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Millager RA, Feldman JI, Williams ZJ, Shibata K, Martinez-Torres KA, Bryan KM, Pruett DG, Mitchell JT, Markfeld JE, Merritt B, Daniels DE, Jones RM, Woynaroski T. Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of American Speech-Language-Hearing Association Publications in 2020. PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2024; 9:836-852. [PMID: 38912383 PMCID: PMC11192539 DOI: 10.1044/2024_persp-23-00204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Purpose One manifestation of systemic inequities in communication sciences and disorders (CSD) is the chronic underreporting and underrepresentation of sex, gender, race, and ethnicity in research. The present study characterized recent demographic reporting practices and representation of participants across CSD research. Methods We systematically reviewed and extracted key reporting and participant data from empirical studies conducted in the United States (US) with human participants published in the year 2020 in journals by the American Speech-Language-Hearing Association (ASHA; k = 407 articles comprising a total n = 80,058 research participants, search completed November 2021). Sex, gender, race, and ethnicity were operationalized per National Institutes of Health guidelines (National Institutes of Health, 2015a, 2015b). Results Sex or gender was reported in 85.5% of included studies; race was reported in 33.7%; and ethnicity was reported in 13.8%. Sex and gender were clearly differentiated in 3.4% of relevant studies. Where reported, median proportions for race and ethnicity were significantly different from the US population, with underrepresentation noted for all non-White racial groups and Hispanic participants. Moreover, 64.7% of studies that reported sex or gender and 67.2% of studies that reported race or ethnicity did not consider these respective variables in analyses or discussion. Conclusion At present, research published in ASHA journals frequently fails to report key demographic data summarizing the characteristics of participants. Moreover, apparent gaps in representation of minoritized racial and ethnic groups threaten the external validity of CSD research and broader health care equity endeavors in the US. Although our study is limited to a single year and publisher, our results point to several steps for readers that may bring greater accountability, consistency, and diversity to the discipline.
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Affiliation(s)
- Ryan A. Millager
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Jacob I. Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
- Frist Center for Autism and Innovation, Vanderbilt University
| | - Zachary J. Williams
- Department of Hearing and Speech Sciences, Vanderbilt University
- Frist Center for Autism and Innovation, Vanderbilt University
- Vanderbilt Brain Institute, Vanderbilt University
- Medical Scientist Training Program, Vanderbilt University School of Medicine
| | - Kiiya Shibata
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Keysha A. Martinez-Torres
- Department of Hearing and Speech Sciences, Vanderbilt University
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
| | | | - Dillon G. Pruett
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Jade T. Mitchell
- Department of Hearing and Speech Sciences, Vanderbilt University
| | - Jennifer E. Markfeld
- Department of Hearing and Speech Sciences, Vanderbilt University
- Frist Center for Autism and Innovation, Vanderbilt University
| | - Brandon Merritt
- Department of Speech, Language, and Hearing Sciences, The University of Texas at El Paso
| | - Derek E. Daniels
- Department of Communication Sciences and Disorders, Wayne State University
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center
| | - Tiffany Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
- Frist Center for Autism and Innovation, Vanderbilt University
- Vanderbilt Brain Institute, Vanderbilt University
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii at Manoa
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Holt HK, Martinez G, Reyes MF, Saraiya M, Qin J, Sawaya GF. Tubal Sterilization and Cervical Cancer Underscreening in the United States. J Womens Health (Larchmt) 2024; 33:729-733. [PMID: 38502830 PMCID: PMC11182708 DOI: 10.1089/jwh.2023.0610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Background: Tubal sterilization is more commonly utilized by racial/ethnic minority groups and has been implicated in underscreening for cervical cancer. The objective is to determine if prior tubal sterilization is a risk factor for cervical cancer underscreening. Methods: National Survey of Family Growth dataset from 2015 to 2019 used for analysis; data were weighted to represent the 72 million women in the U.S. population aged 22-49. Chi-square tests, Fisher exact tests, and logistic regression were used for analysis. The primary predictor variable was tubal sterilization which was categorized into no previous sterilization, sterilization completed <5 years ago, and sterilization completed ≥5 years ago. The outcome variable was underscreened versus not underscreened. Other predictor variables included age, household income as a percent of federal poverty level, previous live birth, primary care provider, and insurance status. Results: Prevalence of tubal sterilization completed 5 or more years ago was 12.5% and varied by most measured characteristics in univariate analyses. Approximately 8% of women were underscreened for cervical cancer. In multivariable analyses, women with a tubal sterilization 5 or more years ago had 2.64 times the odds (95% confidence interval = 1.75-4.00) of being underscreened for cervical cancer compared with women who did not have a tubal sterilization. Conclusions: Approximately 4.3 million women ages 22-49 in the United States are potentially underscreened for cervical cancer and women with previous tubal ligation ≥5 years ago are more likely to be underscreened. These results may inform the need for culturally sensitive public health messages informing people who have had these procedures about the need for continued screening.
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Affiliation(s)
- Hunter K. Holt
- Department of Family and Community Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Gladys Martinez
- Reproductive Statistics Branch, National Center for Health Statistics, Division of Vital Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
| | - Maria F. Reyes
- Department of Obstetrics, Gynecology and Reproductive Sciences, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Mona Saraiya
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jin Qin
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - George F. Sawaya
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Healthcare Value, University of California San Francisco, San Francisco, California, USA
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Wang Y, He Y, Shi Y, Qian DC, Gray KJ, Winn R, Martin AR. Aspiring toward equitable benefits from genomic advances to individuals of ancestrally diverse backgrounds. Am J Hum Genet 2024; 111:809-824. [PMID: 38642557 PMCID: PMC11080611 DOI: 10.1016/j.ajhg.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/22/2024] Open
Abstract
Advancements in genomic technologies have shown remarkable promise for improving health trajectories. The Human Genome Project has catalyzed the integration of genomic tools into clinical practice, such as disease risk assessment, prenatal testing and reproductive genomics, cancer diagnostics and prognostication, and therapeutic decision making. Despite the promise of genomic technologies, their full potential remains untapped without including individuals of diverse ancestries and integrating social determinants of health (SDOHs). The NHGRI launched the 2020 Strategic Vision with ten bold predictions by 2030, including "individuals from ancestrally diverse backgrounds will benefit equitably from advances in human genomics." Meeting this goal requires a holistic approach that brings together genomic advancements with careful consideration to healthcare access as well as SDOHs to ensure that translation of genetics research is inclusive, affordable, and accessible and ultimately narrows rather than widens health disparities. With this prediction in mind, this review delves into the two paramount applications of genetic testing-reproductive genomics and precision oncology. When discussing these applications of genomic advancements, we evaluate current accessibility limitations, highlight challenges in achieving representativeness, and propose paths forward to realize the ultimate goal of their equitable applications.
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Affiliation(s)
- Ying Wang
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
| | - Yixuan He
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Yue Shi
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - David C Qian
- Department of Thoracic Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kathryn J Gray
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Robert Winn
- Virginia Commonwealth University Massey Cancer Center, Richmond, VA, USA
| | - Alicia R Martin
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
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4
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Tong M, Hurtado A, Deshpande R, Pietrzak RH, He C, Kaplan C, Kaplan S, Akhtar S, Feder A, Feingold JH, Ripp JA, Peccoralo LA. Psychological Burden of Systemic Racism-Related Distress in New York City Healthcare Workers During the COVID-19 Pandemic. J Gen Intern Med 2024; 39:450-459. [PMID: 37845586 PMCID: PMC10897117 DOI: 10.1007/s11606-023-08422-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/07/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Little is known about the relationship among systemic racism, psychological symptoms (depression, anxiety, and/or post-traumatic stress disorders), and burnout in healthcare workers (HCWs). OBJECTIVE To determine whether distress related to awareness of systemic racism contributes to psychological symptoms and/or burnout in HCWs. We explored whether this form of racism-related distress may moderate the relationship between race, ethnicity, psychological symptoms, and burnout. DESIGN A cross-sectional survey was conducted from November 19, 2020, through January 11, 2021. Statistical analysis was conducted from May 3, 2022, to June 15, 2022. PARTICIPANTS Frontline HCWs at an urban tertiary care hospital in New York City. MAIN MEASURES Distress related to awareness of systemic racism (SR) and racial disparities in COVID-19 outcomes (RD), psychological symptoms, and burnout. KEY RESULTS Two thousand one of 4654 HCWs completed the survey (response rate 43.0%). Most HCWs reported experiencing distress related to awareness of systemic racism (1329 [66.4%]) and to racial disparities in COVID-19 outcomes (1137 [56.8%]). Non-Hispanic Black participants (SR odds ratio (OR) 2.84, p < .001; RD OR 2.34, p < .001), women (SR OR 1.35, p = .01; RD OR 1.67, p < .001), and those with history of mental illness (SR OR 2.13, p < .001; RD OR 1.66, p < .001) were more likely to report SR- and RD-related distress, respectively. HCWs who experienced "quite-a-bit to extreme" SR-related distress were more likely to screen positive for psychological symptoms (OR 5.90, p < .001) and burnout (OR 2.26, p < .001). CONCLUSIONS Our findings suggest that distress related to awareness of systemic racism, not race/ethnicity, was associated with experiencing psychological symptoms and burnout in HCWs. As the medical community continues to critically examine the role of systemic racism in healthcare, our work is a first step in characterizing its toll on the psychological well-being of HCWs.
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Affiliation(s)
- Michelle Tong
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Alicia Hurtado
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Richa Deshpande
- Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Celestine He
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Carly Kaplan
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Sabrina Kaplan
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Saadia Akhtar
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jordyn H Feingold
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan A Ripp
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren A Peccoralo
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA.
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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5
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Bentz M, Saperstein A, Fullerton SM, Shim JK, Lee SSJ. Conflating race and ancestry: Tracing decision points about population descriptors over the precision medicine research life course. HGG ADVANCES 2024; 5:100243. [PMID: 37771152 PMCID: PMC10585473 DOI: 10.1016/j.xhgg.2023.100243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
Responding to calls for human genomics to shift away from the use of race, genomic investigators are coalescing around the possibility of using genetic ancestry. This shift has renewed questions about the use of social and genetic concepts of difference in precision medicine research (PMR). Drawing from qualitative data on five PMR projects, we illustrate negotiations within and between research teams as genomic investigators deliberate on the relevance of race and genetic ancestry for different analyses and contexts. We highlight how concepts of both social and genetic difference are embedded within and travel through research practices, and identify multiple points across the research life course at which conceptual slippage and conflation between race and genetic ancestry occur. We argue that moving beyond race will require PMR investigators to confront the entrenched ways in which race is built into research practices and biomedical infrastructures.
