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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

Issues in Returning Individual Results
from Genome Research Using
Population-Based Banked Specimens, with
a Focus on the National Health and
Nutrition Examination Survey

WORKSHOP SUMMARY

Kevin Kinsella, Rapporteur

Steering Committee for the Workshop on Guidelines for
Returning Individual Results from Genome Research Using
Population-Based Banked Specimens

Committee on National Statistics

Division of Behavioral and Social Sciences and Education

NATIONAL RESEARCH COUNCIL
                          OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

THE NATIONAL ACADEMIES PRESS     500 Fifth Street, NW     Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by a transfer from the National Center for Health Statistics to Grant No. SES-1024012 between the National Academy of Sciences and the National Science Foundation, which provides funding for the Committee on National Statistics from a consortium of federal agencies. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.

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International Standard Book Number-10: 0-309-30704-X

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Suggested citation: National Research Council. (2014). Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: A Workshop Summary. K. Kinsella, Rapporteur. Steering Committee for the Workshop on Guidelines for Returning Individual Results from Genome Research Using Population-Based Banked Specimens, Committee on National Statistics, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

STEERING COMMITTEE FOR THE WORKSHOP ON GUIDELINES FOR RETURNING INDIVIDUAL RESULTS FROM GENOME RESEARCH USING POPULATION-BASED BANKED SPECIMENS

WYLIE BURKE (Chair), Department of Bioethics and Humanities, University of Washington

LESLIE G. BIESECKER, Genetic Disease Research Branch, National Human Genome Research Institute

JEFFREY BOTKIN, Division of Medical Ethics and Humanities, University of Utah

MILDRED K. CHO, Center for Biomedical Ethics, Stanford University School of Medicine

ELLEN WRIGHT CLAYTON, Center for Biomedical Ethics and Society, Vanderbilt University

EILEEN M. CRIMMINS, Davis School of Gerontology, University of Southern California

KEVIN KINSELLA, Study Director

JACQUELINE R. SOVDE, Program Associate

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

COMMITTEE ON NATIONAL STATISTICS
2013-2014

LAWRENCE D. BROWN (Chair), Department of Statistics, The Wharton School, University of Pennsylvania

JOHN M. ABOWD, School of Industrial and Labor Relations, Cornell University

MARY ELLEN BOCK, Department of Statistics, Purdue University

DAVID CARD, Department of Economics, University of California, Berkeley

ALICIA CARRIQUIRY, Department of Statistics, Iowa State University

MICHAEL E. CHERNEW, Department of Health Care Policy, Harvard Medical School

CONSTANTINE GATSONIS, Center for Statistical Sciences, Brown University

JAMES S. HOUSE, Survey Research Center, Institute for Social Research, University of Michigan

MICHAEL HOUT, Department of Sociology, New York University

SALLIE KELLER, Virginia Bioinformatics Institute at Virginia Tech, Arlington, VA

LISA LYNCH, The Heller School for Social Policy and Management, Brandeis University

COLM O’MUIRCHEARTAIGH, Harris School of Public Policy Studies, University of Chicago

RUTH PETERSON, Criminal Justice Research Center, Ohio State University

EDWARD H. SHORTLIFFE, Departments of Biomedical Informatics, Columbia University and Arizona State University

HAL STERN, Donald Bren School of Information and Computer Sciences, University of California, Irvine

CONSTANCE F. CITRO, Director

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

Acknowledgments

This report summarizes the proceedings of a workshop convened in February 2014 to consider guidelines for returning individual results from genomic research using population-based banked specimens. The workshop was sponsored by the National Center for Health Statistics (NCHS) and convened by the Committee on National Statistics (CNSTAT) in the Division of Behavioral and Social Sciences and Education (DBASSE) of the National Research Council (NRC).

The workshop was organized by a six-member steering committee composed of experts in the fields of bioethics, law and genetics, biomedical genetics, and demography. The committee was chaired by Wylie Burke, University of Washington, and included Leslie G. Biesecker, National Human Genome Research Institute; Jeffrey Botkin, University of Utah; Mildred K. Cho, Stanford University; Ellen Wright Clayton, Vanderbilt University; and Eileen M. Crimmins, University of Southern California. The committee provided indispensable guidance in developing the workshop agenda, securing expert presentations, and facilitating the conduct of the workshop. Although the steering committee members played a central role throughout, they did not actively participate in writing this summary.

