Educating military primary health-care providers in genomic medicine: lessons learned from the MilSeq Project

Airmen and health-care providers’ attitudes toward the use of genomic sequencing in the US Air Force: findings from the MilSeq Project

“…HCP-participants (hereinafter “HCPs”), who were also Airmen, were recruited in person and by group announcement. HCPs attended a 3-hour genetics education session with a genetic counselor 29 and completed pre- and post-education surveys.…”

“…[ 32 ] HCPs’ genetic knowledge was assessed using 14 multiple-choice items developed using published and novel items, including vignettes based on the HCP education session. [ 29 , 32 – 35 ]…”

Navigating the ethical maze of genomics in Canada’s military

“…8 9 The decision to leave the military per se should, in most cases, bring an end to prospective sample and data collection. Given the silence of the TCPS2 on this topic, and taking into account the importance of maintaining the robustness of samples and data as a collective research resource, we believe that a proportionate balance is best struck by informing participants during the informed consent process that if they wish to have their samples and/or data destroyed after leaving the military, that they must either (1) indicate this desire at the time of consenting or (2) notify the research team on leaving. This approach respects participant autonomy in conjunction with scientific freedom and research integrity.…”

“…Most notably, this has been the case with the US Air Force, whose MilSeq project is among the forerunners in examining the clinical, scientific and ethical issues that incorporating genomics into the military poses. 1 Defence Research and Development Canada, a branch of the Canadian Armed Forces (CAF), has also begun incorporating genomics into their research activities. In this article, we are the first to examine the bioethical and legal norms that regulate human genomic research conducted by the CAF.…”

Automated Pharmacogenomic Reports for Clinical Genome Sequencing

“…Prior to the publication of Aldy, PharmCAT, or Stargazer, our laboratory was challenged with providing PGx results in clinical GS reports. Building on our prior PGx reporting experience from targeted NGS data as part of the eMERGE PGx workgroup 28 and with exome sequencing (ES) data as part of the MilSeq Project 29,30 , a pipeline was needed for PGx reporting from clinical GS meeting the following requirements: 1) validation in a CLIA environment, 2) automation to the greatest extent possible, 3) updatable on an ongoing basis as PGx guidelines are revised and expanded, 4) accepts input of shortread GS data, 5) follows the CDC PGx reporting guidelines 18 , 6) analyzes and reports only clinically actionable haplotypes and genotypes, 7) provides clear gene-based phenotypes using standardized terms from the CPIC nomenclature workgroup whenever available 31 , 8) provides concise CPIC guideline dosing recommendations for specific drugs, and 9) considering recent FDA guidance, provides an alternative report referencing FDA drug labels, without drug dosing recommendations.…”