Physician Response to Implementation of Genotype-Tailored Antiplatelet Therapy

Clinical Pharmacology & Therapeutics – Physician responses to genomic information are vital to the success of precision medicine initiatives. We prospectively studied a pharmacogenomics implementation program for the propensity of clinicians to select antiplatelet therapy based on CYP2C19 loss-of-function (LOF) variants in stented patients.

Toward rapid learning in cancer treatment selection: an analytical engine for practice-based clinical data

Journal of Biomedical Informatics – The promise of leveraging vast medical record data to guide clinical decision making has created growing support for the development of “Rapid Learning Systems” (RLS) that gather and leverage practice-based clinical evidence for real-time clinical decision support. The need for such systems is particularly evident within the field of oncology, where controlled clinical trial evidence is only available to guide therapy in a minority of patients.

Impact of GGCX, STX1B and FPGS Polymorphisms on Warfarin Dose Requirements in European‐Americans and Egyptians

Clinical and Translational Science – Genotype‐based algorithms that include VKORC1 and CYP2C9 genotypes are less predictive of warfarin dose variability in Africans as opposed to Europeans. Polymorphisms in GGCX, FPGS, or STX1B are associated with warfarin dose requirements in African‐Americans. We sought to determine if they influenced warfarin dose in European‐Americans, and another African population, specifically Egyptians.

Implementing and Improving Automated Electronic Tumor Molecular Profiling

Journal of Oncology Practice – Oncology practice increasingly requires the use of molecular profiling of tumors to inform the use of targeted therapeutics. However, many oncologists use third-party laboratories to perform tumor genomic testing, and these laboratories may not have electronic interfaces with the provider’s electronic medical record (EMR) system.

Integrating electronic health record genotype and phenotype datasets to transform patient care

Clinical Pharmacology & Theraputics – The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 mandates the development and implementation of electronic health record (EHR) systems across the country. While a primary goal is to improve the care of individual patients, EHRs are also key enabling resources for a vision of individualized (or personalized or precision) medicine: the aggregation of multiple EHRs within or across healthcare systems should allow discovery of patient subsets that have unusual and definable clinical trajectories that deviate importantly from the expected response in a “typical” patient.

FDA’s Draft Guidance on Laboratory-Developed Tests Increases Clinical and Economic Risk to Adoption of Pharmacogenetic Testing

The Journal of Clinical Pharmacology – The US Food and Drug Administration (FDA) notified Congress July 31, 2014, of its intent to regulate laboratory developed tests. These encompass thousands of clinical assays currently used in medical practice including most pharmacogenetic tests. This guidance has the potential to impact the innovation and sustainability of pharmacogenetic research and its clinical implementation.

Pharmacogenomically actionable medications in a safety net health care system

Sage Open Medicine – The implementation of pharmacogenomics is increasingly relevant at the population level. Nearly 70% of Americans take at least one medication and more than 20% take five or more, with spending on medications projected to be over US$457 billion by 2019. Defined as the study of genetic variation associated with drug response, pharmacogenomics seeks to understand how genes affect the pharmacokinetics and pharmacodynamics of drugs.