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Affiliation(s)
- Michael Bentz
- Division of Ethics, Department of Medical Humanities and Ethics, Vagelos College of Physicians & Surgeons, Columbia University, 630 West 168th Street, PH 1525, New York, NY 10032, USA.
| | - Aliya Saperstein
- Department of Sociology, Stanford University, 450 Jane Stanford Way, Building 120, Room 160, Stanford, CA 94305-2047, USA
| | - Stephanie M Fullerton
- Department of Bioethics & Humanities, University of Washington School of Medicine, Box 357120, Seattle, WA 98195-7120, USA
| | - Janet K Shim
- Department of Social & Behavioral Sciences, University of California, San Francisco, 490 Illinois Street, Floor 12, Box 0612, San Francisco, CA 94143-0612, USA
| | - Sandra Soo-Jin Lee
- Division of Ethics, Department of Medical Humanities and Ethics, Vagelos College of Physicians & Surgeons, Columbia University, 630 West 168th Street, PH 1525, New York, NY 10032, USA.
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Fischer B, Van Hulle CA, Langhough R, Norton D, Zuelsdorff M, Gooding DC, Wyman MF, Johnson A, Lambrou N, James T, Bouges S, Carter FP, Salazar H, Kirmess K, Holubasch M, Meyer M, Venkatesh V, West T, Verghese P, Yarasheski K, Carlsson CM, Johnson SC, Asthana S, Gleason CE. Plasma Aβ42/40 and cognitive variability are associated with cognitive function in Black Americans: Findings from the AA-FAIM cohort. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12414. [PMID: 37752907 PMCID: PMC10519622 DOI: 10.1002/trc2.12414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/25/2023] [Indexed: 09/28/2023]
Abstract
Introduction It is critical to develop more inclusive Alzheimer's disease (AD) research protocols to ensure that historically excluded groups are included in preclinical research and have access to timely diagnosis and treatment. If validated in racialized groups, plasma AD biomarkers and measures of subtle cognitive dysfunction could provide avenues to expand diversity in preclinical AD research. We sought to evaluate the utility of two easily obtained, low-burden disease markers, plasma amyloid beta (Aβ)42/40, and intra-individual cognitive variability (IICV), to predict concurrent and longitudinal cognitive performance in a sample of Black adults. Methods Two hundred fifty-seven Black participants enrolled in the African Americans Fighting Alzheimer's in Midlife (AA-FAIM) study underwent at least one cognitive assessment visit; a subset of n = 235 had plasma samples. Baseline IICV was calculated as the standard deviation across participants' z scores on five cognitive measures: Rey Auditory Verbal Learning Test Delayed Recall, Trail Making Test Parts A and B (Trails A and B), and Boston Naming Test. Using mixed effects regression models, we compared concurrent and longitudinal models to baseline plasma Aβ42/40 or IICV by age interactions. PrecivityAD assays quantified baseline plasma Aβ42/40. Results IICV was associated with concurrent/baseline performance on several outcomes but did not modify associations between age and cognitive decline. In contrast, plasma Aβ42/40 was unrelated to baseline cognitive performance, but a pattern emerged in interactions with age in longitudinal models of Trails A and B and Rey Auditory Verbal Learning Test total learning trials. Although not significant after correcting for multiple comparisons, low Aβ42/40 was associated with faster cognitive declines over time. Discussion Our results are promising as they extend existing findings to an Black American sample using low-cost, low-burden methods that can be implemented outside of a research center, thus supporting efforts for inclusive AD biomarker research.
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Affiliation(s)
- Barbara Fischer
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of NeurologyUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Carol Ann Van Hulle
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rebecca Langhough
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Derek Norton
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Department of Biostatistics and Medical InformaticsUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- School of NursingUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Diane Carol Gooding
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Department of PsychologyUniversity of Wisconsin–MadisonMadison, WisconsinUSA
- Department of PsychiatryUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Mary F. Wyman
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Adrienne Johnson
- Center for Tobacco Research and InterventionSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Nickolas Lambrou
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Taryn James
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Shenikqua Bouges
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Fabu Phillis Carter
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Hector Salazar
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | | | | | | | | | - Tim West
- C2N DiagnosticsSt. LouisMissouriUSA
| | | | | | - Cynthia M. Carlsson
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Sterling C. Johnson
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Sanjay Asthana
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Carey E. Gleason
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
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Farajzadeh-Dehkordi M, Samiee-Rad F, Farzam SS, Javadi A, Cheraghi S, Hamedi-Asl D, Rahmani B. Evaluation of a warfarin dosing algorithm including CYP2C9, VKORC1, and CYP4F2 polymorphisms and non-genetic determinants for the Iranian population. Pharmacol Rep 2023; 75:695-704. [PMID: 37039974 DOI: 10.1007/s43440-023-00476-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND The response to warfarin, as an oral anticoagulant agent, varies widely among patients from different ethnic groups. In this study, we tried to ascertain and determine the relationship between non-genetic factors and genetic polymorphisms with warfarin therapy; we then proposed a new warfarin dosing prediction algorithm for the estimation of drug sensitivity and resistance in the Iranian population. METHODS Overall, 200 warfarin-treated patients with stable doses were recruited, the demographic and clinical characteristics were documented, and genotyping was done using a sequencing assay. RESULTS The outcomes of our investigation showed that the genetic polymorphisms of VKORC1(-1639 G > A), CYP2C9*3, CYP2C9*2, amiodarone use, and increasing age were found to be related to a significantly lower mean daily warfarin dose. In contrast, the CYP4F2*3 variant and increased body surface area were linked with an increased dose of warfarin in the Iranians. Our descriptive model could describe 56.5% of the variability in response to warfarin. This population-specific dosing model performed slightly better than other previously published warfarin algorithms for our patient's series. Furthermore, our findings provided the suggestion that incorporating the CYP4F2*3 variant into the dosing algorithm could result in a more precise calculation of warfarin dose requirements in the Iranian population. CONCLUSIONS We proposed and validated a population-specific dosing algorithm based on genetic and non-genetic determinants for Iranian patients and evaluated its performance. Accordingly, by using this newly developed algorithm, prescribers could make more informed decisions regarding the treatment of Iranian patients with warfarin.
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Affiliation(s)
- Mahvash Farajzadeh-Dehkordi
- Cellular and Molecular Research Center, Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Molecular Medicine, Faculty of Medical School, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Samiee-Rad
- Cellular and Molecular Research Center, Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Pathology, Faculty of Medical School, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Seyed Saeed Farzam
- Department of Cardiovascular Surgery, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Javadi
- Department of Social Sciences, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sara Cheraghi
- Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Dariush Hamedi-Asl
- Cellular and Molecular Research Center, Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Molecular Medicine, Faculty of Medical School, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Babak Rahmani
- Cellular and Molecular Research Center, Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
- Department of Molecular Medicine, Faculty of Medical School, Qazvin University of Medical Sciences, Qazvin, Iran.
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8
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Iltis AS, Rolf L, Yaeger L, Goodman MS, DuBois JM. Attitudes and beliefs regarding race-targeted genetic testing of Black people: A systematic review. J Genet Couns 2023; 32:435-461. [PMID: 36644818 DOI: 10.1002/jgc4.1653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 01/17/2023]
Abstract
Geographical ancestry has been associated with an increased risk of various genetic conditions. Race and ethnicity often have been used as proxies for geographical ancestry. Despite numerous problems associated with the crude reliance on race and ethnicity as proxies for geographical ancestry, some genetic testing in the clinical, research, and employment settings has been and continues to be race- or ethnicity-based. Race-based or race-targeted genetic testing refers to genetic testing offered only or primarily to people of particular racial or ethnic groups because of presumed differences among groups. One current example is APOL1 testing of Black kidney donors. Race-based genetic testing raises numerous ethical and policy questions. Given the ongoing reliance on the Black race in genetic testing, it is important to understand the views of people who identify as Black or are identified as Black (including African American, Afro-Caribbean, and Hispanic Black) regarding race-based genetic testing that targets Black people because of their race. We conducted a systematic review of studies and reports of stakeholder-engaged projects that examined how people who identify as or are identified as Black perceive genetic testing that specifically presumes genetic differences exist among racial groups or uses race as a surrogate for ancestral genetic variation and targets Black people. Our review identified 14 studies that explicitly studied this question and another 13 that implicitly or tacitly studied this matter. We found four main factors that contribute to a positive attitude toward race-targeted genetic testing (facilitators) and eight main factors that are associated with concerns regarding race-targeted genetic testing (barriers). This review fills an important gap. These findings should inform future genetic research and the policies and practices developed in clinical, research, public health, or other settings regarding genetic testing.
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Affiliation(s)
| | - Liz Rolf
- Washington University in St. Louis School of Medicine
| | - Lauren Yaeger
- Washington University in St. Louis School of Medicine
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9
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Stites SD, Coe NB. Let's Not Repeat History's Mistakes: Two Cautions to Scientists on the Use of Race in Alzheimer's Disease and Alzheimer's Disease Related Dementias Research. J Alzheimers Dis 2023; 92:729-740. [PMID: 36806503 PMCID: PMC10123855 DOI: 10.3233/jad-220507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Alzheimer's disease and Alzheimer's disease related dementias (AD/ADRD) research has advanced gene and biomarker technologies to aid identification of individuals at risk for dementia. This innovation is a lynchpin in development of disease-modifying therapies. The emerging science could transform outcomes for patients and families. However, current limitations in the racial representation and inclusion of racial diversity in research limits the relevance of these technologies: AD/ADRD research cohorts used to define biomarker cutoffs are mostly White, despite clinical and epidemiologic research that shows Black populations are among those experiencing the greatest burdens of AD/ADRD. White cohorts alone are insufficient to characterize heterogeneity in disease and in life experiences that can alter AD/ADRD's courses. The National Institute on Aging (NIA) has called for increased racial diversity in AD/ADRD research. While scientists are working to implement NIA's plan to build more diverse research cohorts, they are also seeking out opportunities to consider race in AD/ADRD research. Recently, scientists have posed two ways of including race in AD/ADRD research: ancestry-based verification of race and race-based adjustment of biomarker test results. Both warrant careful examination for how they are impacting AD/ADRD science with respect to specific study objectives and the broader mission of the field. If these research methods are not grounded in pursuit of equity and justice, biases they introduce into AD/ADRD science could perpetuate, or even worsen, disparities in AD/ADRD research and care.
