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Understanding Your Risks for Fatty Liver Disease
Did you know that about one in four adults and one out of every ten kids in the U.S. might have a liver problem called non-alcoholic fatty liver disease (NAFLD)? This happens when too much fat builds up in the liver, and it's not because of drinking alcohol. The most serious type of this liver problem is called metabolic and non-alcoholic steatohepatitis (M/NASH). It means there's damage and can be scarring in the liver. About 20% of people with fatty liver disease have M/NASH. What's worrying is that many people don't even know they have it. Dr. Catherine McCarthy, a family medicine doctor at the University of Nevada, Reno School of Medicine, talks about the main risks of M/NASH and how you can check your risk for liver disease during Liver Health Matters Month, or anytime. Who Might Get M/NASH? Doctors aren't sure exactly why some people get fatty liver or M/NASH. While anyone can get M/NASH, people who might be more at risk include those with: Type 2 diabetes Insulin resistance or prediabetes High body mass index (BMI) or obesity High cholesterol or other fats in the blood High blood pressure Signs of liver problems from tests or biopsies A family member living with M/NASH How Do Doctors Find Out If You Have M/NASH? Doctors can do different checks and tests to see if someone has fatty liver or M/NASH. They might look at your liver health through non-invasive tests such as blood work, ultrasounds or MRIs. They might also suggest a special blood test called an Enhanced Liver Fibrosis (ELF) test– offered at no-cost through the Healthy Nevada Project – to check your risks of advancing liver disease. How Can You Treat Fatty Liver Disease or M/NASH? Patients with moderate to advanced liver scarring may also be prescribed a recently approved therapy called Rezdiffra. However, prevention of advancing disease is still the best option. Actions you can take to improve your liver health and reduce your risk include: Eating healthy, especially low-carb foods Exercising regularly Losing weight if needed Not drinking alcohol Keeping an eye on blood sugar if you have diabetes No-Cost Liver Screening Through the Healthy Nevada Project If you live in Nevada and are 18 or older, you can qualify for a no-cost liver health screening by enrolling in the Healthy Nevada Project, one of the largest community-based population health studies in the entire country. This study helps doctors understand your liver health better and plan early treatments to stop liver disease from getting worse. By joining the Healthy Nevada Project, you can: Get the FDA-approved ELF test to check your risks for liver disease See your test results in your medical record to help your doctor plan your care better Help doctors and researchers learn more about M/NASH and work on future treatments Participate in genetic sequencing for high-risk conditions linked to heart disease and certain cancers, including breast and ovarian cancer Gain high-level health insights, including food sensitivities, and ancestry information. Enrolling in the study is easy: Schedule a Virtual Consent Appointment through MyChart where a study representative will answer any questions, confirm your eligibility and sign you up. Once you’re signed up, your representative will schedule your blood test. Go to your blood draw appointment. By taking part in this study, you're helping to make a difference in liver health research!
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Nonalcoholic Liver Disease and Genetics: Is There a Link?
