Our Future Health will play its part in delivering the national genomics strategy across the UK as part of the new plan for implementation published last week: Genome UK: Shared Commitments for UK-wide implementation 2022-25.
The shared commitments in the plan set out how the genomics community across the UK will collaborate during 2022 to 2025 to take forward the government’s vision for genomic healthcare.
The effective application of genomics in healthcare is at the core of the vision set out by the government in Genome UK. Polygenic risk scores (PRS) are a way to provide people with insights into how genetics may affect their risk of developing a range of conditions. As the only national programme that will enrol volunteers in all four nations, Our Future Health will be building an important, UK-wide resource to help researchers understand the utility of polygenic risk scores.
Genotyping in Our Future Health
Volunteers who take part in our programme will be asked to complete an online questionnaire about their lifestyle and medical history and to provide a blood sample, from which DNA will be extracted. This DNA will be genotyped using an array produced for us by Illumina and the genotyping service provided by EuroFins laboratories, with the resulting data stored in our secure database.
Our Future Health and registered researchers that make a successful application to study these secure data will be able to assess the value of a wide range of polygenic risk scores in helping understand and prevent disease. The array has also been designed to allow researchers to better understand drug efficacy and side effects.
Using polygenic risk scores
We plan to be able to offer feedback to people taking part in Our Future Health, beginning in late 2022 and gradually expanding to all our volunteers. As part of this, we will be testing approaches to deliver health-related information to volunteers and assessing the clinical, psychological, behavioural and social outcomes. This information will include providing clinically actionable, integrated disease risk scores which will include genetic (e.g. polygenic risk score) and non-genetic (e.g. age, gender, disease-related exposures) factors that predict risk of disease to provide enhanced insights into disease prevention.
The approaches we take will be people-centred, behaviourally-informed, and co-designed with the public and our volunteers across the UK. We will also work closely with our new Implementation Board that will include health and care representatives on a UK-wide basis, as well as from the NHS, the National Institute for Health Research, the Office for Health Improvement and Disparities, Health Data Research UK, and professional medical societies and colleges.
We also expect that polygenic risk scores will be used in future research involving people taking part in Our Future Health, which could assess their clinical utility and impact either as risk profiling/screening tools, or in clinical decision support algorithms. This will make an important contribution to Genome UK’s commitment to formulate a clear, evidence-based position on whether and how polygenic risk scores can be best utilised at scale in the health service.
Finally, Our Future Health participants have consented to be recontacted and polygenic risk scores may be used to identify those who are at high future risk of a disease who would be candidates for research studies focused on earlier detection.