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Operational Implementation of Prospective Genotyping for Personalized Medicine: The Design of the Vanderbilt PREDICT Project
The promise of “personalized medicine” guided by an understanding of each individual's genome has been fostered by increasingly powerful and economical methods to acquire clinically relevant information. We describe the operational implementation of prospective genotyping linked to an advanced...
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| Published in: | Clinical pharmacology and therapeutics 2012-07, Vol.92 (1), p.87-95 |
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| creator | Pulley, J M Denny, J C Peterson, J F Bernard, G R Vnencak-Jones, C L Ramirez, A H Delaney, J T Bowton, E Brothers, K Johnson, K Crawford, D C Schildcrout, J Masys, D R Dilks, H H Wilke, R A Clayton, E W Shultz, E Laposata, M McPherson, J Jirjis, J N Roden, D M |
| description | The promise of “personalized medicine” guided by an understanding of each individual's genome has been fostered by increasingly powerful and economical methods to acquire clinically relevant information. We describe the operational implementation of prospective genotyping linked to an advanced clinical decision‐support system to guide individualized health care in a large academic health center. This approach to personalized medicine entails engagement between patient and health‐care provider, identification of relevant genetic variations for implementation, assay reliability, point‐of‐care decision support, and necessary institutional investments. In one year, approximately 3,000 patients, most of whom were scheduled for cardiac catheterization, were genotyped on a multiplexed platform that included genotyping for CYP2C19 variants that modulate response to the widely used antiplatelet drug clopidogrel. These data are deposited into the electronic medical record (EMR), and point‐of‐care decision support is deployed when clopidogrel is prescribed for those with variant genotypes. The establishment of programs such as this is a first step toward implementing and evaluating strategies for personalized medicine.
Clinical Pharmacology & Therapeutics (2012); 92 1, 87–95. doi:10.1038/clpt.2011.371 |
| doi_str_mv | 10.1038/clpt.2011.371 |
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Clinical Pharmacology & Therapeutics (2012); 92 1, 87–95. doi:10.1038/clpt.2011.371</description><identifier>ISSN: 0009-9236</identifier><identifier>EISSN: 1532-6535</identifier><identifier>DOI: 10.1038/clpt.2011.371</identifier><identifier>PMID: 22588608</identifier><identifier>CODEN: CLPTAT</identifier><language>eng</language><publisher>Basingstoke: Blackwell Publishing Ltd</publisher><subject>Aryl Hydrocarbon Hydroxylases - genetics ; Biological and medical sciences ; Cardiac Catheterization - drug effects ; Cardiac Catheterization - methods ; Clopidogrel ; Computer-Aided Design ; Cytochrome P-450 CYP2C19 ; Decision Support Systems, Clinical ; Genetic Variation ; Genotyping Techniques - methods ; Humans ; Medical sciences ; Patient Selection ; Pharmacogenetics - methods ; Pharmacogenetics - trends ; Pharmacology. Drug treatments ; Platelet Aggregation Inhibitors - therapeutic use ; Precision Medicine - methods ; Precision Medicine - trends ; Ticlopidine - analogs & derivatives ; Ticlopidine - therapeutic use</subject><ispartof>Clinical pharmacology and therapeutics, 2012-07, Vol.92 (1), p.87-95</ispartof><rights>2012 American Society for Clinical Pharmacology and Therapeutics</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5711-e891c0e53227c2e75ebae1a3c1080be13e0194c685700f5183b7544c477d96f03</citedby><cites>FETCH-LOGICAL-c5711-e891c0e53227c2e75ebae1a3c1080be13e0194c685700f5183b7544c477d96f03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1038%2Fclpt.2011.371$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1038%2Fclpt.2011.371$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,786,790,891,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26116470$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22588608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pulley, J M</creatorcontrib><creatorcontrib>Denny, J C</creatorcontrib><creatorcontrib>Peterson, J F</creatorcontrib><creatorcontrib>Bernard, G R</creatorcontrib><creatorcontrib>Vnencak-Jones, C L</creatorcontrib><creatorcontrib>Ramirez, A H</creatorcontrib><creatorcontrib>Delaney, J T</creatorcontrib><creatorcontrib>Bowton, E</creatorcontrib><creatorcontrib>Brothers, K</creatorcontrib><creatorcontrib>Johnson, K</creatorcontrib><creatorcontrib>Crawford, D C</creatorcontrib><creatorcontrib>Schildcrout, J</creatorcontrib><creatorcontrib>Masys, D R</creatorcontrib><creatorcontrib>Dilks, H H</creatorcontrib><creatorcontrib>Wilke, R A</creatorcontrib><creatorcontrib>Clayton, E W</creatorcontrib><creatorcontrib>Shultz, E</creatorcontrib><creatorcontrib>Laposata, M</creatorcontrib><creatorcontrib>McPherson, J</creatorcontrib><creatorcontrib>Jirjis, J N</creatorcontrib><creatorcontrib>Roden, D M</creatorcontrib><title>Operational Implementation of Prospective Genotyping for Personalized Medicine: The Design of the Vanderbilt PREDICT Project</title><title>Clinical pharmacology and therapeutics</title><addtitle>Clinical Pharmacology & Therapeutics</addtitle><description>The promise of “personalized medicine” guided by an understanding of each individual's genome has been fostered by increasingly powerful and economical methods to acquire clinically relevant information. We describe the operational implementation of prospective genotyping linked to an advanced clinical decision‐support system to guide individualized health care in a large academic health center. This approach to personalized medicine entails engagement between patient and health‐care provider, identification of relevant genetic variations for implementation, assay reliability, point‐of‐care decision support, and necessary institutional investments. In one year, approximately 3,000 patients, most of whom were scheduled for cardiac catheterization, were genotyped on a multiplexed platform that included genotyping for CYP2C19 variants that modulate response to the widely used antiplatelet drug clopidogrel. These data are deposited into the electronic medical record (EMR), and point‐of‐care decision support is deployed when clopidogrel is prescribed for those with variant genotypes. The establishment of programs such as this is a first step toward implementing and evaluating strategies for personalized medicine.
