and these people will have not received the proper counseling.

In general, the piece covered a lot of gorund with this one quote: “This is recreational genetics with a real serious potential for harm,” Ross said. “People are going to think, `If my kid has this, I’m going to have to push real hard. If my kid doesn’t have it, I’m going to give up before I start,” she said. Instead, Ross said, parents should “let kids follow their dreams.”

 

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

While the story indicates that the evidence regarding the ACTN3 gene and athletic performance is still in its “infancy,” it could have provided more detail on where the evidence is lacking. For example, one of the major studies that found an association between the gene and athleticism included only white participants, suggesting that the results may not apply to the general population. As the JAMA commentary points out, the significance of this gene in people who are not elite or professional athletes is still unknown and the studies evaluating this gene are relatively small. In theory, one would like to see an estimate of the likelihood of a child becoming a professional athlete in the sampled population and then a revised likelihood after the test was performed and found to be either positive or negative.

 

Does the story commit disease-mongering?

Satisfactory

 The story did not engage in disease mongering. It points out that while 80% of the population has the ACTN3 allele, only a fraction are elite athletes, underscoring the fact that athletic ability is multifactorial.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

A particular strong point of this story is that it provides multiple viewpoints, including:

  • one of the authors of the JAMA commentary,
  • a consumer who purchased the test for his daughter,
  • representatives from the companies that manufactures the test, 
  • a researcher who has studied the gene, and
  • a medical ethicist.

 

Does the story compare the new approach with existing alternatives?

Satisfactory

Although the story does not go into any detail, it does mention that there are several genes associated with athletic performance, not just ACTN3.

But the real alternative is NOT to test.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

 The story makes it clear that this test is easy to obtain through mail-order.

Does the story establish the true novelty of the approach?

Satisfactory

 According to the story, one U.S. company has been marketing this test since 2008. 

Does the story appear to rely solely or largely on a news release?

Satisfactory

This piece does not rely on a press release.

Total Score: 8 of 10 Satisfactory

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