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Affiliation(s)
- Shana D. Stites
- Department of Psychiatry, Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Norma B. Coe
- Department of Medical Ethics and Health Policy, Perelman School of Medicine and Co-Director of the Population Aging Research Center (PARC), University of Pennsylvania, Philadelphia, PA, USA
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10
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Bouges S, Fischer B, Norton DL, Wyman MF, Lambrou N, Zuelsdorff M, Van Hulle CA, Ennis GE, James TT, Johnson AL, Chin N, Carlsson CM, Gleason CE. Effect of Metabolic Syndrome Risk Factors on Processing Speed and Executive Function in Three Racialized Groups. J Alzheimers Dis 2023; 92:285-294. [PMID: 36744341 PMCID: PMC10211459 DOI: 10.3233/jad-220920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) has been associated with increased risk for Alzheimer's disease and related dementias (ADRD). Understanding the association of MetS risk factors to processing speed and executive function in the pre-clinical stages of ADRD in under-represented groups would offer insight on potential mechanisms through which MetS associates with ADRD risk. OBJECTIVE Examine association of MetS features and processing speed and executive function across three racial groups. METHODS Cognitively unimpaired adults from the Wisconsin Alzheimer's Disease Research Center and the Wisconsin Registry for Alzheimer's Disease Prevention completed blood-draws and neuropsychological testing. Six cognitive outcomes were assessed in association to MetS risk factors: Trailmaking Tests A and B, Animal Fluency, Digit Symbol, and composite scores for Processing Speed and Executive Function. Linear mixed effect models were used to assess the relationship between MetS risk factor count and longitudinal cognitive performance across three racialized groups. RESULTS Participant sample sizes varied by outcome analyzed (N = 714-1,088). African American and Native American groups exhibited higher rates of MetS than non-Hispanic Whites. MetS was associated with processing speed and executive function across all racialized groups. Three-way interaction by racialized group was limited to one cognitive outcome: Trailmaking Test A. CONCLUSION Metabolic dysfunction incrementally affects cognitive trajectory, with generally similar associations across racial groups. Since racialized groups exhibit higher levels of both MetS and ADRD, MetS may represent a driving factor for increased ADRD risk experience by racialized group and an important and modifiable target through which to reduce risk of ADRD.
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Affiliation(s)
- Shenikqua Bouges
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Barbara Fischer
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Neurology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Derek L. Norton
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
| | - Mary F. Wyman
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- University of Wisconsin School of Medicine & Public Health, Department of Psychiatry, Madison, WI, USA
| | - Nickolas Lambrou
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, UW School of Medicine & Public Health, Madison, WI, USA
- University of Wisconsin – Madison School of Nursing
| | - Carol A. Van Hulle
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Gilda E. Ennis
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Taryn T. James
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Adrienne L. Johnson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- University of Wisconsin School of Medicine & Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA
| | - Nathaniel Chin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, UW School of Medicine & Public Health, Madison, WI, USA
| | - Cynthia M. Carlsson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, UW School of Medicine & Public Health, Madison, WI, USA
| | - Carey E. Gleason
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
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11
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Cerdeña JP, Grubbs V, Non AL. Racialising genetic risk: assumptions, realities, and recommendations. Lancet 2022; 400:2147-2154. [PMID: 36502852 DOI: 10.1016/s0140-6736(22)02040-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/07/2022] [Accepted: 10/14/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Jessica P Cerdeña
- Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Anthropology, University of Connecticut, Storrs, CT, USA
| | - Vanessa Grubbs
- Department of Ambulatory and Preventive Medicine, Alameda Health System, Oakland, CA, USA
| | - Amy L Non
- Department of Anthropology, University of California, San Diego, CA, USA.
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12
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Mauro M, Allen DS, Dauda B, Molina SJ, Neale BM, Lewis AC. A scoping review of guidelines for the use of race, ethnicity, and ancestry reveals widespread consensus but also points of ongoing disagreement. Am J Hum Genet 2022; 109:2110-2125. [PMID: 36400022 PMCID: PMC9808506 DOI: 10.1016/j.ajhg.2022.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The use of population descriptors such as race, ethnicity, and ancestry in science, medicine, and public health has a long, complicated, and at times dark history, particularly for genetics, given the field's perceived importance for understanding between-group differences. The historical and potential harms that come with irresponsible use of these categories suggests a clear need for definitive guidance about when and how they can be used appropriately. However, while many prior authors have provided such guidance, no established consensus exists, and the extant literature has not been examined for implied consensus and sources of disagreement. Here, we present the results of a scoping review of published normative recommendations regarding the use of population categories, particularly in genetics research. Following PRISMA guidelines, we extracted recommendations from n = 121 articles matching inclusion criteria. Articles were published consistently throughout the time period examined and in a broad range of journals, demonstrating an ongoing and interdisciplinary perceived need for guidance. Examined recommendations fall under one of eight themes identified during analysis. Seven are characterized by broad agreement across articles; one, "appropriate definitions of population categories and contexts for use," revealed substantial fundamental disagreement among articles. Additionally, while many articles focus on the inappropriate use of race, none fundamentally problematize ancestry. This work can be a resource to researchers looking for normative guidance on the use of population descriptors and can orient authors of future guidelines to this complex field, thereby contributing to the development of more effective future guidelines for genetics research.
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Affiliation(s)
- Madelyn Mauro
- Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA, USA
| | - Danielle S. Allen
- Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA, USA
| | - Bege Dauda
- Center for Global Genomics and Health Equity, University of Pennsylvania, Philadelphia, PA, USA,Institute of Clinical Bioethics, Saint Joseph’s University, Philadelphia, PA, USA
| | | | - Benjamin M. Neale
- Broad Institute of Harvard and MIT, Cambridge, MA, USA,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA,Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Anna C.F. Lewis
- Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA, USA,Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Corresponding author
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13
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Khan AT, Gogarten SM, McHugh CP, Stilp AM, Sofer T, Bowers ML, Wong Q, Cupples LA, Hidalgo B, Johnson AD, McDonald MLN, McGarvey ST, Taylor MR, Fullerton SM, Conomos MP, Nelson SC. Recommendations on the use and reporting of race, ethnicity, and ancestry in genetic research: Experiences from the NHLBI TOPMed program. CELL GENOMICS 2022; 2:100155. [PMID: 36119389 PMCID: PMC9481067 DOI: 10.1016/j.xgen.2022.100155] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
How race, ethnicity, and ancestry are used in genomic research has wide-ranging implications for how research is translated into clinical care and incorporated into public understanding. Correlation between race and genetic ancestry contributes to unresolved complexity for the scientific community, as illustrated by heterogeneous definitions and applications of these variables. Here, we offer commentary and recommendations on the use of race, ethnicity, and ancestry across the arc of genetic research, including data harmonization, analysis, and reporting. While informed by our experiences as researchers affiliated with the NHLBI Trans-Omics for Precision Medicine (TOPMed) program, these recommendations are applicable to basic and translational genomic research in diverse populations with genome-wide data. Moving forward, considerable collaborative effort will be required to ensure that race, ethnicity, and ancestry are described and used appropriately to generate scientific knowledge that yields broad and equitable benefit.
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Affiliation(s)
- Alyna T. Khan
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- Institute for Public Health Genetics, University of Washington, Seattle, WA, USA
| | | | - Caitlin P. McHugh
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Adrienne M. Stilp
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Tamar Sofer
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Michael L. Bowers
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Quenna Wong
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew D. Johnson
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Framingham, MA, USA
- The Framingham Heart Study, Framingham, MA, USA
| | - Merry-Lynn N. McDonald
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephen T. McGarvey
- Department of Epidemiology and International Health Institute, Brown University School of Public Health, Providence, RI, USA
- Department of Anthropology, Brown University, Providence, RI, USA
| | - Matthew R.G. Taylor
- Department of Medicine, Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | | | - Sarah C. Nelson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- Institute for Public Health Genetics, University of Washington, Seattle, WA, USA
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14
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Wu H, Shui YB, Liu Y, Liu X, Siegfried CJ. Trabecular Meshwork Mitochondrial Function and Oxidative Stress. OPHTHALMOLOGY SCIENCE 2022; 2:100107. [PMID: 36246185 PMCID: PMC9562365 DOI: 10.1016/j.xops.2021.100107] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/11/2021] [Accepted: 12/16/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Hongli Wu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of North Texas Health Science Center, Fort Worth, Texas
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas
| | - Ying-Bo Shui
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Ying Liu
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Xiaobin Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of North Texas Health Science Center, Fort Worth, Texas
| | - Carla J. Siegfried
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
- Correspondence: Carla J. Siegfried, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8096, St. Louis, MO 63110.
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15
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Kahn J. Diversity's Pandemic Distractions. HEALTH MATRIX (CLEVELAND, OHIO : 1991) 2022; 32:149-213. [PMID: 36504562 PMCID: PMC9733320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pandemic diseases have a nasty history of racialization. COVID-19 is no exception. Beyond the obvious racist invocations of the "China virus" or the "Wuhan Flu" are subtler racializing dynamics that are often veiled in more benign motives but are nonetheless deeply problematic. The racialization of COVID-19 proceeded along two distinct trajectories each of which threatened to reinforce inaccurate biologized conceptions of race while diverting attention from the social, legal, and political forces historically structuring race-based health disparities. First, early on as significant racial disparities in disease incidence and mortality became evident, a frame of race-based genetic difference came to the fore as a possible explanation. Second, as vaccine development ramped up there came widespread calls for racially "diversifying" clinical trials for the vaccines being tested. The rationales for such diversification were varied but tended to reinforce genetic frames of racial difference. Most common was the assertion (without substantial evidence) that vaccines might work differently in Black or Brown bodies and so racial diversity in trials was imperative for reasons of safety and efficacy. Derrick Bell cautioned 20 years ago that "the concept of diversity … is a serious distraction in the ongoing efforts to achieve racial justice." (Derrick Bell, Diversity's Distractions, 103 Colum. L. Rev. 1622, 1622 (2003).) This article explores the dynamics of how the concept of "diversity" racialized responses to COVID-19 and considers their broader implications for understanding and responding to racial disparities in the face of pandemic emergencies and beyond. In the short term, vaccine developers did a decent job of enrolling minorities in their clinical trials and the vaccines have proven to have the same safety and efficacy across races. In the long term, diversity in the biomedical context of pandemic response not only distracts attention from important structural causes of health injustice, but it also focuses attention on the genetics of disparities in a manner that has the potential to reinforce pernicious and false ideas of essential biological difference among racial groups. This article argues that an uncritical embrace of the idea of diversity in analyzing and responding to emergent health crises has the potential to distract us from considering deeper historical and structural formations contributing to racial health disparities. It proceeds first by exploring the dynamics through which initial responses to racial disparities in COVID-19 became geneticized. It will then move on to unpack the rationales for such racialization, examine their merits (or lack thereof), and consider their implications for developing an equitable response to pandemic emergencies. The next section will examine the subsequent racialization of clinical trials for COVID-19 vaccines through the concept of "diversity." It then moves on to explore how the geneticization of COVID-19 racial disparities laid the foundations for a similar geneticization of race in vaccine development. It will argue that in failing to clearly distinguish social and biological rationales for diversity, such framings, while generally well-intentioned, are poorly supported and work in tandem with the geneticization of racial disparities in COVID-19 morbidity and mortality to locate the causes of disparities in the minds and bodies of minoritized populations; again this distracts attention from the historical and structural forces contributing to such disparities. The article concludes by recognizing a certain intractability to the problems of using race in biomedical research and practice, particularly in the context of public health emergencies. It offers modest suggestions for improvement that could have significant practical effects if taken to heart by researchers, clinicians, and policy makers.