What exactly is the relationship between genetics and disease? Powered by Renown Health, the Healthy Nevada Project is one of the most visible genomic studies in the United States. They are recruiting participants here in northern Nevada to understand the relationship between genetics and nonalcoholic liver disease. Joseph Grzymski, Principal Investigator at the Healthy Nevada Project and Chief Scientific Officer at Renown Health, shares why this study is so important and who should take part. Many people are aware that heavy drinking can lead to liver disease. Yet they are unaware that other types of liver disease are not caused by alcohol consumption. These types of liver disease are more difficult to diagnose but are equally dangerous. What is NASH? A build-up of fat causes nonalcoholic Fatty Liver Disease (NAFLD) in the liver. The most dangerous form is called Nonalcoholic Steatohepatitis (NASH). It causes inflammation and damages liver cells, leading to fibrosis, scarring of the liver, and decreased liver function. If NASH goes untreated, irreversible liver damage can occur, leading to cirrhosis, cancer, or liver failure. These conditions can be fatal. What’s most concerning about NASH is that the symptoms don’t typically cause pain and aren’t noticeable. The good news is that a new local study is raising awareness about this disease by recruiting at-risk people for NASH. Am I at risk for developing NASH? The following factors put you at risk: Obesity Type 2 diabetes Metabolic syndrome High blood lipids, such as cholesterol and triglycerides Does having a family member with nonalcoholic liver disease increase my risk? We do not know a lot about inheriting NASH, although a lot risk factors run in families. One goal of this study is to better understand the genetic component of NASH. There are certainly other risks too, such as environmental and behavioral risk factors. However, we don’t yet have a good grasp on how these impact NASH risk. How is NASH diagnosed? Diagnosis is traditionally done with either a liver ultrasound or biopsy. However, both procedures are expensive and the invasive biopsy has risks. Therefore doctors often use risk factors or less invasive blood tests for diagnosis. This NASH study will include a new blood test called the enhanced liver function (ELF) test. Doctors and researchers have data suggesting that the ELF test is a better diagnostic test for NASH risk. Conducting this cutting-edge test with study participants allows them to share results with their doctors to ensure the best care. What can I do to reduce my NASH risk? Limiting exposure to the risk factors of NASH often lowers risk. Eating a healthy diet, maintaining a recommended weight and exercising regularly can proactively lower your risk.
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How to Fight Cancer that Runs in the Family
Your mother had breast cancer. Your uncle had colon cancer. A cousin has stomach cancer. Could yours be the next name to make the family cancer list? “Possibly,” says Dr. Robert Nathan Slotnick, MD, PhD, Medical Geneticist at Renown Medical Group. In this article, the doctor discusses the genetics behind Lynch syndrome — and how you and your family can fight it. What is Lynch Syndrome? Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), is one of the most common genetic conditions known to increase cancer risk in individuals and families. It enables colon and other cancers to develop by causing mutations in mismatch repair (MMR) genes. “The genes MLH1, MSH2, MSH6, PMS2 and EPCAM normally help to repair damaged DNA,” explains Dr. Slotnick. “But when they don’t work properly, naturally occurring DNA replication errors are not repaired efficiently. These errors accumulate and cancer can be the result.” Colon cancer is just one of many possibilities. People with Lynch syndrome also have a higher risk of developing endometrial cancer (cancer of the inside lining of the uterus) as well as cancer of the ovaries, stomach, pancreas, kidney, brain, and bile duct, among others. These syndrome-enabled cancers often appear in patients before the age of 50. Family Cancer Clues The family connection to cancer is a strong one notes the doctor. “Cancer is best considered a genetic disease because it is always tied to changes (or mutations) in our inherited material: our DNA,” says Dr. Slotnick. “These DNA changes cause cells to lose control of their normal constraints on growth and metabolism and can allow abnormalities to develop.” “Although all cancers are genetic,” he adds, “not all cancers are hereditary or passed down through generations.” But because Lynch syndrome IS a hereditary condition, personal and family cancer histories provide invaluable information toward diagnostic confirmation and to a path of surveillance, prevention and treatment. Once a strong family history of cancer is confirmed, doctors and geneticists can move forward with targeted genetic testing to identify specific gene mutations. If Lynch syndrome is diagnosed, testing can also reveal your risk for associated cancers. And your results could be a wake-up call to family members. According to the Centers for Disease Control and Prevention (CDC), close relatives of people with Lynch syndrome have a 50% chance of having similar gene mutations and a higher risk of cancer. The good news is detection and prevention progress is being made. “Lynch is just one of many cancer syndromes where risk is tied to heredity,” explains Dr. Slotnick. “In the last few years, our ability to identify those at risk for this type of cancer predisposition has improved markedly, both in diagnostic accuracy and cost. This allows us to provide aggressive surveillance and prevention choices to individuals and families at risk. Healthier families and lower cost: it’s a win-win.”
