Personalized Medicine and the Million Veteran Program

Imagine your next visit to the doctor’s. After reviewing your health history and your VA electronic medical record, she says: “Your blood pressure medicine isn’t working quite as well as I would like, but I know what will work for you!”

How can she be so certain?

The answer could lie in a new VA Research initiative that will help clinicians personalize medical treatment. Called the Million Veteran Program, the initiative is being launched today on a national scale as part of VA Research Week. Through the anticipated participation of as many as one million Veteran volunteers, MVP will help researchers better understand the effects that genes have on health and illness, with the ultimate objective of improving Veterans’ health care. By collecting, analyzing, and comparing a rich mix of Veteran patient data—genetic profile, health history, lifestyle–MVP  will help customize health care in a way that was once unimaginable, bringing us closer to personalized medicinefor Veterans, and ultimately, all Americans.

It must be emphasized that MVP is first and foremost a partnership between Veterans and VA.  As Dr. Joel Kupersmith noted earlier this week in VAntage Point, it is an example of the many types of research collaborations we celebrate as part of Research Week.

Over the next five to seven years, Veterans who choose to participate in MVP will help to create the world’s largest research database of genetic, military exposure, and health information. This database, built on a foundation of protecting Veteran privacy, will be used for studies that lead to new ways of preventing and treating illnesses in Veterans and all Americans. As part of this research partnership, Veterans are being asked to provide a blood sample, from which their DNA will be extracted; complete a health information survey; and allow access to their medical record. Using the data collected, researchers will be able to study how genetic variations, environmental factors, and military service are associated with illness and health.

VA has been conducting genomic research for a number of years, and genetic tests are already used clinically, for example, to determine if Veterans who have blood clots in the legs are predisposed to developing them again, and to help diagnose and treat colon and breast cancers and other diseases. Importantly, MVP will provide a foundation upon which VA investigators can design and conduct future studies that use genetic, environmental, and military service information to help prevent disease and improve medical care.

Three factors are key and cannot be overemphasized. First, participation in MVP is entirely voluntary. Further, a decision to participate, or not participate, will not in any way affect Veterans’ access to health care or benefits.

Second, as I mentioned earlier, data security is a top priority. Samples collected from Veterans for MVP will be labeled with a code instead of their name, address, date of birth or social security number. Researchers who are allowed to analyze these samples will not have access to this type of personal information.

Third, this research will be carried out in a culturally sensitive manner that respects ALL Veterans and their ethnic and cultural identity.

MVP is being rolled out in phases and will ultimately be open to participation by all Veterans receiving care in the VA health care system. Today there are more than 20 sites, with more coming online each month.

In addition to his role as Deputy CRADO, Dr. O’Leary, is Director, Office of Clinical Science Research and Development (CSR&D. His clinical and research expertise is in the use of molecular genetics for diagnosis and treatment of disease.

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