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Affiliation(s)
- Jonathan Kahn
- Professor of Law and Biology, Northeastern University
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16
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Marzinke MA, Greene DN, Bossuyt PM, Chambliss AB, Cirrincione LR, McCudden CR, Melanson SEF, Noguez JH, Patel K, Radix AE, Takwoingi Y, Winston-McPherson G, Young BA, Hoenig MP. Limited Evidence for Use of a Black Race Modifier in eGFR Calculations: A Systematic Review. Clin Chem 2021; 68:521-533. [DOI: 10.1093/clinchem/hvab279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Commonly used estimated glomerular filtration rate (eGFR) equations include a Black race modifier (BRM) that was incorporated during equation derivation. Race is a social construct, and a poorly characterized variable that is applied inconsistently in clinical settings. The BRM results in higher eGFR for any creatinine concentration, implying fundamental differences in creatinine production or excretion in Black individuals compared to other populations. Equations without inclusion of the BRM have the potential to detect kidney disease earlier in patients at the greatest risk of chronic kidney disease (CKD), but also has the potential to over-diagnose CKD or impact downstream clinical interventions. The purpose of this study was to use an evidence- based approach to systematically evaluate the literature relevant to the performance of the eGFR equations with and without the BRM and to examine the clinical impact of the use or removal.
Content
PubMed and Embase databases were searched for studies comparing measured GFR to eGFR in racially diverse adult populations using the Modification of Diet in Renal Disease or the 2009-Chronic Kidney Disease Epidemiology Collaboration-creatinine equations based on standardized creatinine measurements. Additionally, we searched for studies comparing clinical use of eGFR calculated with and without the BRM. 8,632 unique publications were identified; an additional 3 studies were added post-hoc. In total, 96 studies were subjected to further analysis and 44 studies were used to make a final assessment.
Summary
There is limited published evidence to support the use of a BRM in eGFR equations.
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Affiliation(s)
- Mark A Marzinke
- Departments of Pathology and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dina N Greene
- Department of Laboratory Medicine and Pathology; University of Washington, Seattle, WA; Kaiser Permanente, Renton, WA
| | - Patrick M Bossuyt
- Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | | | | | - Christopher R McCudden
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital; University of Ottawa; Eastern Ontario Regional Laboratory Association, Ottawa, Ontario, Canada
| | - Stacy E F Melanson
- Department of Pathology; Brigham and Women’s Hospital; Harvard Medical School, Boston, MA
| | - Jaime H Noguez
- Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Khushbu Patel
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Asa E Radix
- Callen-Lorde Community Health Center, New York, NY
| | - Yemisi Takwoingi
- Institute of Applied Health Research,University of Birmingham and NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, United Kingdom
| | | | - Bessie A Young
- Office of Healthcare Equity, Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA
| | - Melanie P Hoenig
- Renal Division, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
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17
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Gleason CE, Zuelsdorff M, Gooding DC, Kind AJH, Johnson AL, James TT, Lambrou NH, Wyman MF, Ketchum FB, Gee A, Johnson SC, Bendlin BB, Zetterberg H. Alzheimer's disease biomarkers in Black and non-Hispanic White cohorts: A contextualized review of the evidence. Alzheimers Dement 2021; 18:1545-1564. [PMID: 34870885 PMCID: PMC9543531 DOI: 10.1002/alz.12511] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 02/06/2023]
Abstract
Black Americans are disproportionately affected by dementia. To expand our understanding of mechanisms of this disparity, we look to Alzheimer's disease (AD) biomarkers. In this review, we summarize current data, comparing the few studies presenting these findings. Further, we contextualize the data using two influential frameworks: the National Institute on Aging-Alzheimer's Association (NIA-AA) Research Framework and NIA's Health Disparities Research Framework. The NIA-AA Research Framework provides a biological definition of AD that can be measured in vivo. However, current cut-points for determining pathological versus non-pathological status were developed using predominantly White cohorts-a serious limitation. The NIA's Health Disparities Research Framework is used to contextualize findings from studies identifying racial differences in biomarker levels, because studying biomakers in isolation cannot explain or reduce inequities. We offer recommendations to expand study beyond initial reports of racial differences. Specifically, life course experiences associated with racialization and commonly used study enrollment practices may better account for observations than exclusively biological explanations.
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Affiliation(s)
- Carey E Gleason
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA.,Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA.,University of Wisconsin School of Nursing, Madison, Wisconsin, USA
| | - Diane C Gooding
- Department of Psychology, University of Wisconsin, Madison, Madison, Wisconsin, USA.,Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Amy J H Kind
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA.,Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.,Center for Health Disparities Research, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Adrienne L Johnson
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Taryn T James
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA
| | - Nickolas H Lambrou
- Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Mary F Wyman
- Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.,Department of Psychology, University of Wisconsin, Madison, Madison, Wisconsin, USA
| | - Fred B Ketchum
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Alexander Gee
- Nehemiah Center for Urban Leadership Development, Madison, Wisconsin, USA
| | - Sterling C Johnson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA.,Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Barbara B Bendlin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Wisconsin Alzheimer's Disease Research Center, Madison, Wisconsin, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Hong Kong Center for Neurodegeneration, Hong Kong, China
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18
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Aifah A, Onakomaiya D, Rakhra A, Ogedegbe G. Uprooting race-based assumptions in biomedical journal articles. Trends Mol Med 2021; 27:830-832. [PMID: 34172389 PMCID: PMC8219490 DOI: 10.1016/j.molmed.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 11/26/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has exacerbated the structural inequities in healthcare and the challenges of translating research into public discourse. This article highlights key antiracist considerations, presents previously noted core challenges, and provides recommendations for writing and reporting. Importantly, this article contributes to combating racialized science in the biomedical community.
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Affiliation(s)
- Angela Aifah
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Deborah Onakomaiya
- Vilcek Institute of Graduate Biomedical Sciences, New York University Grossman School of Medicine, New York, NY, USA
| | - Ashlin Rakhra
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, USA.
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19
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Reporting and Analyzing Race and Ethnicity in Orthopaedic Clinical Trials: A Systematic Review. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2021; 5:01979360-202105000-00016. [PMID: 34019498 PMCID: PMC8143759 DOI: 10.5435/jaaosglobal-d-21-00027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The distinction between race and ethnicity should be carefully understood and described for demographic data collection. Racial healthcare differences have been observed across many orthopaedic subspecialties. However, the frequency of reporting and analyzing race and ethnicity in orthopaedic clinical trials has not been determined. Therefore, the primary purpose of this systematic review was to determine how frequently race and ethnicity are reported and analyzed in orthopaedic clinical trials. METHODS The top 10 journals by impact factor in the field of orthopaedics were manually screened from 2015 to 2019. All randomized controlled trials related to orthopaedics and assessing clinical outcomes were included. Eligible studies were evaluated for bias using the Cochrane risk-of-bias tool and for whether the trial reported and analyzed several demographics, including age, sex, height, weight, race, and ethnicity. The frequency of reporting and analyzing by each demographic was accessed. In addition, comparisons of reporting and analyzing race/ethnicity were made based on orthopaedic subspecialty and journal of publication. RESULTS A total of 15,488 publications were screened and 482 met inclusion criteria. Of these 482 trials, 460 (95.4%) reported age and 456 (94.6%) reported sex, whereas 35 (7.3%) reported race and 15 (3.1%) reported ethnicity for the randomized groups; 79 studies (16.4%) analyzed age and 72 studies (14.9%) analyzed sex, whereas 6 studies (1.2%) analyzed race and 1 study (0.2%) analyzed ethnicity. The orthopaedic subspecialty of spine was found to report race (23.5%) and ethnicity (17.6%) more frequently than all the other subspecialties, whereas sports medicine reported race and/or ethnicity in only 3 of 150 trials (2.0%). CONCLUSIONS Race and ethnicity are not frequently reported or analyzed in orthopaedic randomized controlled trials. Social context, personal challenges, and economic challenges should be considered while analyzing the effect of race and ethnicity on outcomes.
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Truong M, Sharif MZ. We're in This Together: A Reflection on How Bioethics and Public Health Can Collectively Advance Scientific Efforts Towards Addressing Racism. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:113-116. [PMID: 33415592 DOI: 10.1007/s11673-020-10069-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Racism is a key driver of the social, political, and economic injustices that cause and maintain health inequities. Over centuries and across continents, racism has become deeply ingrained within societies. Therefore, we believe that it is our professional and ethical obligation as scientists, and public health scholars specifically, to address racism head on in order to ameliorate racialized health disparities. We argue that greater focus is needed on addressing racism rather than race and how race is described or defined. We offer input from public health scholarship to help bioethicists and other scientists contribute to addressing racism. To do so effectively and comprehensively, public health scholars, bioethicists, and other scientists should work together to identify and implement equity-driven collaborations to eliminate the deleterious effects of racism on individuals, families, and communities.
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Affiliation(s)
- Mandy Truong
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia.
| | - Mienah Z Sharif
- Center for the Study of Racism, Social Justice and Health, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South 21-275E CHS, Los Angeles, CA, 90095-1772, USA
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21
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Araghi S, Nguyen T. A Hybrid Supervised Approach to Human Population Identification Using Genomics Data. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2021; 18:443-454. [PMID: 31150342 DOI: 10.1109/tcbb.2019.2919501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Single nucleotide polymorphisms (SNPs) are one type of genetic variations and each SNP represents a difference in a single DNA building block, namely a nucleotide. Previous research demonstrated that SNPs can be used to identify the correct source population of an individual. In addition, variations in the DNA sequences have an influence on human diseases. In this regard, SNPs studies are helpful for personalized medicine and treatment. In the literature, unsupervised clustering methods especially principal component analysis (PCA) have been popular for studying population structure. In this study, we investigate supervised approaches, particularly the LASSO multinomial regression classification method, for recognizing individuals' origin genetic population. Then, we introduce PCA-LASSO as an extension of LASSO method that benefits from advantageous characteristics of both PCA and LASSO regression. The experimental results obtained on the 1,000 genome project dataset show PCA-LASSO's significantly high accuracy in prediction of individual's origin population.
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Lewis DD, Cropp CD. The Impact of African Ancestry on Prostate Cancer Disparities in the Era of Precision Medicine. Genes (Basel) 2020; 11:E1471. [PMID: 33302594 PMCID: PMC7762993 DOI: 10.3390/genes11121471] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/24/2022] Open
Abstract
Prostate cancer disproportionately affects men of African ancestry at nearly twice the rate of men of European ancestry despite the advancement of treatment strategies and prevention. In this review, we discuss the underlying causes of these disparities including genetics, environmental/behavioral, and social determinants of health while highlighting the implications and challenges that contribute to the stark underrepresentation of men of African ancestry in clinical trials and genetic research studies. Reducing prostate cancer disparities through the development of personalized medicine approaches based on genetics will require a holistic understanding of the complex interplay of non-genetic factors that disproportionately exacerbate the observed disparity between men of African and European ancestries.