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Give the Gift of Health This Season with ELF Testing
Renown Health and the University of Nevada, Reno School of Medicine give the gift of early diagnosis and disease prevention this holiday season. With the season of giving upon us, give yourself the gift of health. The Renown Institute for Health Innovation (IHI) and the University of Nevada, Reno School of Medicine (UNR Med) are excited to offer a free Enhanced Liver Fibrosis (ELFTM) test to patients at risk for a common type of liver disease, e.g. metabolic and nonalcoholic steatohepatitis (M/NASH), and who enroll or are currently enrolled in the Healthy Nevada Project. The ELF Test is an FDA (Food and Drug Administration) approved non-invasive test to help identify people most at risk for liver scarring, e.g. cirrhosis, and allows doctors to intervene before irreversible damage occurs. If undetected and untreated, M/NASH can result in liver cirrhosis which could require liver transplantation or lead to death. This test is important as the symptoms of M/NASH can be silent or non-specific, making it difficult to diagnose. “There are currently more than 11,000 people across the U.S. on the national liver transplant waiting list, and with the heightened prevalence of NAFLD and M/NASH, this number is projected to keep rising; however, with research such as the ELF Test at our disposal, we are continuing to find ways to improve the health of those at risk for advanced liver disease,” said Bill Plauth, MD, Chief Medical Officer for Renown Health and Associate Dean of Clinical Affairs at UNR Med. “We encourage our community to participate in this early risk detection. Through this sophisticated, noninvasive, blood test, our physicians and Advanced Practice Providers can better evaluate liver fibrosis to help those affected and enable researchers to improve the prevention and treatment of nonalcoholic liver disease as a whole.” This liver health-focused sub-study of the Healthy Nevada Project seeks to enhance the understanding of both NAFLD and M/NASH and to help inform the development of treatment options for these conditions, as few currently exist. “Providing access to cutting-edge innovations such as the ELF Test is critical for both participants and the physicians and advanced practice providers that care for them.” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project and the Liver Disease Study and research professor at UNR Med. Those interested in determining their risk for M/NASH and its progression are encouraged to enroll in the Metabolic & Nonalcoholic Steatohepatitis study. Those who have consented and participated in the M/NASH research will be eligible and contacted with more information on how to receive the ELF Test. The Renown IHI is also happy to connect with physicians and Advanced Practice Providers interested in having their patients enroll in the Healthy Nevada Project and join the study. For members of the community who would like more information and learn how to enroll, please contact the Renown IHI at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About the ELF™ Test The ELF Test is a noninvasive blood test that can quickly identify which patients are at an elevated risk for developing cirrhosis and other liver-related clinical events (LREs). In contrast to standard liver enzyme tests that reflect liver damage that has already occurred, the ELF Test combines three serum direct biomarkers of active fibrosis. The ELF Test algorithm measures each of these biomarkers to create an ELF score, which can be used as an aid to assess the risk for future disease progression. Doctors may use this ELF score to help evaluate if a patient requires increased medical care and monitoring for their condition. Individuals interested in determining their risk for NASH and its progression are encouraged to enroll in the Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study. Those who have already consented and participated in the study will be contacted with more information on how to receive an ELF blood test. For more information or to enroll, please contact RenownIHI@renown.org or (775) 982-6914. In the U.S., the ELF Testing Service is available from Brio Clinical, Inc., a CLIA-certified laboratory offering specialized testing throughout the United States. Brio Clinical is regulated under CLIA as qualified to perform high complexity testing.
