Genomics & Precision Medicine

The Minnesota-KPMP will recruit and follow-up study participants with chronic kidney disease due to diabetes or hypertension, the most common causes of chronic kidney disease, plus participants with type 1 diabetes who do not have clinical manifestations of kidney disease despite long diabetes duration. Underserved and underrepresented populations are disproportionately affected by chronic kidney disease, and the Minnesota-KPMP will engage a diverse patient population to evaluate and address barriers to enrollment in KPMP and to elicit the perspectives of local participants on ethical issues posed by the KPMP, such as return of results and biobank governance. In a highly diverse metropolitan area actively confronting racism and disparities, this will add significantly to KPMP community engagement and ethics.
This study will develop and implement a genomic return of result (gRoR) process in the Framingham Heart Study and Jackson Heart Study cohorts and explore associated medical, behavioral and economic outcomes. The study will also explore ways to automate and streamline genomic variant interpretation at scale, and pursue novel analysis techniques for aggregating data to aid assessment of penetrance. The discoveries generated will provide guidance for gRoR for large-scale population studies and biobanks, including underrepresented minority participants.
This innovative 3-year project, based cooperatively at the University of Minnesota and Vanderbilt University, has convened a national Working Group of top legal and scientific experts to analyze current federal and state law and regulation on translational genomics and to generate consensus guidance on what the law should be. The project team will build a searchable online database of relevant law and an annotated bibliography for free public access, systematically collect and analyze a range of stakeholder inputs, convene a national public conference, and publish analyses and recommendations to help shape the law to support genomic medicine.
MPMC’s new initiative is among the six interdisciplinary projects selected to receive Grand Challenges Research Interdisciplinary Team Awards from the Office of the Executive Vice President and Provost. MPMC II focuses on one of the most mature domains of precision medicine – pharmacogenomics (PGx), which despite its proven scientific basis and immense promise has not yet been widely implemented in healthcare systems. 
The Minnesota Precision Medicine Collaborative (MPMC) is a transformative initiative to use 21st century technologies – including genomics, informatics, bioengineering, analysis of environmental exposures, and behavioral sciences – to tailor health care to the challenges facing individuals and their communities.
This 3-year program developed a research educational program – Big Data Coursework for Computational Medicine (BDC4CM) – that instructs students, fellows, and scientists in the use of specific new methods and tools for Big Data by providing tailored, in-depth instruction, hands-on laboratory modules, and case studies on Big Data access, integration, processing, and analysis.
This empirical and normative bioethics research project was created to guide policy and practice about the disclosure of genomic incidental findings (GIFD), a much-debated topic. With ethical guidance from a multidisciplinary ELSI Working Group, we conducted an experiment designed to develop strategies for offering incidental findings to family members of probands in a biobank for pancreatic cancer.
This project addressed recent regulatory amendments that require CLIA-certified and -exempt laboratories that are subject to the HIPAA Privacy Rule to comply with new individual data-access requirements.
This 2-year project generated multiple articles on the question of how to handle incidental findings (IFs) and individual research results (IRRs). The question of whether researchers should return IFs and IRRs of clinical significance challenges the traditional line drawn between research and clinical care, a line fundamental to the structure of research practice, health law, and bioethics.
This funding encompasses work on two related projects addressing cutting-edge issues posed by the latest advances in biomedical science in the linked domains of genomics and reproductive technologies. Both raise high-profile issues of immediate concern to federal and state government, scientists, and physicians. Both projects address how legal and ethical obligations to those who are most vulnerable (participants in genomic research and children produced using reproductive technologies) should fundamentally change policy and practice.
This 2-year project convened a multidisciplinary working group of national experts to analyze and generate recommendations on managing incidental findings and individual research results in genomic research using biobanks and large archives. In order to understand the genetic contribution to a host of diseases and conditions of great importance to public health, scientists are increasingly assembling large biobanks, archiving many individuals' DNA and health information for scientific reanalysis over time.
This project, led by researchers at the University of Minnesota collaborating with a working group of prominent national scholars, tackled how researchers should handle incidental findings identified during research. Incidental findings are defined as unexpected findings beyond the domain of key interest in the research that have potential clinical significance, such as a suspicious mass revealed in a functional MRI (fMRI) study or an incidental finding of non-paternity in genetic research.
This project explored the impending collision between biological and regulatory classifications of population subgroups in American society. Researchers focused on the interaction between biological categories emerging from the effort to create a haplotype map of the human genome and preexisting categories specifying race and ethnicity embodied in the U.S. Office of Management and Budget's Directive 15, which governs collection of data by all federal agencies and in federally funded research.
This grant was awarded to the Center for Bioethics and Joint Degree Program in Law, Health & the Life Sciences to complete a comprehensive investigation of the ethical, legal, and policy issues in the use of genetic information in private and public disability insurance and to recommend policies based on the findings.