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Affiliation(s)
- Deyana D. Lewis
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, Baltimore, MD 21224, USA
| | - Cheryl D. Cropp
- Department of Pharmaceutical, Social and Administrative Sciences, Samford University McWhorter School of Pharmacy, Birmingham, AL 35229, USA;
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Latin American Genes: The Great Forgotten in Rheumatoid Arthritis. J Pers Med 2020; 10:jpm10040196. [PMID: 33114702 PMCID: PMC7711650 DOI: 10.3390/jpm10040196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/19/2020] [Accepted: 10/24/2020] [Indexed: 11/28/2022] Open
Abstract
The successful implementation of personalized medicine will rely on the integration of information obtained at the level of populations with the specific biological, genetic, and clinical characteristics of an individual. However, because genome-wide association studies tend to focus on populations of European descent, there is a wide gap to bridge between Caucasian and non-Caucasian populations before personalized medicine can be fully implemented, and rheumatoid arthritis (RA) is not an exception. In this review, we discuss advances in our understanding of genetic determinants of RA risk among global populations, with a focus on the Latin American population. Geographically restricted genetic diversity may have important implications for health and disease that will remain unknown until genetic association studies have been extended to include Latin American and other currently under-represented ancestries. The next few years will witness many breakthroughs in personalized medicine, including applications for common diseases and risk stratification instruments for targeted prevention/intervention strategies. Not all of these applications may be extrapolated from the Caucasian experience to Latin American or other under-represented populations.
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Nagar SD, Conley AB, Jordan IK. Population structure and pharmacogenomic risk stratification in the United States. BMC Biol 2020; 18:140. [PMID: 33050895 PMCID: PMC7557099 DOI: 10.1186/s12915-020-00875-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Pharmacogenomic (PGx) variants mediate how individuals respond to medication, and response differences among racial/ethnic groups have been attributed to patterns of PGx diversity. We hypothesized that genetic ancestry (GA) would provide higher resolution for stratifying PGx risk, since it serves as a more reliable surrogate for genetic diversity than self-identified race/ethnicity (SIRE), which includes a substantial social component. We analyzed a cohort of 8628 individuals from the United States (US), for whom we had both SIRE information and whole genome genotypes, with a focus on the three largest SIRE groups in the US: White, Black (African-American), and Hispanic (Latino). Our approach to the question of PGx risk stratification entailed the integration of two distinct methodologies: population genetics and evidence-based medicine. This integrated approach allowed us to consider the clinical implications for the observed patterns of PGx variation found within and between population groups. RESULTS Whole genome genotypes were used to characterize individuals' continental ancestry fractions-European, African, and Native American-and individuals were grouped according to their GA profiles. SIRE and GA groups were found to be highly concordant. Continental ancestry predicts individuals' SIRE with > 96% accuracy, and accordingly, GA provides only a marginal increase in resolution for PGx risk stratification. In light of the concordance between SIRE and GA, taken together with the fact that information on SIRE is readily available to clinicians, we evaluated PGx variation between SIRE groups to explore the potential clinical utility of race and ethnicity. PGx variants are highly diverged compared to the genomic background; 82 variants show significant frequency differences among SIRE groups, and genome-wide patterns of PGx variation are almost entirely concordant with SIRE. The vast majority of PGx variation is found within rather than between groups, a well-established fact for almost all genetic variants, which is often taken to argue against the clinical utility of population stratification. Nevertheless, analysis of highly differentiated PGx variants illustrates how SIRE partitions PGx variation based on groups' characteristic ancestry patterns. These cases underscore the extent to which SIRE carries clinically valuable information for stratifying PGx risk among populations, albeit with less utility for predicting individual-level PGx alleles (genotypes), supporting the concept of population pharmacogenomics. CONCLUSIONS Perhaps most interestingly, we show that individuals who identify as Black or Hispanic stand to gain far more from the consideration of race/ethnicity in treatment decisions than individuals from the majority White population.
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Affiliation(s)
- Shashwat Deepali Nagar
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA USA
- PanAmerican Bioinformatics Institute, Cali, Colombia
| | - Andrew B. Conley
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA USA
- PanAmerican Bioinformatics Institute, Cali, Colombia
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, 950 Atlantic Drive, Atlanta, GA 30332 USA
| | - I. King Jordan
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA USA
- PanAmerican Bioinformatics Institute, Cali, Colombia
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, 950 Atlantic Drive, Atlanta, GA 30332 USA
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25
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The Genetics of Spondyloarthritis. J Pers Med 2020; 10:jpm10040151. [PMID: 33023259 PMCID: PMC7711559 DOI: 10.3390/jpm10040151] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022] Open
Abstract
The term spondyloarthritis (SpA) encompasses a group of chronic inflammatory diseases with common features in terms of clinical presentation and genetic predisposition. SpA is characterized by inflammation of the spine and peripheral joints, and is also be associated with extra-articular inflammatory manifestations such as psoriasis, uveitis, or inflammatory bowel disease (IBD). The etiology of SpA is not completely understood, but it is known to have a strong genetic component dominated by the human leukocyte antigen (HLA)-B27. In the last few years, our understanding of genetic susceptibility to SpA, particularly ankylosing spondylitis (AS), has greatly improved thanks to the findings derived from powered genome-wide association studies (GWAS) based on single nucleotide polymorphism (SNP) arrays. These studies have identified many candidate genes, therefore providing new potential directions in the exploration of disease mechanisms, especially with regard to the key role of the immune system in the pathogenesis of SpA. SpA is a complex disease where genetic variability, environmental factors, and random events interact to trigger pathological pathways. The aim of this review is to summarize current findings on the genetics of SpA, some of which might help to study new treatment approaches.
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Batai K, Hooker S, Kittles RA. Leveraging genetic ancestry to study health disparities. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 175:363-375. [PMID: 32935870 PMCID: PMC8246846 DOI: 10.1002/ajpa.24144] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/22/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022]
Abstract
Research to understand human genomic variation and its implications in health has great potential to contribute in the reduction of health disparities. Biological anthropology can play important roles in genomics and health disparities research using a biocultural approach. This paper argues that racial/ethnic categories should not be used as a surrogate for sociocultural factors or global genomic clusters in biomedical research or clinical settings, because of the high genetic heterogeneity that exists within traditional racial/ethnic groups. Genetic ancestry is used to show variation in ancestral genomic contributions to recently admixed populations in the United States, such as African Americans and Hispanic/Latino Americans. Genetic ancestry estimates are also used to examine the relationship between ancestry‐related biological and sociocultural factors affecting health disparities. To localize areas of genomes that contribute to health disparities, admixture mapping and genome‐wide association studies (GWAS) are often used. Recent GWAS have identified many genetic variants that are highly differentiated among human populations that are associated with disease risk. Some of these are population‐specific variants. Many of these variants may impact disease risk and help explain a portion of the difference in disease burden among racial/ethnic groups. Genetic ancestry is also of particular interest in precision medicine and disparities in drug efficacy and outcomes. By using genetic ancestry, we can learn about potential biological differences that may contribute to the heterogeneity observed across self‐reported racial groups. Special Issue: Race reconciled II: Interpreting and communicating biological variation and race in 2021
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Affiliation(s)
- Ken Batai
- Department of Urology, University of Arizona, Tucson, Arizona, USA
| | - Stanley Hooker
- Division of Health Equities, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Rick A Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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27
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Benn Torres J. Anthropological perspectives on genomic data, genetic ancestry, and race. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 171 Suppl 70:74-86. [DOI: 10.1002/ajpa.23979] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Jada Benn Torres
- Vanderbilt UniversityDepartment of Anthropology Nashville Tennessee
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Gutin I. Essential(ist) medicine: promoting social explanations for racial variation in biomedical research. MEDICAL HUMANITIES 2019; 45:224-234. [PMID: 29941665 DOI: 10.1136/medhum-2017-011432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
Biomedical research has a long and complicated history as a tool of oppression, exemplary of the racial science used to legitimise and maintain racial hierarchies in the USA and abroad. While the explicit racism and racial inferiority supported by this research has dissipated and modern methods of inquiry have increased in sophistication and rigor, contemporary biomedical research continues to essentialise race by distilling racial differences and disparities in health to an underlying, biogenetic source. Focusing on the persistence of essentialism in an era of genomic medicine, this paper examines the deep social origins and social implications of the essentialist viewpoint in biomedicine and how it relates to the broader construction of social and scientific knowledge. Invoking Hacking's 'looping effects' as a useful conceptual tool, I then demonstrate how sociohistorical forces influence scientific and medical research in producing evidence that favours and legitimises a biological construction of race. I extend the looping framework to consider a parallel 'louping' process whereby applying a socially rooted meaning to race in biomedical research results becomes magnified to influence social norms and ideas about race. As many biomedical researchers are motivated by a desire to eliminate racial disparities in outcomes, I argue that greater social acuity allows scientists to avoid individualising and racialising health, challenge preconceived assumptions about the meaning of racial variation in health and medicine and thus promote and strengthen a socioenvironmental focus on how to best improve individuals' and population health. Concluding with a call for structural competency in biomedical research, I suggest that empowering scientists to more freely discuss sociostructural factors in their work allows for the continued use of race in biological and medical research, while social scientists and medical humanities scholars stand to benefit from seeing their work imbued with the cultural authority currently granted to biomedicine.
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Affiliation(s)
- Iliya Gutin
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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29
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Menon U, Cohn E, Downs CA, Gephart SM, Redwine L. Precision health research and implementation reviewed through the conNECT framework. Nurs Outlook 2019; 67:302-310. [PMID: 31280842 DOI: 10.1016/j.outlook.2019.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/13/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Precision health is a population-based approach that incorporates big-data strategies to understand the complex interactions between biological, environmental, lifestyle, and psychosocial factors that influence health. PURPOSE A promising tool to facilitate precision health research and its dissemination is the ConNECT Framework. METHODS Here, we discuss the relationship of the five broad and synergistic principles within the ConNECT Framework as they may apply to nursing science research: (1) Integrating Context, (2) Fostering a Norm of Inclusion, (3) Ensuring Equitable Diffusion of Innovations, (4) Harnessing Communication Technology, and (5) Prioritizing Specialized Training. DISCUSSION/CONCLUSION The principles within this framework can be used by nurse scientists and educators to guide and disseminate precision health research.