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Early Detection is Key to Surviving Colorectal Cancer
Colorectal cancer is the number two cancer killer in Nevada, only second to lung cancer, yet it is also one of the most preventable. Still, in 2020, 20.7% of Nevadans said they had never been screened for this deadly disease, according to the Nevada Cancer Coalition. At the start of the COVID-19 pandemic, unfortunately many healthcare services were halted, including colorectal cancer screenings. Those delays in screenings can lead to delays in diagnoses of colorectal cancer, resulting in poorer outcomes. Per the American Cancer Society, if colorectal cancer can be found early the relative 5-year survival rate is approximately 90%. Screening is key, and it is important to engage in preventative care. Even if you have no personal or family history of colorectal cancer, ask your doctor about colorectal risk factors and when to start screening, and if you’re up to date on your screenings, talk to loved ones and make sure they are too. According to the American Cancer Society, most colorectal cancer cases are found in those without a family history. This month let us help raise awareness for colorectal cancer and the importance of routine, life-saving screenings. To learn more, we spoke to Renown Health oncology nurse Christina Alsop, APRN. What is Colorectal Cancer Colorectal cancer is a disease in which the cells in the colon or rectum grow out of control. It usually forms from precancerous polyps, or abnormal growths, in the colon or rectum, which can become malignant without presenting any symptoms. How do Screenings Work Screening tests like stool tests, colonoscopies and others can detect these precancerous polyps, so they can be removed by a physician before turning into cancer. Screening tests can also find colorectal cancer early, resulting in better treatment outcomes. As of 2021, the U.S. Preventative Services Task Force recommends adults begin colorectal cancer screenings beginning at age 45, through 75. Screening methods include a blood stool test, which needs to take place every year or a colonoscopy, which takes place every 5-10 years. Healthy Habits Can Help Stave Off Risk Routine screenings are the only way to determine colorectal health, yet some healthy habits may reduce your risk for colorectal cancer. These factors include maintaining a healthy weight, being physically active, eating a diet rich in fresh fruits, vegetables and whole grains, limiting alcohol intake and not smoking.
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Renown Institute Expands Partnership to Offer ELF Testing
Together, will test over 30,000 qualifying study participants by 2023 for risk of cirrhosis and liver-related illnesses. Renown Institute for Health Innovation (IHI) announced today that the organization and Gilead Sciences, Inc. will be joining forces with Siemens Healthineers to offer the Enhanced Liver Fibrosis (ELF™) Test to people with risks for nonalcoholic steatohepatitis (NASH) enrolled in the Healthy Nevada Project (HNP). The ELF Test will help identify people most at risk for progressing to cirrhosis and liver-related outcomes and allow healthcare providers to intervene before irreparable damage occurs. This noninvasive blood test uses three serum biomarkers to create an ELF score from a predefined algorithm, which can be used by doctors to help evaluate if a patient requires increased medical care and monitoring for their condition. Nonalcoholic fatty liver disease (NAFLD), which includes NASH, is prevalent in Nevada and under-diagnosed, likely affecting more than 500,000 adult Nevadans. If undetected and untreated, NASH can result in liver cirrhosis and may require liver transplantation or lead to death. There are more than 12,000 people on a waitlist for liver transplantation in the U.S. and this number continues to rise due to the increasing prevalence of NAFLD. “Thanks to important data collected through our Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study, we now know that NASH is prevalent in the state of Nevada,” said Tony Slonim, M.D., DrPH, FACHE, president and CEO of Renown Health. “We are proud to expand our partnership with Gilead and begin working with Siemens Healthineers to improve health of those with liver disease and to take early detection one step further by offering Enhanced Liver Fibrosis, ELF testing for patients of Renown Health. This test provides our team of highly-skilled physicians an advanced, noninvasive method to actively assess dynamic liver fibrosis in study participants and intervene whenever necessary, contributing to a healthier Nevada.” “Gilead believes that noninvasive tests, including the ELF Test, will help improve the experience of people living with NASH. These tests may help to diagnose liver disease, monitor disease progression and evaluate responses to treatment without the requirement for liver biopsy,” said Rob Myers, MD, Vice President, Liver Fibrosis Clinical Research at Gilead Sciences. “The ELF Test has proven itself to be a valuable tool in NASH management and we hope this