Related Publications

Clayton EW, McCullough LB, Biesecker LG, Joffe S, Ross LF, Wolf SM, for the Clinical Sequencing Exploratory Research (CSER) Consortium Pediatrics Working Group. Addressing the Ethical Challenges in Genetic Testing and Sequencing of Children. American Journal of Bioethics 2014;14(3):3-9. Download PDF (76.34 KB)
Jarvik GP, Amendola LM, Berg JS, Brothers K, Clayton EW, Chung W, Evans BJ, Evans JP, Fullerton SM, Gallego CJ, Garrison NA, Gray SW, Holm IA, Kullo IJ, Lehmann LS, McCarty C, Prows CA, Rehm HL, Sharp RR, Salama J, Sanderson S, Van Driest SL, Williams MS, Wolf SM, Wolf WA, eMERGE Act-ROR Committee and CERC Committee, CSER Act-ROR Working Group, Burke W. Return of genomic results to research participants: the floor, the ceiling, and the choices in between. American Journal of Human Genetics 2014;94(6):818-826. Download PDF (122.5 KB)
Henderson GE, Wolf SM, Kuczynski KJ, Joffe S, Sharp RR, Parsons DW, Knoppers BM, Yu JH, Appelbaum PS. The Challenge of Informed Consent and Return of Results in Translational Genomics: Empirical Analysis and Recommendations. Journal of Law, Medicine & Ethics 2014;42(3):344-355. Download PDF (641.56 KB)
Wolf SM. Return of Individual Research Results and Incidental Findings: Facing the Challenges of Translational Science. Annual Review of Genomics and Human Genetics 2013;14:557-577. Download PDF (686.1 KB)
Wolf SM. Return of Results in Genomic Biobank Research: Ethics Matters. Genetics in Medicine 2013;2(157):157-159. Download PDF (133.13 KB)
Green RC, Berg JS, Grody WW, Kalia SS, Korf BR, Martin CL, McGuire AL, Nussbaum RL, O'Daniel JM, Ormond KE, Rehm HL, Watson MS, Williams MS, Biesecker LG. ACMG Recommendations for Reporting of Incidental Findings in Clinical Exome and Genome Sequencing. Genetics in Medicine 2013;15(7):565-574. Download PDF (425.94 KB)
Burke W, Matheny Antommaria AH, Bennett R, Botkin J, Clayton EW, Henderson GE, Holm IA, Jarvik GP, Khoury MJ, Knoppers BM, Press NA, Ross LF, Rothstein MA, Saal H, Uhlmann WR, Wilfond B, Wolf SM, Zimmern R. Recommendations for returning genomic incidental findings? We need to talk!. Genetics in Medicine 2013;15(11):854-859. Download PDF (45.47 KB)
Berg JS, Amendola LM, Eng C, Van Allen E, Gray S, Wagle N, Rehm HL, DeChene ET, Dulik MC, Hisama FM, Burke W, Spinner NB, Garraway L, Green RC, Plon S, Evans JP, Jarvik GP. Processes and Preliminary Outputs for Identification of Actionable Genes as Incidental Findings in Genomic Sequence Data in the Clinical Sequencing Exploratory Research Consortium. Genetics in Medicine 2013;15(11):860-867. Download PDF (252.16 KB)
McGuire AL, Joffe S, Koenig B, Biesecker BB, McCullough LB, Blumenthal-Barby JS, Caulfield T, Terry SF, Green RC. Ethics and Genomic Incidental Findings: Point-Counterpoint. Science 2013;340(6136):1047-1048. Download PDF (116.64 KB)
Wolf SM, Annas GJ, Elias S. Patient Autonomy and Incidental Findings in Clinical Genomics: Point-Counterpoint. Science 2013;340(6136):1049-1050. Download PDF (120.72 KB)
Evans J, Rothschild BR. Return of Results: Not that Complicated?. Genetics in Medicine 2012;14(4):358-360. Download PDF (197.86 KB)
Wolf SM, Crock BN, Van Ness B, Lawrenz F, Kahn JP, Beskow LM, Cho MK, Christman MF, Green RC, Hall R, Illes J, Keane M, Knoppers BM, Koenig BA, Kohane IS, Leroy B, Maschke KJ, McGeveran W, Ossorio P, Parker LS, Petersen GM, Richardson HS, Scott JA, Terry SF, Wilfond BS, Wolf WA. Managing Incidental Findings and Research Results in Genomic Research Involving Biobanks and Archived Data Sets. Genetics in Medicine 2012;14(4):361-384. Download PDF (515.12 KB)