Rethinking genetic strategies to study complex diseases

Understanding the genetic basis of complex diseases is turning out to be difficult, prompting a widespread (re-)evaluation of the relevant issues. ‘Forward’ and ‘reverse’ genetics strategies have been applied arguably in a manner only suitable for much simpler diseases. It would now be beneficial to pay detailed attention to experimental design, and to increase study scales dramatically. Ultimately, this would lead to completely hypothesis-free, truly comprehensive, multi-platform investigations. Such studies would maximize the chances of finding data patterns indicative of real etiology, although many aspects of complex disease causation might simply be too intricate and inconsistent to ever be deciphered. Therefore, considerable technology development is an immediate priority, along with parallel advances in bioinformatics and biostatistics systems aimed at discriminating between marginal signals and background noise within extremely large, diverse and complex data sets. Community standards and open data sharing will be essential ingredients for success in this exciting 21st-century challenge.