Display options
Cite
Overby CL, Tarczy-Hornoch P, Kalet IJ, et al. Developing a prototype system for integrating pharmacogenomics findings into clinical practice. J Pers Med. 2012;2(4):241-56doi: 10.3390/jpm2040241.
Overby, C. L., Tarczy-Hornoch, P., Kalet, I. J., Thummel, K. E., Smith, J. W., Del Fiol, G., Fenstermacher, D., & Devine, E. B. (2012). Developing a prototype system for integrating pharmacogenomics findings into clinical practice. Journal of personalized medicine, 2(4), 241-56. https://doi.org/10.3390/jpm2040241
Overby, Casey Lynnette, et al. "Developing a prototype system for integrating pharmacogenomics findings into clinical practice." Journal of personalized medicine vol. 2,4 (2012): 241-56. doi: https://doi.org/10.3390/jpm2040241
Overby CL, Tarczy-Hornoch P, Kalet IJ, Thummel KE, Smith JW, Del Fiol G, Fenstermacher D, Devine EB. Developing a prototype system for integrating pharmacogenomics findings into clinical practice. J Pers Med. 2012 Nov 20;2(4):241-56. doi: 10.3390/jpm2040241. PMID: 23741623; PMCID: PMC3670105.
Copy Download .nbib Format: NLM
Share it on

J Pers Med. 2012 Nov 20;2(4):241-56. doi: 10.3390/jpm2040241.

Developing a prototype system for integrating pharmacogenomics findings into clinical practice.

Journal of personalized medicine

Casey Lynnette Overby, Peter Tarczy-Hornoch, Ira J Kalet, Kenneth E Thummel, Joe W Smith, Guilherme Del Fiol, David Fenstermacher, Emily Beth Devine

Affiliations

  1. Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, USA ; Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA.

PMID: 23741623 PMCID: PMC3670105 DOI: 10.3390/jpm2040241

Abstract

Findings from pharmacogenomics (PGx) studies have the potential to be applied to individualize drug therapy to improve efficacy and reduce adverse drug events. Researchers have identified factors influencing uptake of genomics in medicine, but little is known about the specific technical barriers to incorporating PGx into existing clinical frameworks. We present the design and development of a prototype PGx clinical decision support (CDS) system that builds on existing clinical infrastructure and incorporates semi-active and active CDS. Informing this work, we updated previous evaluations of PGx knowledge characteristics, and of how the CDS capabilities of three local clinical systems align with data and functional requirements for PGx CDS. We summarize characteristics of PGx knowledge and technical needs for implementing PGx CDS within existing clinical frameworks. PGx decision support rules derived from FDA drug labels primarily involve drug metabolizing genes, vary in maturity, and the majority support the post-analytic phase of genetic testing. Computerized provider order entry capabilities are key functional requirements for PGx CDS and were best supported by one of the three systems we evaluated. We identified two technical needs when building on this system, the need for (1) new or existing standards for data exchange to connect clinical data to PGx knowledge, and (2) a method for implementing semi-active CDS. Our analyses enhance our understanding of principles for designing and implementing CDS for drug therapy individualization and our current understanding of PGx characteristics in a clinical context. Characteristics of PGx knowledge and capabilities of current clinical systems can help govern decisions about CDS implementation, and can help guide decisions made by groups that develop and maintain knowledge resources such that delivery of content for clinical care is supported.

Keywords: clinical decision support systems; computerized provider order entry; electronic health records; knowledge representation; personalized medicine; pharmacogenomics

References

  1. J Am Med Inform Assoc. 2006 Jan-Feb;13(1):67-73 - PubMed
  2. Clin Pharmacol Ther. 2007 Oct;82(4):427-34 - PubMed
  3. BMC Bioinformatics. 2010 Oct 28;11 Suppl 9:S10 - PubMed
  4. J Am Med Inform Assoc. 2007 Jul-Aug;14(4):489-96 - PubMed
  5. PLoS Curr. 2010 Sep 02;2: - PubMed
  6. Fed Regist. 2012 Sep 4;77(171):54163-292 - PubMed
  7. AMIA Annu Symp Proc. 2006;:904 - PubMed
  8. Clin Pharmacol Ther. 2011 Mar;89(3):464-7 - PubMed
  9. Hum Genomics. 2011 Jul;5(5):506-15 - PubMed
  10. Genet Med. 2005 Nov-Dec;7(9):605-10 - PubMed
  11. Mt Sinai J Med. 2000 Mar;67(2):144-51 - PubMed
  12. Nucleic Acids Res. 2008 Jan;36(Database issue):D913-8 - PubMed
  13. AMIA Annu Symp Proc. 2005;:1003 - PubMed
  14. J Biomed Inform. 2012 Aug;45(4):726-35 - PubMed
  15. Pharmacotherapy. 2008 Aug;28(8):992-8 - PubMed

Publication Types

Grant support