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US Air Force Studying Impact of Exome Sequencing in Routine Care

NEW YORK (GenomeWeb) – The US Air Force and several academic sites have launched a study called MilSeq to explore the impact of incorporating genomic data into active duty members' routine care.

"It is important to understand the unique benefits and challenges of incorporating genomic medicine in a military population," Major Cubby Gardner, joint principal investigator of the study said in a statement. "We need to explore how sequencing may or may not affect the perception of fitness for duty, how the finding might influence clinical decision making among military clinicians, and how knowledge of the findings might impact the individual’s downstream healthcare utilization."

In this two-year research effort, several institutions within the Air Force will collaborate with organizations such as Brigham and Women's Hospital, Harvard Medical School, VA Boston Healthcare System, Baylor College of Medicine, Case Western Reserve University, Ohio State University, Partners Personalized Medicine, and the Broad Institute. The study will be co-led by Gardner and Robert Green, a professor of medicine at Harvard Medical School.

MilSeq will enroll 75 healthy, active duty Air Force service members who consent to having their exomes sequenced. The study will also recruit 15 active duty healthcare providers in primary care, internal medicine, and family practice.

The doctors will receive an educational primer in genomics and on-site genetic counseling support. After exome testing is performed on patients, their doctors will get a report listing the pathogenic and likely pathogenic variants related to dominant and recessive monogenic conditions, risks for complex diseases, and response to drugs. These results will be entered into the service members' electronic medical records.

The researchers will then track how well doctors understood the genomic information and assessed their patients based on test results. They will also evaluate whether having this information in the active service members' records influence their behavior, health, lifestyle, and family members.

"By launching this study now, before sequencing becomes commonplace, we are hoping to ensure that active-duty military personnel will benefit from accelerating trends in genomic medicine," said Green, director of the Genome2People Research Program, which has been exploring the medical, behavioral, and economic impact of genetic risk information in various contexts. "The special considerations around fitness for duty and privacy make this a particularly challenging study to design and implement, but also an extremely important domain in which to gather empirical data around benefits and risks."


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