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a research although there is noth<strong>in</strong>g to say that it could<br />

not be attempted <strong>in</strong> a cl<strong>in</strong>ical situation to get some sort<br />

of layered approach. It is not really a very complicated<br />

th<strong>in</strong>g. It looks complicated and it sounds complicated, and<br />

<strong>in</strong> practice it has not -- we have not had anyone refuse<br />

anyth<strong>in</strong>g or have any problems with it and it has been <strong>in</strong><br />

effect for a couple of years now.<br />

DR. MURRAY: Steve?<br />

DR. HOLTZMAN: I would like to just try to<br />

focus then if I can on where I th<strong>in</strong>k -- I would like to<br />

focus if possible on where I th<strong>in</strong>k your recommendations are<br />

similar to what we have said and where they are different,<br />

and maybe try to elicit the differences <strong>in</strong> th<strong>in</strong>k<strong>in</strong>g.<br />

With respect to the prospectively collected<br />

samples I believe we are very, very similar <strong>in</strong> our th<strong>in</strong>k<strong>in</strong>g<br />

at least with respect to those which are collected <strong>in</strong> a<br />

research context leav<strong>in</strong>g open whether we th<strong>in</strong>k those<br />

collected <strong>in</strong> a cl<strong>in</strong>ical context can have such a robust<br />

consent process.<br />

With respect to the extant samples you have<br />

focused on the sample be<strong>in</strong>g anonymous or anonymized versus<br />

our focus on the research be<strong>in</strong>g conducted anonymously or<br />

encrypted, what you call identifiable us<strong>in</strong>g the ASHG<br />

categories.

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