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Affiliation(s)
- Usha Menon
- College of Nursing, University of South Florida, Tampa, FL.
| | | | - Charles A Downs
- School of Nursing & Health Studies, University of Miami, Miami, FL
| | | | - Laura Redwine
- College of Nursing, University of South Florida, Tampa, FL
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Ing EB, Miller NR, Nguyen A, Su W, Bursztyn LLCD, Poole M, Kansal V, Toren A, Albreki D, Mouhanna JG, Muladzanov A, Bernier M, Gans M, Lee D, Wendel C, Sheldon C, Shields M, Bellan L, Lee-Wing M, Mohadjer Y, Nijhawan N, Tyndel F, Sundaram ANE, Ten Hove MW, Chen JJ, Rodriguez AR, Hu A, Khalidi N, Ing R, Wong SWK, Torun N. Neural network and logistic regression diagnostic prediction models for giant cell arteritis: development and validation. Clin Ophthalmol 2019; 13:421-430. [PMID: 30863010 PMCID: PMC6388759 DOI: 10.2147/opth.s193460] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To develop and validate neural network (NN) vs logistic regression (LR) diagnostic prediction models in patients with suspected giant cell arteritis (GCA). Design: Multicenter retrospective chart review. METHODS An audit of consecutive patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at 14 international medical centers. The outcome variable was biopsy-proven GCA. The predictor variables were age, gender, headache, clinical temporal artery abnormality, jaw claudication, vision loss, diplopia, erythrocyte sedimentation rate, C-reactive protein, and platelet level. The data were divided into three groups to train, validate, and test the models. The NN model with the lowest false-negative rate was chosen. Internal and external validations were performed. RESULTS Of 1,833 patients who underwent TABx, there was complete information on 1,201 patients, 300 (25%) of whom had a positive TABx. On multivariable LR age, platelets, jaw claudication, vision loss, log C-reactive protein, log erythrocyte sedimentation rate, headache, and clinical temporal artery abnormality were statistically significant predictors of a positive TABx (P≤0.05). The area under the receiver operating characteristic curve/Hosmer-Lemeshow P for LR was 0.867 (95% CI, 0.794, 0.917)/0.119 vs NN 0.860 (95% CI, 0.786, 0.911)/0.805, with no statistically significant difference of the area under the curves (P=0.316). The misclassification rate/false-negative rate of LR was 20.6%/47.5% vs 18.1%/30.5% for NN. Missing data analysis did not change the results. CONCLUSION Statistical models can aid in the triage of patients with suspected GCA. Misclassification remains a concern, but cutoff values for 95% and 99% sensitivities are provided (https://goo.gl/THCnuU).
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Affiliation(s)
- Edsel B Ing
- Ophthalmology, University of Toronto, Toronto, ON, Canada,
| | - Neil R Miller
- Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
| | | | - Wanhua Su
- Statistics, MacEwan University, Edmonton, AB, Canada
| | | | | | - Vinay Kansal
- Ophthalmology, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Dana Albreki
- Ophthalmology, University of Ottawa, Ottawa, ON, Canada
| | | | | | | | - Mark Gans
- Ophthalmology, McGill University, Montreal, QC, Canada
| | - Dongho Lee
- University of British Columbia, Vancouver, BC, Canada
| | - Colten Wendel
- Ophthalmology, University of British Columbia, Vancouver, BC, Canada
| | - Claire Sheldon
- Ophthalmology, University of British Columbia, Vancouver, BC, Canada
| | - Marc Shields
- Ophthalmology, University of Virginia, Fisherville, VA, USA
| | - Lorne Bellan
- Ophthalmology, University of Manitoba, Winnipeg, MB, Canada
| | | | | | | | - Felix Tyndel
- Neurology, University of Toronto, Toronto, ON, Canada
| | | | | | - John J Chen
- Ophthalmology & Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Angela Hu
- Rheumatology, McMaster University, Hamilton, ON, Canada
| | - Nader Khalidi
- Rheumatology, McMaster University, Hamilton, ON, Canada
| | - Royce Ing
- Undergraduate Science, Ryerson University, Toronto, ON, Canada
| | | | - Nurhan Torun
- Ophthalmology, Harvard University, Boston, MA, USA
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Nelson SC, Yu JH, Wagner JK, Harrell TM, Royal CD, Bamshad MJ. A content analysis of the views of genetics professionals on race, ancestry, and genetics. AJOB Empir Bioeth 2019; 9:222-234. [PMID: 30608210 DOI: 10.1080/23294515.2018.1544177] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Over the past decade, the proliferation of genetic studies on human health and disease has reinvigorated debates about the appropriate role of race and ancestry in research and clinical care. Here we report on the responses of genetics professionals to a survey about their views on race, genetics, and ancestry across the domains of science, medicine, and society. Through a qualitative content analysis of free-text comments from 515 survey respondents, we identified key themes pertaining to multiple meanings of race, the use of race as a proxy for genetic ancestry, and the relevance of race and ancestry to health. Our findings suggest that for many genetics professionals the questions of what race is and what race means remain both professionally and personally contentious. Looking ahead as genomics is translated into the practice of precision medicine and as learning health care systems offer continued improvements in care through integrated research, we argue for nuanced considerations of both race and genetic ancestry across research and care settings.
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Affiliation(s)
- Sarah C Nelson
- a Institute for Public Health Genetics , University of Washington
| | - Joon-Ho Yu
- b Department of Pediatrics , University of Washington
| | - Jennifer K Wagner
- c Center for Translational Bioethics & Health Care Policy , Geisinger Health System
| | | | - Charmaine D Royal
- d Department of African & African American Studies , Duke University
| | - Michael J Bamshad
- b Department of Pediatrics , University of Washington.,e Department of Genome Sciences , University of Washington
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Affiliation(s)
- Richard S Cooper
- Department of Public Health Sciences, Loyola University Medical School, Maywood, Illinois
| | - Girish N Nadkarni
- The Charles Bronfman Institute of Personalized Medicine, Mt Sinai Hospital and Medical Center, New York, New York
| | - Gbenga Ogedegbe
- Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York
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Hefner JT. The macromorphoscopic databank. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:994-1004. [DOI: 10.1002/ajpa.23492] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/08/2018] [Accepted: 04/05/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Joseph T. Hefner
- Department of AnthropologyMichigan State UniversityEast Lansing Michigan 48824
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Gardner K. The Science of Cancer Health Disparities: A Young Discipline with an Old Heritage. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 188:268-270. [PMID: 29137949 DOI: 10.1016/j.ajpath.2017.08.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/31/2017] [Accepted: 08/08/2017] [Indexed: 01/27/2023]
Abstract
This Guest Editorial highlights the reviews in the Race in Cancer Health Disparities Theme Issue that improve our understanding of the complex role of race in disparities in cancer frequency and outcome.
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Affiliation(s)
- Kevin Gardner
- Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland; National Institute on Minority Health and Health Disparities, Bethesda, Maryland.
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The Impact of Genetic and Non-Genetic Factors on Warfarin Dose Prediction in MENA Region: A Systematic Review. PLoS One 2016; 11:e0168732. [PMID: 27992547 PMCID: PMC5167425 DOI: 10.1371/journal.pone.0168732] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/05/2016] [Indexed: 01/13/2023] Open
Abstract
Background Warfarin is the most commonly used oral anticoagulant for the treatment and prevention of thromboembolic disorders. Pharmacogenomics studies have shown that variants in CYP2C9 and VKORC1 genes are strongly and consistently associated with warfarin dose variability. Although different populations from the Middle East and North Africa (MENA) region may share the same ancestry, it is still unclear how they compare in the genetic and non-genetic factors affecting their warfarin dosing. Objective To explore the prevalence of CYP2C9 and VKORC1 variants in MENA, and the effect of these variants along with other non-genetic factors in predicting warfarin dose. Methods In this systematic review, we included observational cross sectional and cohort studies that enrolled patients on stable warfarin dose and had the genetics and non-genetics factors associated with mean warfarin dose as the primary outcome. We searched PubMed, Medline, Scopus, PharmGKB, PHGKB, Google scholar and reference lists of relevant reviews. Results We identified 17 studies in eight different populations: Iranian, Israeli, Egyptian, Lebanese, Omani, Kuwaiti, Sudanese and Turkish. Most common genetic variant in all populations was the VKORC1 (-1639G>A), with a minor allele frequency ranging from 30% in Egyptians and up to 52% and 56% in Lebanese and Iranian, respectively. Variants in the CYP2C9 were less common, with the highest MAF for CYP2C9*2 among Iranians (27%). Variants in the VKORC1 and CYP2C9 were the most significant predictors of warfarin dose in all populations. Along with other genetic and non-genetic factors, they explained up to 63% of the dose variability in Omani and Israeli patients. Conclusion Variants of VKORC1 and CYP2C9 are the strongest predictors of warfarin dose variability among the different populations from MENA. Although many of those populations share the same ancestry and are similar in their warfarin dose predictors, a population specific dosing algorithm is needed for the prospective estimation of warfarin dose.
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Cservenka A, Yardley MM, Ray LA. Review: Pharmacogenetics of alcoholism treatment: Implications of ethnic diversity. Am J Addict 2016; 26:516-525. [PMID: 28134463 DOI: 10.1111/ajad.12463] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/21/2016] [Accepted: 10/02/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pharmacogenetic studies of alcohol use disorder (AUD) have suggested that the efficacy of treatments for AUD is, in part, influenced by the genetic background of an individual. Since the frequency of alleles associated with pharmacotherapy for AUD varies by ancestral background, the effectiveness of medications used to treat AUD may vary among different populations. The purpose of this review is to summarize the existing pharmacogenetic studies of treatments for AUD in individuals of European, East Asian, African, and American Indian/Alaska Native ancestry. METHODS Electronic databases were searched for pharmacogenetic studies of AUD treatment that included individuals of diverse ancestral backgrounds. RESULTS Pharmacogenetic studies of AUD reviewed here have primarily investigated genetic variation thought to play a role in the response to naltrexone, ondansetron, and topiramate. There is support that the A118G polymorphism should be further investigated in individuals of East Asian ancestry. DISCUSSION AND CONCLUSIONS Given the lack of pharmacogenetic research on response to AUD medication in ethnic minority populations and the mixed results, there is a critical need for future studies among individuals of different ancestries. More efforts should be devoted to standardizing procedures such that results can be more readily integrated into a body of literature that can directly inform clinical practice. SCIENTIFIC SIGNIFICANCE This review highlights the importance for future research to aim for inclusiveness in pharmacogenetic studies of AUD and increase diversity of clinical trials in order to provide the best treatment outcomes for individuals across different racial and ethnic groups. (Am J Addict 2017;26:516-525).