partnership will further support its use in routine care.” “We are very pleased that NASH patients in the Healthy Nevada Project now have access to the ELF Test which offers clinically useful prognostic information for their condition with the convenience of a simple blood test. Using our advanced laboratory expertise together with Renown IHI and Gilead, we can work towards better understanding of NASH and liver disease in a representative patient population,” said Sebastian Kronmueller, Head of Molecular Diagnostics at Siemens Healthineers. “We launched the Healthy Nevada Project to help people understand more about their health, to identify serious health risks, and to give people access to innovations like the ELF Test, so they can live their best lives,” said Renown’s chief scientific officer, Dr. Joseph Grzymski, who is also a research professor at the Desert Research Institute and principal investigator of the Healthy Nevada Project. It’s incredibly rewarding to be able to report clinical findings to help our 50,000 volunteer study participants, and to assist healthcare providers in helping their patients.” The provision of the ELF Test builds on a previously announced strategic collaboration between the Renown IHI and Gilead in July 2019. This ongoing partnership aims to collect and analyze de-identified genetic and electronic health data from 60,000 qualifying study participants to enhance the understanding of NAFLD and NASH and to potentially inform development of treatment options for these diseases. About NAFLD and NASH NAFLD is a build-up of fat in the liver of people who do not have a history of alcohol misuse. It is normal for the liver to contain some fat, but if more than 5 percent of the liver content is fat, it’s considered a fatty liver (steatosis). NASH is the most severe form of NAFLD in which a person has liver cell damage and inflammation of the liver. Inflammation and liver cell damage can cause fibrosis, or scarring of the liver, and can cause decreased liver function (1). The symptoms of NASH are often silent or non-specific, making it difficult to diagnose. About one-third of people with NASH develop cirrhosis or irreversible liver damage (2). About the ELF™ Test The ELF Test is a noninvasive blood test that can quickly identify which patients are at an elevated risk for developing cirrhosis and other liver-related clinical events (LREs). In contrast to standard liver enzyme tests that reflect liver damage that has already occurred, the ELF Test combines three serum direct biomarkers of active fibrosis. The ELF Test algorithm measures each of these biomarkers to create an ELF score, which can be used as an aid to assess the risk for future disease progression. Doctors may use this ELF score to help evaluate if a patient requires increased medical care and monitoring for their condition. Individuals interested in determining their risk for NASH and its progression are encouraged to enroll in the Nonalcoholic Steatohepatitis Liver Disease Genome Atlas study. Those who have already consented and participated in the study will be contacted with more information on how to receive an ELF blood test. For more information or to enroll, please contact RenownIHI@renown.org or (775) 982-6914. The Enhanced Liver Fibrosis (ELF™) Test kit is not available for sale in the U.S. Product availability may vary from country to country and is subject to varying regulatory requirements. In the U.S., the ELF Testing Service is available from Siemens Healthcare Laboratory, LLC (SHL), a CLIA-certified laboratory located in Berkeley, Calif. The ELF Testing Service, including the establishment of performance characteristics, was developed by SHL. The ELF Test has not been cleared or approved by the U.S. Food and Drug Administration. SHL is regulated under CLIA as qualified to perform high complexity testing. The ELF Test is used for clinical purposes and should not be regarded as investigational use only or research use only. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Health, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information visit, renown.org. About the Renown Institute for Health Innovation Renown Institute for Health Innovation is a collaboration between Renown Health - a locally governed and locally owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California; and the Desert Research Institute - a recognized world leader in investigating the effects of natural and human-induced environmental change and advancing technologies aimed at assessing a changing planet. Renown IHI research teams are focused on integrating personal healthcare and environmental data with socioeconomic determinants to help Nevada address some of its most complex environmental health problems; while simultaneously expanding the state’s access to leading-edge clinical trials and fostering new connections with biotechnology and pharmaceutical companies. Learn more at healthynv.org. Renown Health is Nevada’s most comprehensive and integrated healthcare network and maintains electronic health records for 1.02 million registered patients. In 2016, Renown Health