The committee would like to thank NCHS staff members Virginia Cain, Jennifer Madans, Geraldine McQuillan, and Kathryn Porter for their planning-meeting input prior to the workshop. The presentations during the workshop provided the basis for lively and informative discussions. We greatly appreciate the contributions of Benjamin Berkman,

Page viii Cite
Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

Laura Beskow, Barbara Biesecker, Jeffrey Botkin, Kelly Edwards, Carolyn Tucker Halpern, Tina Hambuch, Robert M. Hauser, Gail Jarvik, Steven Joffe, Sharon Kardia, Muin Khoury, Jennifer H. Madans, Martha McClintock, John Moye, Kathryn Porter, Henry S. Richardson, David Weir, Marc Williams, and Susan M. Wolf.

The steering committee acknowledges the work of the staff of the NRC in organizing the workshop and this report. Constance F. Citro, director of CNSTAT, provided overall direction and guidance for the project. Adam C. Berger of the Institute of Medicine offered valuable suggestions regarding steering committee membership and chaired a workshop session. Kevin Kinsella of the DBASSE Committee on Population assisted with organizing the steering committee and setting the agenda for the study, and served as rapporteur for the workshop. Jacqui Sovde of CNSTAT provided invaluable assistance with all aspects of the project, including myriad logistical details as well as report preparation. Paula Whitacre edited the report, and Kirsten Sampson Snyder orchestrated the review process.

This workshop summary was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the NRC. The purpose of this independent review is to provide candid and critical comments that assist the institution in making its report as sound as possible, and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

The panel thanks the following individuals for their review of this report: Eileen M. Crimmins, Andrus Gerontology Center, University of Southern California; Alan R. Fleischman, Clinical Pediatrics and Clinical Epidemiology and Population Health, Albert Einstein College of Medicine; Norman Fost, Pediatrics and Bioethics, University of Wisconsin School of Medicine and Public Health; and Jennifer R. Harris, Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway.

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the report nor did they see the final draft of the report before its release. The review of this report was overseen by Robert M. Groves, Provost and Department of Mathematics and Statistics, and Department of Sociology, Georgetown University. Appointed by the NRC, he was responsible for

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

making certain that the independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of the report rests entirely with the rapporteur and the NRC.

Wylie Burke, Chair
Steering Committee for the Workshop on
Guidelines for Returning Individual Results from
Genomic Research Using Population-Based Banked Specimens

Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×

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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Page viii Cite
Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
×
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Suggested Citation:"Front Matter." National Research Council. 2014. Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18829.
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Population surveys traditionally collect information from respondents about their circumstances, behaviors, attitudes, and other characteristics. In recent years, many surveys have been collecting not only questionnaire answers, but also biologic specimens such as blood samples, saliva, and buccal swabs, from which a respondent's DNA can be ascertained along with other biomarkers (e.g., the level of a certain protein in the blood). The National Health and Nutrition Examination Survey (NHANES), sponsored by the National Center for Health Statistics (NCHS), has been collecting and storing genetic specimens since 1991, and other surveys, such as the Health and Retirement Study (HRS) funded by the National Institute on Aging, have followed suit. In order to give their informed consent to participate in a survey, respondents need to know the disposition and use of their data. Will their data be used for one research project and then destroyed, or will they be archived for secondary use? Sponsors of repeated cross-sectional surveys, such as NHANES, and of longitudinal surveys that follow panels of individuals over time, such as HRS, generally want to retain data for a wide range of secondary uses, many of which are not explicitly foreseen at the time of data collection. They typically inform respondents that their data will be stored in a secure manner and may be provided to researchers with suitable protections against individual identification.

The addition of biologic specimens to a survey adds complications for storing, protecting, and providing access to such data and measurements made from them. There are also questions of whether, when, and for which biologic measurements the results should be reported back to individual respondents. Recently, the cost of full genomic sequencing has plummeted, and research findings are beginning to accumulate that bear up under replication and that potentially have clinical implications for a respondent. For example, knowing that one possesses a certain gene or gene sequence might suggest that one should seek a certain kind of treatment or genetic counseling or inform one's blood relatives. Biomedical research studies, in which participants are asked to donate tissues for genetic studies and are usually told that they will not be contacted with any results, are increasingly confronting the issue of when and which DNA results to return to participants.

Issues in Returning Individual Results from Genome Research Using Population-Based Banked Specimens, with a Focus on the National Health and Nutrition Examination Survey is the summary of a workshop convened in February 2013 by the Committee on National Statistics in the Division of Behavioral and Social Sciences and Education of the National Research Council. This report considers how population surveys, in particular NHANES, should implement the reporting of results from genomic research using stored specimens and address informed consent for future data collection as well as for the use of banked specimens covered by prior informed consent agreements. The report will be of interest to survey organizations that include or contemplate including the collection of biologic specimens in population surveys for storing for genetic research. The issues involved are important for advancing social, behavioral, and biomedical knowledge while appropriately respecting and protecting individual survey respondents.

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