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Affiliation(s)
- Anita Cservenka
- School of Psychological Science, Oregon State University, Corvallis, Oregon
| | - Megan M Yardley
- Department of Psychology, University of California, Los Angeles, California
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California.,Brain Research Institute, University of California, Los Angeles, California
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Ramachandran HJ, Wu VX, Kowitlawakul Y, Wang W. Awareness, knowledge and healthy lifestyle behaviors related to coronary heart disease among women: An integrative review. Heart Lung 2016; 45:173-85. [DOI: 10.1016/j.hrtlng.2016.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/28/2015] [Accepted: 02/05/2016] [Indexed: 12/16/2022]
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Genética da artrite reumatoide: é necessário um novo impulso em populações latino‐americanas. REVISTA BRASILEIRA DE REUMATOLOGIA 2016. [DOI: 10.1016/j.rbr.2015.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Genetic ancestry as an effect modifier of naltrexone in smoking cessation among African Americans: an analysis of a randomized controlled trial. Pharmacogenet Genomics 2016; 25:305-12. [PMID: 25918964 DOI: 10.1097/fpc.0000000000000138] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine whether there were differential quit rates between African Americans (AA) and European Americans with the experimental treatment naltrexone, and examine the role of genetic ancestry on these outcomes among AAs. METHODS Data from a previous randomized trial of 315 smokers to naltrexone versus placebo were reanalyzed using West African (WA) genetic ancestry to define subpopulations. Logistic regression models were used to estimate treatment effects on early and end of treatment quit rates, by race and WA ancestry. RESULTS Among European Americans (n=136), naltrexone significantly increased quit rates at 4 weeks (62 vs. 43%, P=0.03) with directional, but not statistically significant effects at 12 weeks (30 vs. 18%, P=0.12). In contrast, among the AAs (n=95), quit rates did not differ between naltrexone and placebo groups at either interval (4 weeks: 43 vs. 32%, P=0.27; 12 weeks: 22 vs. 18%, P=0.60). A median split was conducted in AAs for WA ancestry. Among AAs with low WA ancestry, quit rates were significantly higher with naltrexone compared with placebo (60 vs. 27%, P=0.03). There was no advantage in quit rates with naltrexone for the high WA ancestry group. CONCLUSION Naltrexone efficacy for smoking cessation varies across AA individuals with different levels of WA ancestry. These results suggest that genetic background may partially explain racial differences in drug response.
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Byrd WC, Best LE. Between (Racial) Groups and a Hard Place: An Exploration of Social Science Approaches to Race and Genetics, 2000-2014. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2016; 62:281-299. [PMID: 27809658 DOI: 10.1080/19485565.2016.1238299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
As the social sciences expand their involvement in genetic and genomic research, more information is needed to understand how theoretical concepts are applied to genetic data found in social surveys. Given the layers of complexity of studying race in relation to genetics and genomics, it is important to identify the varying approaches used to discuss and operationalize race and identity by social scientists. The present study explores how social scientists have used race, ethnicity, and ancestry in studies published in four social science journals from 2000 to 2014. We identify not only how race, ethnicity, and ancestry are classified and conceptualized in this growing area of research, but also how these concepts are incorporated into the methodology and presentation of results, all of which structure the discussion of race, identity, and inequality. This research indicates the slippage between concepts, classifications, and their use by social scientists in their genetics-related research. The current study can assist social scientists with clarifying their use and interpretations of race and ethnicity with the incorporation of genetic data, while limiting possible misinterpretations of the complexities of the connection between genetics and the social world.
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Affiliation(s)
- W Carson Byrd
- a Department of Pan-African Studies , University of Louisville , Louisville , Kentucky , USA
| | - Latrica E Best
- a Department of Pan-African Studies , University of Louisville , Louisville , Kentucky , USA
- b Department of Sociology , University of Louisville , Louisville , Kentucky , USA
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Castro-Santos P, Díaz-Peña R. Genetics of rheumatoid arthritis: a new boost is needed in Latin American populations. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 56:171-7. [PMID: 27267531 DOI: 10.1016/j.rbre.2015.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 08/30/2015] [Indexed: 01/17/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune inflammatory rheumatic disease which affects several organs and tissue, predominantly the synovial joints. Like many other autoimmune diseases, RA is a complex disease, where genetic variants, environmental factors and random events interact to trigger pathological pathways. Genetic implication in RA is evident, and recent advances have expanded our knowledge about the genetic factors that contribute to RA. An exponential increment in the number of genes associated with the disease has been described, mainly through gene wide screen studies (GWAS) involving international consortia with large patient cohorts. However, there are a few studies on Latin American populations. This article describes what is known about the RA genetics, the future that is emerging, and how this will develop a more personalized approach for the treatment of the disease. Latin American RA patients cannot be excluded from this final aim, and a higher collaboration with the international consortia may be needed for a better knowledge of the genetic profile of patients from this origin.
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Affiliation(s)
| | - Roberto Díaz-Peña
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile; Department of Immunology, Hospital Universitario Central de Asturias, Oviedo, Spain.
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Dyke SOM, Cheung WA, Joly Y, Ammerpohl O, Lutsik P, Rothstein MA, Caron M, Busche S, Bourque G, Rönnblom L, Flicek P, Beck S, Hirst M, Stunnenberg H, Siebert R, Walter J, Pastinen T. Epigenome data release: a participant-centered approach to privacy protection. Genome Biol 2015; 16:142. [PMID: 26185018 PMCID: PMC4504083 DOI: 10.1186/s13059-015-0723-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/09/2015] [Indexed: 11/10/2022] Open
Abstract
Large-scale epigenome mapping by the NIH Roadmap Epigenomics Project, the ENCODE Consortium and the International Human Epigenome Consortium (IHEC) produces genome-wide DNA methylation data at one base-pair resolution. We examine how such data can be made open-access while balancing appropriate interpretation and genomic privacy. We propose guidelines for data release that both reduce ambiguity in the interpretation of open-access data and limit immediate access to genetic variation data that are made available through controlled access.
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Affiliation(s)
- Stephanie O M Dyke
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, H3A 0G1, Canada.
| | - Warren A Cheung
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montreal, QC, H3A 0G1, Canada
| | - Yann Joly
- Centre of Genomics and Policy, Department of Human Genetics, McGill University, Montreal, QC, H3A 0G1, Canada
| | - Ole Ammerpohl
- Institute of Human Genetics, University Hospital Schleswig-Holstein, Campus Kiel & Christian-Albrechts-University Kiel, 24105, Kiel, Germany
| | - Pavlo Lutsik
- Saarland University, 66123, Saarbrücken, Germany
| | - Mark A Rothstein
- Institute for Bioethics, Health Policy and Law, University of Louisville School of Medicine, Louisville, KY, 40202, USA
| | - Maxime Caron
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montreal, QC, H3A 0G1, Canada
| | - Stephan Busche
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montreal, QC, H3A 0G1, Canada
| | - Guillaume Bourque
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montreal, QC, H3A 0G1, Canada
| | - Lars Rönnblom
- Department of Medical Sciences, Science for Life Laboratory, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Paul Flicek
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1SD, UK
| | - Stephan Beck
- Medical Genomics, UCL Cancer Institute, University College London, London, WC1E 6BT, UK
| | - Martin Hirst
- Centre for High-Throughput Biology, University of British Columbia and Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, V5Z 4S6, Canada
| | - Henk Stunnenberg
- Department of Molecular Biology, RIMLS, Faculty of Science, Radboud University, 6500 HB, Nijmegen, The Netherlands
| | - Reiner Siebert
- Institute of Human Genetics, University Hospital Schleswig-Holstein, Campus Kiel & Christian-Albrechts-University Kiel, 24105, Kiel, Germany
| | - Jörn Walter
- Saarland University, 66123, Saarbrücken, Germany
| | - Tomi Pastinen
- Department of Human Genetics, McGill University and Genome Quebec Innovation Centre, Montreal, QC, H3A 0G1, Canada.
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Santos RV, da Silva GO, Gibbon S. Pharmacogenomics, human genetic diversity and the incorporation and rejection of color/race in Brazil. BIOSOCIETIES 2015; 10:48-69. [PMID: 26290677 PMCID: PMC4538779 DOI: 10.1057/biosoc.2014.21] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Public funding for research on the action of drugs in countries like the United States requires that racial classification of research subjects should be considered when defining the composition of the samples as well as in data analysis, sometimes resulting in interpretations that Whites and Blacks differ in their pharmacogenetic profiles. In Brazil, pharmacogenomic results have led to very different interpretations when compared with those obtained in the United States. This is explained as deriving from the genomic heterogeneity of the Brazilian population. This article argues that in the evolving field of pharmacogenomics research in Brazil there is simultaneously both an incorporation and rejection of the US informed race-genes paradigm. We suggest that this must be understood in relation to continuities with national and transnational history of genetic research in Brazil, a differently situated politics of Brazilian public health and the ongoing valorization of miscegenation or race mixture by Brazilian geneticists as a resource for transnational genetic research. Our data derive from anthropological investigation conducted in INCA (Brazilian National Cancer Institute), in Rio de Janeiro, with a focus on the drug warfarin. The criticism of Brazilian scientists regarding the uses of racial categorization includes a revision of mathematical algorithms for drug dosage widely used in clinical procedures around the world. Our analysis reveals how the incorporation of ideas of racial purity and admixture, as it relates to the efficacy of drugs, touches on issues related to the possibility of application of pharmaceutical technologies on a global scale.
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Mersha TB, Abebe T. Self-reported race/ethnicity in the age of genomic research: its potential impact on understanding health disparities. Hum Genomics 2015; 9:1. [PMID: 25563503 PMCID: PMC4307746 DOI: 10.1186/s40246-014-0023-x] [Citation(s) in RCA: 255] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 12/01/2014] [Indexed: 12/02/2022] Open
Abstract
This review explores the limitations of self-reported race, ethnicity, and genetic ancestry in biomedical research. Various terminologies are used to classify human differences in genomic research including race, ethnicity, and ancestry. Although race and ethnicity are related, race refers to a person's physical appearance, such as skin color and eye color. Ethnicity, on the other hand, refers to communality in cultural heritage, language, social practice, traditions, and geopolitical factors. Genetic ancestry inferred using ancestry informative markers (AIMs) is based on genetic/genomic data. Phenotype-based race/ethnicity information and data computed using AIMs often disagree. For example, self-reporting African Americans can have drastically different levels of African or European ancestry. Genetic analysis of individual ancestry shows that some self-identified African Americans have up to 99% of European ancestry, whereas some self-identified European Americans have substantial admixture from African ancestry. Similarly, African ancestry in the Latino population varies between 3% in Mexican Americans to 16% in Puerto Ricans. The implication of this is that, in African American or Latino populations, self-reported ancestry may not be as accurate as direct assessment of individual genomic information in predicting treatment outcomes. To better understand human genetic variation in the context of health disparities, we suggest using "ancestry" (or biogeographical ancestry) to describe actual genetic variation, "race" to describe health disparity in societies characterized by racial categories, and "ethnicity" to describe traditions, lifestyle, diet, and values. We also suggest using ancestry informative markers for precise characterization of individuals' biological ancestry. Understanding the sources of human genetic variation and the causes of health disparities could lead to interventions that would improve the health of all individuals.
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Affiliation(s)
- Tesfaye B Mersha
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
| | - Tilahun Abebe
- Department of Biology, University of Northern Iowa, Cedar Falls, IA, USA.