and the Desert Research Institute established the Healthy Nevada Project (HNP), the nation’s first community-based population health study. In 2017 HNP began a partnership with Helix to leverage its population health services, Exome+™ sequencing, and consumer engagement tools. The HNP is now an ongoing collaboration between Renown IHI, the Desert Research Institute, a global leader in environmental data and applied research, and Helix, a personal genomics company. HNP combines genetic, environmental, social and clinical data to address individual and community health needs with the goal of improving health across the state and the nation. The HNP currently has over 60,000 participants. For more information, visit healthynv.org. About Siemens Healthineers Siemens Healthineers AG (listed in Frankfurt, Germany: SHL) is shaping the future of Healthcare. As a leading medical technology company headquartered in Erlangen, Germany, Siemens Healthineers enables healthcare providers worldwide through its regional companies to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, improving the patient experience, and digitalizing healthcare. Siemens Healthineers is continuously developing its product and service portfolio, with AI-supported applications and digital offerings that play an increasingly important role in the next generation of medical technology. These new applications will enhance the company’s foundation in in-vitro diagnostic, image-guided therapy, and in-vivo diagnostics. Siemens Healthineers also provides a range of services and solutions to enhance healthcare providers ability to provide high-quality, efficient care to patients. In fiscal 2020, which ended on September 30, 2020, Siemens Healthineers, which has approximately 54,000 employees worldwide, generated revenue of €14.5 billion and adjusted EBIT of €2.2 billion. Further information is available at www.siemens-healthineers.com.Media Contact for Siemens Healthineers: Lance LongwellM: 610-448-6341E: lance.longwell@siemens-healthineers.com
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Study Shows Importance of Ensuring Participant and Provider Follow-up After a Genetic Screening Result
Released in partnership with the Desert Research Institute: New research from the Healthy Nevada Project® finds that a confirmed diagnosis does not always result in changes to patient care. Presenting individuals with potentially life-altering health information doesn’t mean the individuals – or their healthcare providers – will act on it. Follow-up education and conversations about actionable care plans with patients and their doctors are key next steps, according to new research from the Healthy Nevada Project. The Healthy Nevada Project is a genetic screening and research project that launched in 2016 as a partnership between DRI and Renown Health. The project now has more than 50,000 participants, with genetic sequencing provided by Helix. Between September 2018 and September 2020, the Healthy Nevada Project successfully notified 293 participants that they were genetically at risk for hereditary breast and ovarian cancer syndrome, Lynch syndrome, or familial hypercholesterolemia – three common genetic conditions known collectively as the Centers for Disease Control and Prevention (CDC) Tier 1 conditions. In a study published today in Frontiers in Genetics, Healthy Nevada Project scientists looked at the impact that notifying a patient of a positive finding for a CDC Tier 1 condition had on the care that the patient received in the months and years that followed. According to their results, among the 293 Healthy Nevada Project participants who were notified of their genetic risk of a CDC Tier 1 condition, 71 percent of participants with electronic health records shared their findings with healthcare providers. However, only 30 percent of the electronic health records for these patients contained documentation of the genetic diagnosis, and only 10 percent of examined patients experienced a possible change in care after receiving the results of their genetic screening. “The Healthy Nevada Project was implemented with a ‘hands-off’ approach where the participants receive their findings and decide with whom and when to share those findings. The findings were not automatically added to their electronic health records,” said Dr. Gai Elhanan, health data scientist at DRI and co-lead author of the study. “What we’re learning now is that to ensure that important genetic findings are integrated into the care journey it is important to make their inclusion into the electronic health records part of the study.” This study builds on previous Healthy Nevada Project research published in Nature Medicine demonstrating the importance of screening for CDC Tier 1 conditions, which affect about one in 75 individuals and can be mitigated or even prevented from developing into disease when detected early. This study found that as many as 90 percent of the CDC Tier 1 cases are missed by clinical providers during normal clinical care screenings and examinations. During the current study, the Healthy Nevada Project scientists