Kaiser Permanente of Washington, Seattle, WA.
Geisinger, Danville, PA.
Genet Med. 2022 May;24(5):1130-1138. doi: 10.1016/j.gim.2022.01.015. Epub 2022 Feb 23.
The goal of Electronic Medical Records and Genomics (eMERGE) Phase III Network was to return actionable sequence variants to 25,084 consenting participants from 10 different health care institutions across the United States. The purpose of this study was to evaluate system-based issues relating to the return of results (RoR) disclosure process for clinical grade research genomic tests to eMERGE3 participants.
RoR processes were developed and approved by each eMERGE institution's internal review board. Investigators at each eMERGE3 site were surveyed for RoR processes related to the participant's disclosure of pathogenic or likely pathogenic variants and engagement with genetic counseling. Standard statistical analysis was performed.
Of the 25,084 eMERGE participants, 1444 had a pathogenic or likely pathogenic variant identified on the eMERGEseq panel of 67 genes and 14 single nucleotide variants. Of these, 1077 (74.6%) participants had results disclosed, with 562 (38.9%) participants provided with variant-specific genetic counseling. Site-specific processes that either offered or required genetic counseling in their RoR process had an effect on whether a participant ultimately engaged with genetic counseling (P = .0052).
The real-life experience of the multiarm eMERGE3 RoR study for returning actionable genomic results to consented research participants showed the impact of consent, method of disclosure, and genetic counseling on RoR.
电子病历和基因组学(eMERGE)第三阶段网络的目标是将可操作的序列变异返回给来自美国 10 家不同医疗机构的 25084 名同意参与者。本研究的目的是评估与临床级研究基因组测试的结果返回(RoR)披露过程相关的基于系统的问题,以用于 eMERGE3 参与者。
RoR 流程由每个 eMERGE 机构的内部审查委员会制定和批准。对每个 eMERGE3 站点的调查人员进行了有关参与者的致病性或可能致病性变异的披露和遗传咨询参与的 RoR 流程调查。进行了标准的统计分析。
在 25084 名 eMERGE 参与者中,有 1444 名参与者在 67 个基因和 14 个单核苷酸变异的 eMERGEseq 面板上发现了致病性或可能致病性变异。其中,有 1077 名(74.6%)参与者的结果被披露,其中 562 名(38.9%)参与者接受了特定变异的遗传咨询。在 RoR 过程中提供或要求遗传咨询的特定站点流程对参与者最终是否接受遗传咨询有影响(P =.0052)。
多臂 eMERGE3 RoR 研究返回同意的研究参与者可操作基因组结果的实际经验表明了同意,披露方法和遗传咨询对 RoR 的影响。