Benefits and harms of wellness initiatives

Clin Chem Lab Med. 2019 Sep 25;57(10):1494-1500. doi: 10.1515/cclm-2019-0122.

Abstract

Wellness projects are large scale studies of healthy individuals through extensive laboratory and other testing. The "Hundred Person Wellness Study", was one of the first to report results and lessons from its approach and these lessons can be applied to other wellness projects which are being undertaken by major companies and other organizations. In the "Hundred Person Wellness Study", investigators from the Institute for Systems Biology (ISB) sequenced the genome, and analyzed the blood, saliva, urine and microbiome of 108 healthy participants every 3 months, for 9 months, to look for subtle changes signifying the transition to disease. We discuss some of the possible shortcomings of this approach; questioning the need to "improve" biomarker levels, excessive testing leading to over-diagnosis and over-treatment, expected results and improvements, selection of tests, problems with whole genome sequencing and speculations on therapeutic measures. We hope this discussion will lead to a continued evaluation of wellness interventions, leading to strategies that truly benefit patients within the constraint of limited health care resources.

Keywords: direct to consumer testing; over-diagnosis; over-testing; over-treatment; patient safety; technology; wellness initiatives.

MeSH terms

  • Clinical Laboratory Techniques / trends
  • Health Promotion / ethics*
  • Health Promotion / trends*
  • Humans
  • Incidental Findings
  • Medical Overuse
  • Registries / ethics