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Al-Alem U, Rauscher G, Shah E, Batai K, Mahmoud A, Beisner E, Silva A, Peterson C, Kittles R. Association of genetic ancestry with breast cancer in ethnically diverse women from Chicago. PLoS One 2014; 9:e112916. [PMID: 25423363 PMCID: PMC4244099 DOI: 10.1371/journal.pone.0112916] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 10/21/2014] [Indexed: 11/25/2022] Open
Abstract
Introduction Non-Hispanic (nH) Black and Hispanic women are disproportionately affected by early onset disease, later stage, and with more aggressive, higher grade and ER/PR negative breast cancers. The purpose of this analysis was to examine whether genetic ancestry could account for these variation in breast cancer characteristics, once data were stratified by self-reported race/ethnicity and adjusted for potential confounding by social and behavioral factors. Methods We used a panel of 100 ancestry informative markers (AIMs) to estimate individual genetic ancestry in 656 women from the “Breast Cancer Care in Chicago” study, a multi-ethnic cohort of breast cancer patients to examine the association between individual genetic ancestry and breast cancer characteristics. In addition we examined the association of individual AIMs and breast cancer to identify genes/regions that may potentially play a role in breast cancer disease disparities. Results As expected, nH Black and Hispanic patients were more likely than nH White patients to be diagnosed at later stages, with higher grade, and with ER/PR negative tumors. Higher European genetic ancestry was protective against later stage at diagnosis (OR 0.7 95%CI: 0.54–0.92) among Hispanic patients, and higher grade (OR 0.73, 95%CI: 0.56–0.95) among nH Black patients. After adjustment for multiple social and behavioral risk factors, the association with later stage remained, while the association with grade was not significant. We also found that the AIM SNP rs10954631 on chromosome 7 was associated with later stage (p = 0.02) and higher grade (p = 0.012) in nH Whites and later stage (p = 0.03) in nH Blacks. Conclusion Non-European genetic ancestry was associated with later stage at diagnosis in ethnic minorities. The relation between genetic ancestry and stage at diagnosis may be due to genetic factors and/or unmeasured environmental factors that are overrepresented within certain racial/ethnic groups.
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Affiliation(s)
- Umaima Al-Alem
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Garth Rauscher
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Ebony Shah
- Department of Surgery, Division of Urology, University of Arizona, Tucson, Arizona, United States of America
| | - Ken Batai
- Department of Surgery, Division of Urology, University of Arizona, Tucson, Arizona, United States of America
| | - Abeer Mahmoud
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Erin Beisner
- College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Abigail Silva
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Edward Hines, Jr. VA Hospital, Hines, Illinois, United States of America
| | - Caryn Peterson
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Rick Kittles
- Department of Surgery, Division of Urology, University of Arizona, Tucson, Arizona, United States of America
- * E-mail:
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Abstract
Personalized medicine has seen a recent increase in popularity amongst medical researchers and policymakers. Nevertheless, there are persistent legal, ethical, and social questions that need to be explored, particularly related to the criticism that personalized medicine constitutes an elitist model of healthcare. Investigating this critique the current manuscript argues that personalized medicine has the potential to become a positive force for equitable access to better healthcare at a national and international level.
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Affiliation(s)
- Yann Joly
- Centre de génomique et politique, université McGill, 740 avenue du Dr Penfield, Montréal, Québec H3A 0G1, Canada
| | - Bartha M Knoppers
- Centre de génomique et politique, université McGill, 740 avenue du Dr Penfield, Montréal, Québec H3A 0G1, Canada
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Geller G, Dvoskin R, Thio CL, Duggal P, Lewis MH, Bailey TC, Sutherland A, Salmon DA, Kahn JP. Genomics and infectious disease: a call to identify the ethical, legal and social implications for public health and clinical practice. Genome Med 2014; 6:106. [PMID: 25593592 PMCID: PMC4295297 DOI: 10.1186/s13073-014-0106-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Advances in genomics are contributing to the development of more effective, personalized approaches to the prevention and treatment of infectious diseases. Genetic sequencing technologies are furthering our understanding of how human and pathogen genomic factors - and their interactions - contribute to individual differences in immunologic responses to vaccines, infections and drug therapies. Such understanding will influence future policies and procedures for infectious disease management. With the potential for tailored interventions for particular individuals, populations or subpopulations, ethical, legal and social implications (ELSIs) may arise for public health and clinical practice. Potential considerations include balancing health-related benefits and harms between individuals and the larger community, minimizing threats to individual privacy and autonomy, and ensuring just distribution of scarce resources. In this Opinion, we consider the potential application of pathogen and host genomic information to particular viral infections that have large-scale public health consequences but differ in ELSI-relevant characteristics such as ease of transmission, chronicity, severity, preventability and treatability. We argue for the importance of anticipating these ELSI issues in advance of new scientific discoveries, and call for the development of strategies for identifying and exploring ethical questions that should be considered as clinical, public health and policy decisions are made.
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Affiliation(s)
- Gail Geller
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205 USA ; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA ; Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA ; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA
| | - Rachel Dvoskin
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Chloe L Thio
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA
| | - Michelle H Lewis
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Theodore C Bailey
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205 USA ; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | - Andrea Sutherland
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA
| | - Daniel A Salmon
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA ; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA
| | - Jeffrey P Kahn
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205 USA ; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205 USA
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Udler MS, Nadkarni GN, Belbin G, Lotay V, Wyatt C, Gottesman O, Bottinger EP, Kenny EE, Peter I. Effect of Genetic African Ancestry on eGFR and Kidney Disease. J Am Soc Nephrol 2014; 26:1682-92. [PMID: 25349204 DOI: 10.1681/asn.2014050474] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/02/2014] [Indexed: 01/08/2023] Open
Abstract
Self-reported ancestry, genetically determined ancestry, and APOL1 polymorphisms are associated with variation in kidney function and related disease risk, but the relative importance of these factors remains unclear. We estimated the global proportion of African ancestry for 9048 individuals at Mount Sinai Medical Center in Manhattan (3189 African Americans, 1721 European Americans, and 4138 Hispanic/Latino Americans by self-report) using genome-wide genotype data. CKD-EPI eGFR and genotypes of three APOL1 coding variants were available. In admixed African Americans and Hispanic/Latino Americans, serum creatinine values increased as African ancestry increased (per 10% increase in African ancestry, creatinine values increased 1% in African Americans and 0.9% in Hispanic/Latino Americans; P≤1x10(-7)). eGFR was likewise significantly associated with African genetic ancestry in both populations. In contrast, APOL1 risk haplotypes were significantly associated with CKD, eGFR<45 ml/min per 1.73 m(2), and ESRD, with effects increasing with worsening disease states and the contribution of genetic African ancestry decreasing in parallel. Using genetic ancestry in the eGFR equation to reclassify patients as black on the basis of ≥50% African ancestry resulted in higher eGFR for 14.7% of Hispanic/Latino Americans and lower eGFR for 4.1% of African Americans, affecting CKD staging in 4.3% and 1% of participants, respectively. Reclassified individuals had electrolyte values consistent with their newly assigned CKD stage. In summary, proportion of African ancestry was significantly associated with normal-range creatinine and eGFR, whereas APOL1 risk haplotypes drove the associations with CKD. Recalculation of eGFR on the basis of genetic ancestry affected CKD staging and warrants additional investigation.
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Affiliation(s)
- Miriam S Udler
- Departments of Medicine and Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine,
| | - Girish N Nadkarni
- Departments of Medicine and The Charles Bronfman Institute for Personalized Medicine, Division of Nephrology
| | - Gillian Belbin
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine
| | - Vaneet Lotay
- The Charles Bronfman Institute for Personalized Medicine
| | | | - Omri Gottesman
- Departments of Medicine and The Charles Bronfman Institute for Personalized Medicine
| | - Erwin P Bottinger
- Departments of Medicine and The Charles Bronfman Institute for Personalized Medicine, Division of Nephrology
| | - Eimear E Kenny
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine, The Center for Statistical Genetics, and The Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Inga Peter
- Genetics and Genomic Sciences, The Charles Bronfman Institute for Personalized Medicine, The Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York
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Takezawa Y, Kato K, Oota H, Caulfield T, Fujimoto A, Honda S, Kamatani N, Kawamura S, Kawashima K, Kimura R, Matsumae H, Saito A, Savage PE, Seguchi N, Shimizu K, Terao S, Yamaguchi-Kabata Y, Yasukouchi A, Yoneda M, Tokunaga K. Human genetic research, race, ethnicity and the labeling of populations: recommendations based on an interdisciplinary workshop in Japan. BMC Med Ethics 2014; 15:33. [PMID: 24758583 PMCID: PMC4018961 DOI: 10.1186/1472-6939-15-33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 04/11/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND A challenge in human genome research is how to describe the populations being studied. The use of improper and/or imprecise terms has the potential to both generate and reinforce prejudices and to diminish the clinical value of the research. The issue of population descriptors has not attracted enough academic attention outside North America and Europe. In January 2012, we held a two-day workshop, the first of its kind in Japan, to engage in interdisciplinary dialogue between scholars in the humanities, social sciences, medical sciences, and genetics to begin an ongoing discussion of the social and ethical issues associated with population descriptors. DISCUSSION Through the interdisciplinary dialogue, we confirmed that the issue of race, ethnicity and genetic research has not been extensively discussed in certain Asian communities and other regions. We have found, for example, the continued use of the problematic term, "Mongoloid" or continental terms such as "European," "African," and "Asian," as population descriptors in genetic studies. We, therefore, introduce guidelines for reporting human genetic studies aimed at scientists and researchers in these regions. CONCLUSION We need to anticipate the various potential social and ethical problems entailed in population descriptors. Scientists have a social responsibility to convey their research findings outside of their communities as accurately as possible, and to consider how the public may perceive and respond to the descriptors that appear in research papers and media articles.
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Affiliation(s)
- Yasuko Takezawa
- Institute for Research in Humanities, Kyoto University, Yoshidahonmachi, Sakyo-ku, Kyoto 606-8501, Japan.
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Fernández JR, Pearson KE, Kell KP, Bohan Brown MM. Genetic admixture and obesity: recent perspectives and future applications. Hum Hered 2013; 75:98-105. [PMID: 24081225 DOI: 10.1159/000353180] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The process of the colonization of the New World that occurred centuries ago served as a natural experiment, creating unique combinations of genetic material in newly formed admixed populations. Through a genetic admixture approach, the identification and genotyping of ancestry informative markers have allowed for the estimation of proportions of ancestral parental populations among individuals in a sample. These admixture estimates have been used in different ways to understand the genetic contributions to individual variation in obesity and body composition parameters, particularly among diverse admixed groups known to differ in obesity prevalence within the United States. Although progress has been made through the use of genetic admixture approaches, further investigations are needed in order to explore the interaction of environmental factors with the degree of genetic ancestry in individuals. A challenge to confront at this time would be to further stratify and define environments in progressively more granular terms, including nutrients, muscle biology, stress responses at the cellular level, and the social and built environments.
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Affiliation(s)
- José R Fernández
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Ala., USA
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