VA contends that it now has the world’s largest biobank

The richness of the data being gleaned from the Department of Veterans Affairs’ Million Veteran Program is enabling researchers to begin to shed light on the genetics of a range of medical conditions.

“Today, eight years after it began, it is the largest mega-biobank in the world,” according to Carolyn Clancy, MD, deputy undersecretary for discovery, education and affiliate networks for the Veterans Health Administration. “Over 750,000 veterans from all 50 states, Guam and Puerto Rico have enrolled, and we also have their clinical electronic data—which makes it literally a unique resource in the world.”

The VA’s MVP research program is designed to link genetic, clinical, lifestyle and military-exposure information to better understand the impact on the health—and illness—of veterans.

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Volunteers donate blood, give permission to researchers to access their electronic health records, as well as agree to take a baseline and periodic follow-up surveys.

Clancy told a House committee on Wednesday that the VA is working with the University of Chicago and the Open Commons Consortium to pilot a data commons where de-identified data from MVP and EHRs will be made available to the research community.

“An essential step to realize our promise to participants to advance precision medicine is to establish a modern computational infrastructure that can scale to support hundreds of analyses occurring in parallel,” Clancy testified. “Our goal is to have the infrastructure and services to support a minimum of 100 parallel projects in the VA Data Commons by the end of fiscal year 2021.”

On a related note, Clancy said that her office is “actively working with Cerner” to ensure that the VA’s transition over 10 years from its legacy VistA system to Cerner’s Millennium platform will support MVP’s research needs. At the same time, she commented that “it’s safe to say that they probably don’t have a customer with the extent and depth of the research that we support.”

“We’ve all highlighted how rich VA data are and currently those data are held in a VistA system” added Rachel Ramoni, the VA’s chief research and development officer. “One of the key factors in ensuring that we continue to derive value from that data for our veterans is that the historical data be maintained, and that it not simply be mapped to the new system—because you lose information when you map it to a new system.”

Separately, Clancy said the VA is partnering with the Department of Defense to “follow thousands of veterans with mild traumatic brain injury experienced in combat—each of these participants undergoes intensive bio-sampling and imaging, enabling us to identify biomarkers associated with brain injury and comorbidities like PTSD.”

Clancy also said that the VA is funding a study of precision medicine’s role in improving treatment for veterans with major depressive disorder. As part of the PRecision medicine In MEntal health Care (PRIME Care), volunteers will submit a cheek swab so researchers can test their DNA to determine which antidepressant to prescribe.

According to Clancy, the study will determine whether “matching veterans with depression to medications based on their genetic variation leads to improved outcomes.”

As part of another MVP initiative, the Department of Energy’s Oak Ridge National Laboratory is partnering with the VA under the Computational Health Analytics for Medical Precision to Improve Outcomes Now (CHAMPION), with an initial focus on three health problems that affect the largest number of veterans—cardiovascular disease, prostate cancer and suicide.

“We’ve just completed the (Institutional Review Board) approvals for the three (CHAMPION) projects,” testified Sumitra Muralidhar, program director for MVP in VHA’s Office of Research and Development. “The computing environment is ready in the Department of Energy. We’re just waiting to get the work started.”

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