found that 19 percent of studied participants had already developed one of the CDC Tier 1 conditions, and thus would have potentially benefited from earlier notification about their condition. The study team hopes that their findings will encourage individuals in Nevada to obtain genetic testing for these relatively common conditions. Even if individuals are older or have already suffered from diseases related to these conditions, testing could also prove beneficial to siblings, children, and grandchildren who may also be at risk and who could subsequently be screened in the event of a positive finding. The study team also encourages informing health care providers of the importance of incorporating genetic diagnoses into the pharmaceutical (for example, for Familial Hypercholesterolemia) and treatment advice given to patients. “As a result of this analysis, the clinicians at Renown Health and the Healthy Nevada Project researchers have made significant changes, including obtaining informed consent from participants to report positive findings from their genetics reports directly into their electronic medical record,” said Daniel Kiser, M.S., assistant research scientist of data science at DRI and co-lead author of the study. “This will help both participants, their clinical providers, and the whole state maximize the long-term benefits of the Healthy Nevada Project voluntary population-based genetic screening.” Additional information: The full text of the study, Incomplete Penetrance of Population-Based Genetic Screening Results in Electronic Health Record, is available from Frontiers in Genetics: https://www.frontiersin.org/articles/10.3389/fgene.2022.866169/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Genetics&id=866169. This project was funded by Renown Health, the Renown Health Foundation, and the Nevada Governor’s Office of Economic Development. Study authors included Gai Elhanan (DRI), Daniel Kiser (DRI), Iva Neveux (DRI), Shaun Dabe (Renown Health), Alexander Bolze (Helix), William Metcalf (DRI), James Lu (Helix), and Joseph Grzymski (DRI/Renown Health). For more information on the Healthy Nevada Project® or to request genetic screening, please visit: https://healthynv.org/ About DRI The Desert Research Institute (DRI) is a recognized world leader in basic and applied environmental research. Committed to scientific excellence and integrity, DRI faculty, students who work alongside them, and staff have developed scientific knowledge and innovative technologies in research projects around the globe. Since 1959, DRI’s research has advanced scientific knowledge on topics ranging from humans’ impact on the environment to the environment’s impact on humans. DRI’s impactful science and inspiring solutions support Nevada’s diverse economy, provide science-based educational opportunities, and inform policymakers, business leaders, and community members. With campuses in Las Vegas and Reno, DRI serves as the non-profit research arm of the Nevada System of Higher Education. For more information, please visit www.dri.edu. About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org. About Helix Helix is the leading population genomics and viral surveillance company operating at the intersection of clinical care, research, and data analytics. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision making. Learn more at www.helix.com.
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CEO Blog: Improving Health Through Genetics and Big Data
Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.
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What is the Healthy Nevada Project?
The Healthy Nevada Project (HNP) is one of the most visible genomic studies in the United States, and guess what? Renown Health powers it! The Healthy Nevada Project (HNP) aligns with Renown's goal to do the best for our patients. The genomic study is at no-cost for Nevadans and gives participants insight into different genetic traits, including results on three prevalent and serious health conditions known as CDC Tier 1 conditions. CDC Tier 1 Conditions Include: Hereditary Breast and Ovarian Cancer Syndrome (HBOC) Lynch Syndrome Familial Hypercholesterolemia (FH) Not only does HNP give participants insights into their genetic background, but it also facilitates Renown's ability to study population health. Research lays the foundation for the future of medicine, and Renown's HNP is on the cutting edge of genetic research. We do this by providing skilled researchers access to studies for the diseases that currently have limited treatment, including nonalcoholic steatohepatitis liver disease or NASH. For example, the observational NASH study helps researchers understand genetic links to the disease. Make an Appointment to Get Screened If you haven't already, join the over 55,000 HNP participants and make an appointment to have yourself screened. You can schedule a screening appointment through MyChart. Click “Schedule an Appointment" and select Research Appointment - Genetic Screening. Prior to your appointment, please complete e-Check-in and complete your consent form.
