What about clinical utility? So-called personalized medicine has been touted as the critical yardstick against which to measure the success of genetic studies. We believe clinical utility is the ultimate goal, but an inappropriate proximal goal. Still, there are a number of findings whose clinical significance should be evaluated. For example, SV testing is often part of the clinical evaluation of ASD, and careful evaluation of its utility in psychosis is warranted. As another example, Dr Roy Perlis and colleagues are evaluating the “repurposing” of isradipine (an approved antihypertensive that interacts with the protein product of CACNA1C) for the treatment of BIP. It is possible that risk profile scores, SV burden, or rare variant burden could have clinical utility. If these assess latent liability, they might be useful in selected clinical scenarios (e.g., predicting which patients require aggressive treatment in the psychosis prodrome). 136
