Both in the public eye as well as within the scientific community (1), much of the current enthusiasm for genomics rests on the prospect that assaying a patients genetic information will improve the effectiveness of health care-that is, it will directly inform their medical care in ways that improve outcomes and reduce costs. However, it remains controversial whether these high hopes for what is termed "genomic medicine" are well founded. In this issue of Science Translational Medicine, Roberts et al. (2) describe their use of epidemiological data from twin registries to attempt to answer a pressing question in genomics: How much predictive value for disease risk will actually be obtained when the genomes of healthy individuals are routinely sequenced in a clinical setting?
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