Best listening experience is on Chrome, Firefox or Safari. Subscribe to Federal Drive’s daily audio interviews on Apple Podcasts or PodcastOne.
The Million Veteran Program of the Veterans Affairs Department does not quite have a million participants. Not quite yet. But it did recently reach 900,000, when a retired reservist and purple heart recipient joined up. For an update on what VA calls its largest research project ever, the Federal Drive with Tom Temin spoke to program director Sumitra Muralidhar.
Tom Temin: So 900,000 sounds like a pretty good milestone to me. But are you still driving toward literally a million veterans to be in this program?
Sumitra Muralidhar: Oh, absolutely. In fact, we know we’re looking forward to getting to the million and even going beyond, we’re not going to stop when we get to the million.
Tom Temin: So this is the idea of big data driven medicine. Is that the fundamental theory behind this program?
Sumitra Muralidhar: Yes, absolutely. So to really, you know, get to the bottom of how our genetics, our environment, our lifestyle, how all these different factors interplay and influence our health and illness, we need large numbers, it is a numbers game, as I always call it. We need large numbers of people with a particular condition and an even larger without it so you can compare and see what contributions each of these factors are making, in terms of causing risk or a specific illness.
Tom Temin: It sounds as if there are a range of treatments available for a given malady or situation that a person has. But it may not be within the range of knowledge of a given practitioner for a given patient to know what is the exact best thing in that particular situation. So analytics can maybe help determine that, is that is one of the foundational ideas here?
Sumitra Muralidhar: Yes, that is one major aspect of it. It’s called pharmacogenomics and that the way people respond to a medication is in part determined by genetics for some of the medications. And so really knowing that you could tailor the treatment to the person, you know, at the right time and at the right dose, sometimes it’s just a matter of varying the dose that that’s best for that person. Again, detail could be determined by genetics.
Tom Temin: And what information then comes from each participant, the 900,000, and eventually a million that you’ll have, what does it need from them to be able to power this type of research?
Sumitra Muralidhar: Great question. So first and foremost, the VA has one of the best, the deepest electronic health records. And that is the treasure, we need their health information from their health record, what diagnosis they’ve had, when, how long, what they’ve been treated for, what their responses have been. So we can see all of that that’s their health record clinical data. Then we collect data from self-reported surveys, you know, a lot of things about what you eat, what your lifestyle is, how much you exercise, do you drink, do you smoke, all of that is not really well documented in the electronic health record. So we obtain all these additional information on lifestyle. And maybe in the case of veterans, even, you know, where they had been deployed, what they might have been exposed to, you know, military exposures, and experience. And that’s the second piece, lifestyle, nutrition, military experience, and so on. The third piece is molecular data, we want to get the genetics and other molecular profiles. And for that we collect a blood sample from our participants. And we do a baseline genetics on everyone who participates. And then we’re diving deeper on subsets of patients to do other kinds of analyses, like proteomics, metabolomics, that’s the goal to keep doing deeper dive into the molecular information. So then we have this very comprehensive data set on a person that you can then look at how they all contribute.
Tom Temin: And some of this data is…
Read More: VA inches closer to getting the bodies it needs for its largest research project