All subjects are enrollees in the MVP32. Active users of the Veterans Health Administration healthcare system (>8 million veterans) learn of MVP via an invitational mailing and/or through MVP staff while receiving clinical care with informed consent and HIPAA authorization as the only inclusion criteria. As of August 2018, more than 670,000 veterans have enrolled in the program; for the current analyses, genotyping data were available from approximately 350,000 participants. Research involving MVP in general is approved by the VA Central IRB; the current project was also approved by IRBs in Boston, San Diego, and West Haven.
