Pediatrics has been at the forefront of genomic technology adoption since the Food and Drug Administration’s approval 30 years ago of human recombinant insulin as the first genetically engineered protein product for human use. For about as long, some have predicted that genomics would precipitate an imminent revolution in the day-to-day practice of medicine. This has yet to happen; in fact, evolution may be a more accurate description of the pace at which clinical changes are occurring. The complexity of genomics, uncertainty regarding the clinical benefits of new and often expensive applications, and a myriad of more pressing health and social issues confronting patients and physicians have limited the uptake of genomic application in many pediatric settings.
