people, I trusted the people, I knew the research they were doing, I wanted it to go forward.”

She expressed concern about the delayed effects of treatment. If a woman develops a heart condition 10 years after receiving radiation treatments for cancer, there is no way to explore the connection between these two events because no system exists to make those linkages. And without knowing about such linkages, patients cannot be fully informed of the risks.

Smith emphasized the importance of engaging patients as partners if researchers want samples of tissue and data over time. This would provide a much fuller picture of the benefits and side effects of treatment.

Finally, evidence-based medicine requires new trial designs and end points for Phase I, Phase II, and Phase III trials, said Smith. “Right now, we don’t have them.”

A PUBLIC HEALTH OFFICER’S PERSPECTIVE

Public health thinks about the individual within the context of a community, a nation, and the global population, observed Calonge. Public health is more than publicly funded health, though that is part of it. Viewed broadly, public health provides the following essential services:

  • Monitoring health status to identify and solve community health problems.
  • Diagnosing and investigating health problems and health hazards in the community.
  • Informing, educating, and empowering people about health issues.
  • Mobilizing community partnerships and action to identify and solve health problems.
  • Developing policies and plans that support individual and community health efforts.
  • Enforcing laws and regulations that protect health and ensure safety.
  • Linking people to needed personal health services and assuring the provision of health care when otherwise unavailable.
  • Assuring a competent public and personal health care workforce.
  • Evaluating effectiveness, accessibility, and quality of personal and population-based health services.
  • Conducting research for new insights and innovative solutions to health problems.

Calonge focused on more of a macroeconomic evaluation of genomics and public health. He noted that in Colorado, premiums for state Medicaid medical services will exceed school finance’s share of the general fund in



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