Project Description

Enabling Personalized Medicine through Exome Sequencing in the U.S. Air Force (the MilSeq Project) is a pilot study examining the process of incorporating genome sequencing (GS) into the United States Air Force (USAF) military health system. Active-duty service members of the USAF (Airmen) are enrolled into the study to undergo GS. Results are returned directly to Airmen by military healthcare providers who are also study participants, and are placed in their electronic health records by the study genetic counselor. Healthcare providers participate in an education session about genomic medicine and are supported by the study genetic counselor.

Through pre- and post-disclosure surveys, we ask Airmen about their motivations and barriers to undergoing GS, the impact of receiving their sequencing results, and their thoughts on integrating this type of information into the USAF military health system. Healthcare providers complete surveys about the genomic education session, their genetic knowledge and feelings of preparedness to communicate this information, and their perceived utility of the information. We are also assessing how the information is used to inform the management of the Airmen’s health.

We are interested in gaining knowledge about the barriers to and medical, behavioral, and economic implications of implementing genomic sequencing information into clinical care in the military health system through the perspectives of USAF Airmen and healthcare providers.  

Supported by: FA8650-16-2-6704, by Air Force Medical Support Agency, Research and Acquisition Directorate AFMSA/SG5

Disclaimer

This material is based on research sponsored by Air Force Medical Support Agency, Research and Acquisition Directorate AFMSA/SG5 under cooperative agreement number FA8650-17-2-6704. The U.S. Government is authorized to reproduce and distribute reprints for Governmental purposes notwithstanding any copyright notation thereon.

The views and conclusions contained herein are those of the authors and should not be interpreted as necessarily representing the official policies or endorsements, either expressed or implied, of Air Force Medical Support Agency, Research and Acquisition Directorate AFMSA/SG5 or the U.S. Government.

The voluntary, fully informed consent of the subjects used in this research was obtained as required by 32 CFR 219 and AFI 40-402, Protection of Human Subjects in Biomedical and Behavioral Research.

Project Personnel

Principal Investigators

Robert Green, M.D., M.P.H., Co-Principal Investigator
Amy McGuire, J.D., Ph.D., Co-Principal Investigator
Cubby Gardner, FNP-C, Ph.D., Maj, USAF, Co-Principal Investigator
Jacqueline Killian, RN, Ph.D., Lt Col, USAF, Co-Principal Investigator

Co-Investigators

Mary Majumder, J.D, Ph.D, Associate Professor
Stacey Pereira, Ph.D., Assistant Professor
Maxwell J. Mehlman, J.D., Consultant
Efthimios Parasidis, M.BE, J.D., Project 1 Consultant

Project Personnel

Megan Maxwell, MS, LCGC, Genetic Counselor and Project Manager
Bethany Zettler, M.A. Project Manager

Center Project Personnel

Jill Oliver Robinson, M.A., Research Manager
Rebecca Hsu, Project Coordinator
Rubaiya Islam, Research Assistant

Publications

De Castro M, Biesecker L, Turner C, Brenner R, Witkop C, Mehlman M, Bradburne, Green RC. Genomic Medicine in the Military.  Genomic Medicine. 2016: 1:15008. 

Presentations

Hsu RL, Pereira S, Robinson JO, Islam R, Majumder M, Parasidis E, Mehlman MJ, Christensen K, Maxwell MD, Blout C, Lebo M, Killian JK, De Castro M, Green RC, McGuire AL. US Air Force Airmen’s Perceptions after Receiving Genome Sequencing: Preliminary Results from the MilSeq Project. American Society for Bioethics and Humanities Annual Meeting. Pittsburgh, PA, US. October 24-27, 2019. Accepted as oral presentation.

Blout CL, Sirotich E, Zoltick E, Christensen K, Robinson JO, Pereira S, Petersen DK, Maxwell MD, Gardner C, De Castro M, Lebo M, McGuire AL, Brenner R, Green, RC. Healthy Genomic Sequencing: What Airmen Want to Know? Findings from the MilSeq Project. National Society of Genetic Counselors Annual Meeting. Atlanta, GA, US. November 14-17, 2019. Poster presentation.

Pereira S, Robinson JO, Hsu, RL, Petersen DK, Majumder MA, Parasidis E, Mehlman MJ, Christensen KD, Maxwell MD, Blout CL, Lebo M, Brenner R, Gardner C, De Castro M, Green RC, McGuire AL. Airmen’s Attitudes Toward Genomic Sequencing In The US Air Force: Results From The Milseq Project. American Society for Bioethics and Humanities Annual Meeting. Anaheim, CA, US. October 18-21, 2018. Oral presentation.

Hsu RL, Pereira S, Robinson JO, Petersen JK, Majumder M, Parasidis E, Mehlman M, Christensen K, Maxwell MD, Blout C, Lebo M, Brenner R, Gardner C, De Castro M, Green RC, McGuire AL. Airmen’s Attitudes toward Genomic Sequencing in the US Air Force: Results from The MilSeq Project. American Society for Human Genetics Annual Meeting. San Diego, CA, US. October 16-20, 2019. Poster presentation.

Maxwell, MD. Robinson JO, Gardner CL, De Castro M, Lebo M, Blout CL, Vassy JL, Christensen KD, Krier JB, Pereira S, McGuire AL, Mehlman MJ, Parasidis E, Brenner R, Green RC. Pharmacogenomics in the US Air Force: Development of a Tailored Panel for the MilSeq Project. American College of Medical Genetics and Genomics. Charlotte, NC. April 2018.

Press Release 

US Air Force Studying Impact of Exome Sequencing in Routine Care, Genomeweb Clinical Sequencing. October 2017.