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Much reduction will be required in the cost of gene sequencing because the pricing goal is $1,000 per three gigabases. A price-performance point has to be reached that would allow previously impossible for genome-wide studies. There will have to be broad-based correlations between mutations and phenotype, which can be done either through large-scale association studies, bioinformatics predictions, or biological methods. Topics covered are the importance of genotyping, the goal (a denovo sequence assembled with 99.9 percent accuracy (or no more than one error per 10,000 nucleotides with no gaps), the longevity of the market, potential use of SBH (sequencing-by-hybridization) for analysis of isolates of pathogenic bacteria, advantages of sequence information extracted from single DNA molecules without amplification of DNA or incorporation of labels, and the benefits of rapid sequencing. Rapid sequencing could provide needed information about individual genomes that could instantly affect bedside care. Sequence-directed choice of care will be particularly crucial for such heterogeneous diseases such as cancer. For the purposes of insurance coverage, sequencing should decrease overall patient-related costs, including days in the hospital or number of procedures. An issue that must be addressed is fairness in the use of genetic information, so the U.S. government, including the DOE and the National Institutes of Health (NIH), use between three percent and 5 percent of their annual Human Genome Project budgets to study ethical, legal, and social matters related to availability of genetic information.
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