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The Healthy Nevada Project Changed My Life: A Local Mom's Story
Read about Jordan Stiteler, a local mom who says the Healthy Nevada Project provided insights into her family’s genetic makeup — and the likely cause of her dad and great grandfather’s deaths. Now she is changing her life due to her new diagnosis of familial hypercholesterolemia, which will allow her to take steps toward preventing the same fate. Jordan Stiteler’s dad died suddenly of a stroke nearly ten years ago — at only 45 years old. His grandfather died at age 40. Now through the Healthy Nevada Project’s no-cost genetic testing, she is closer to understanding why that may have happened. And she can take proactive steps to prevent the unhealthy symptoms that often lead to a stroke and heart problems. After getting her Geno 2.0 by National Geographic ancestry report, Stiteler got a call from Renown Institute for Heart & Vascular Health Cardiologist and Renown IHI Director of Research, Dr. Christopher Rowan. “They told me that I have FH, which is familial hypercholesterolemia,” she said. “I have genetically very high cholesterol because I have a non-functioning gene that doesn’t get rid of my cholesterol like a normal body would.” Familial Hypercholesterolemia: Simple Life Changes Dr. Rowan told Stiteler it is curable with medication and a change in lifestyle. Stiteler has embraced healthy lifestyle changes by exercising more and eating healthier. “It is so important. Being a mom, I think you have so much more to live for. Having this information has changed my life.” Stiteler feels confident FH affected her Dad. “It is helping my family realize that we need to get tested,” she said. “There were big milestones that my Dad missed. He didn’t get to see either of us get married or have our children. That was huge.” She has become passionate about sharing the need to join the Healthy Nevada Project as her way of helping to prevent other families from possibly going through what she and her family did with the early loss of her Dad. In addition to FH results, the Healthy Nevada Project is returning clinical results on BRCA 1/2 (hereditary breast and ovarian cancer) and Lynch syndrome (colorectal and endometrial cancer) to consenting study participants. To sign up for the Healthy Nevada Project, go to HealthyNV.org. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up
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Introducing Dana Renown Institute for Health Innovations New Life Sized Holographic Kiosk
Presented by the Desert Research Institute and Renown Health, DANA will help people learn more about the Healthy Nevada Project® and their own unique, genetic health traits What is the Healthy Nevada Project®? What are the benefits of joining this research study? How can I find out if I carry genes for health risks like heart disease, hereditary breast and ovarian cancer syndrome and Lynch syndrome? What if a holographic avatar, powered by artificial intelligence (AI), could answer all these questions and more? DANA has all the answers, she is a virtual assistant with “DNA” in her name, presented by the Renown Institute for Health Innovation (Renown IHI), a collaboration between Renown Health and the Desert Research Institute (DRI). This life-sized, holographic avatar will greet individuals outside Renown Regional Medical Center’s Sierra Café, and talk to them about the Healthy Nevada Project, the world’s largest community-based genetic population health study. Members of the media are invited to meet DANA this morning from 10 a.m. – noon. Please reply to this email or call (775) 691-7308 to coordinate a meet and greet. “Unfortunately, Nevada ranks among the lowest in the nation for health outcomes—and we are working to change that,” said Anthony Slonim, M.D., D.Ph., president and CEO of Renown Health and president of Renown Institute for Health Innovation. “Through the Healthy Nevada Project® , our goal is to offer genetic testing to every Nevadan interested in learning more about their health and genetic profile. Thanks to this advanced technology, DANA will offer people a personalized explanation of the Project, and help them take the next step to better understand their health, and their health risks, so they can modify their behavior and ultimately, live a healthier, happier life.” With more than 51,000 study participants enrolled to date, the Healthy Nevada Project® is considered the fastest-enrolling genetic study in the country. The Project is also the first of its kind to return clinical results to study volunteers, which means participants can learn their genetic risks tied to heart disease and certain cancers, as well as lifestyle changes that could potentially help reduce their risk and prevent disease. Furthermore, participants can choose to share their information with their medical provider to improve and enhance their medical care. “We are always happy to engage with our study participants and look forward to having them meet and engage with DANA,” said Joseph Grzymski, Ph.D., research professor at DRI, principal investigator of the Healthy Nevada Project® and chief scientific officer for Renown Health. “At a time of physical distancing and limiting human contact where possible, using tools like an avatar and AI are important for communicating, whether it be for genetics, vaccinations or other important health information.” Visitors can interact with DANA through a touch screen (cleaned and sanitized after every encounter) to learn more about the study, enter their contact information and schedule an appointment to join the free genetics study or receive more information about their test results. Kiosk visitors are asked to maintain physical distance guidelines and use the hand sanitizer and Sani Wipes available next to the kiosk. Renown Institute for Health Innovation is a collaboration between Renown Health - a locally governed and locally owned, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California; and the Desert Research Institute - a recognized world leader in investigating the effects of natural and human-induced environmental change and advancing technologies aimed at assessing a changing planet. Renown IHI research teams are focused on integrating personal healthcare and environmental data with socioeconomic determinants to help Nevada address some of its most complex environmental health problems; while simultaneously expanding the state’s access to leading-edge clinical trials and fostering new connections with biotechnology and pharmaceutical companies. Learn more at healthynv.org.
