Cohn Elizabeth Gross, Hamilton Nalo, Larson Elaine L, Williams Janet K
School of Nursing, Columbia University, New York, NY, USA.
Adelphi University, Garden City, NY, USA.
J Community Genet. 2017 Jul;8(3):229-238. doi: 10.1007/s12687-017-0308-6. Epub 2017 Jun 16.
Precision medicine envisions a future of effective diagnosis, treatment, and prevention grounded in precise understandings of the genetic and environmental determinants of disease. Given that the original genome-wide association studies represented a predominately European White population, and that diversity in genomic studies must account for genetic variation both within and across racial categories, new research studies are at a heightened risk for inadequate representation. Currently biological samples are being made available for sequencing in biobanks across the USA, but the diversity of those samples is unknown. The aims of this study were to describe the types of recruitment and enrollment materials used by US biobanks and the diversity of the samples contained within their collection. Biobank websites and brochures were evaluated for reading level, health literacy, and factors known to encourage the recruitment of minorities, such as showing pictures of diverse populations. Biobank managers were surveyed by mail on the methods and materials used for enrollment, recruitment, consent, and the self-reported race/ethnicity of biobank participants. From 51 US biobanks (68% response rate), recruitment and enrollment materials were in English only, and most of the websites and brochures exceeded a fifth-grade reading level. When compared to the 2015 US Census, self-reported race/ethnicity of participants was not significantly different for Whites (61%) and blacks (13%). The percentages were significantly lower for Hispanics and Latinos (18 vs. 7%, p = 0.00) and Hawaiian/Pacific Islanders (0.2 vs. 0.01%; p = 0.01) and higher for Asians (13 vs. 5%, p = 0.01). Materials for recruitment predominantly in English may limit participation by underrepresented populations.
精准医学展望了一个基于对疾病遗传和环境决定因素的精确理解,实现有效诊断、治疗和预防的未来。鉴于最初的全基因组关联研究主要代表欧洲白人人群,且基因组研究中的多样性必须考虑种族类别内部和之间的遗传变异,新的研究存在代表性不足的更高风险。目前,美国各地的生物样本库正在提供用于测序的生物样本,但这些样本的多样性尚不清楚。本研究的目的是描述美国生物样本库使用的招募和入组材料类型以及其收集样本的多样性。对生物样本库网站和宣传册进行了阅读水平、健康素养以及已知鼓励少数族裔招募的因素(如展示不同人群图片)的评估。通过邮件对生物样本库管理人员进行了调查,内容包括用于入组、招募、同意以及生物样本库参与者自我报告的种族/族裔的方法和材料。从51个美国生物样本库(回复率68%)来看,招募和入组材料仅为英文,且大多数网站和宣传册的阅读水平超过五年级。与2015年美国人口普查相比,参与者自我报告的白人(61%)和黑人(13%)种族/族裔没有显著差异。西班牙裔和拉丁裔(18%对7%,p = 0.00)以及夏威夷/太平洋岛民(0.2%对0.01%;p = 0.01)的百分比显著较低,而亚洲人(13%对5%,p = 0.01)的百分比较高。主要为英文的招募材料可能会限制代表性不足人群的参与。