Clinical Pharmacology & Therapeutics (2012); 92 1, 87–95. doi:10.1038/clpt.2011.371</description><subject>Aryl Hydrocarbon Hydroxylases - genetics</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization - drug effects</subject><subject>Cardiac Catheterization - methods</subject><subject>Clopidogrel</subject><subject>Computer-Aided Design</subject><subject>Cytochrome P-450 CYP2C19</subject><subject>Decision Support Systems, Clinical</subject><subject>Genetic Variation</subject><subject>Genotyping Techniques - methods</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Patient Selection</subject><subject>Pharmacogenetics - methods</subject><subject>Pharmacogenetics - trends</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Precision Medicine - methods</subject><subject>Precision Medicine - trends</subject><subject>Ticlopidine - analogs & derivatives</subject><subject>Ticlopidine - therapeutic use</subject><issn>0009-9236</issn><issn>1532-6535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNp9kc2P0zAQxSMEYsvCkSvKBYlLih3Hsc0BCWV3S1FhIxSotBfLcSZdL_nCTheK-ONxtqXAhZM19m_ezPMLgqcYzTEi_KVuhnEeI4znhOF7wQxTEkcpJfR-MEMIiUjEJD0JHjl348tEcP4wOIljynmK-Cz4eTmAVaPpO9WEy3ZooIVuvLsI-zrMbe8G0KO5hXABXT_uBtNtwrq3YQ7WTV3mB1The6iMNh28CotrCM_Amc1d_-irz6qrwJamGcP84_nZMism2Ruv-jh4UKvGwZPDeRp8ujgvsrfR6nKxzN6sIk0ZxhFwgTUCbyxmOgZGoVSAFdEYcVQCJoCwSHTKKUOoppiTktEk0QljlUhrRE6D13vdYVu2UGnv0KpGDta0yu5kr4z896Uz13LT30pCOSaIeoEXBwHbf92CG2VrnIamUR30WycxirFgAgnh0WiPav91zkJ9HIORnBKTU2JySkz6xDz_7O_djvTviDzw_AAop1VTW9Vp4_5wKcZpwiaTYs99Mw3s_j9VZnmRrfJiqvdLHJY2boTvx15lv8iUEUbl-sNCvhMXV_HVei0R-QXih8FA</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Pulley, J M</creator><creator>Denny, J C</creator><creator>Peterson, J F</creator><creator>Bernard, G R</creator><creator>Vnencak-Jones, C L</creator><creator>Ramirez, A H</creator><creator>Delaney, J T</creator><creator>Bowton, E</creator><creator>Brothers, K</creator><creator>Johnson, K</creator><creator>Crawford, D C</creator><creator>Schildcrout, J</creator><creator>Masys, D R</creator><creator>Dilks, H H</creator><creator>Wilke, R A</creator><creator>Clayton, E W</creator><creator>Shultz, E</creator><creator>Laposata, M</creator><creator>McPherson, J</creator><creator>Jirjis, J N</creator><creator>Roden, D M</creator><general>Blackwell Publishing Ltd</general><general>Nature Publishing Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201207</creationdate><title>Operational Implementation of Prospective Genotyping for Personalized Medicine: The Design of the Vanderbilt PREDICT Project</title><author>Pulley, J M ; Denny, J C ; Peterson, J F ; Bernard, G R ; Vnencak-Jones, C L ; Ramirez, A H ; Delaney, J T ; Bowton, E ; Brothers, K ; Johnson, K ; Crawford, D C ; Schildcrout, J ; Masys, D R ; Dilks, H H ; Wilke, R A ; Clayton, E W ; Shultz, E ; Laposata, M ; McPherson, J ; Jirjis, J N ; Roden, D M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5711-e891c0e53227c2e75ebae1a3c1080be13e0194c685700f5183b7544c477d96f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aryl Hydrocarbon Hydroxylases - genetics</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization - drug effects</topic><topic>Cardiac Catheterization - methods</topic><topic>Clopidogrel</topic><topic>Computer-Aided Design</topic><topic>Cytochrome P-450 CYP2C19</topic><topic>Decision Support Systems, Clinical</topic><topic>Genetic Variation</topic><topic>Genotyping Techniques - methods</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Patient Selection</topic><topic>Pharmacogenetics - methods</topic><topic>Pharmacogenetics - trends</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Precision Medicine - methods</topic><topic>Precision Medicine - trends</topic><topic>Ticlopidine - analogs & derivatives</topic><topic>Ticlopidine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pulley, J M</creatorcontrib><creatorcontrib>Denny, J C</creatorcontrib><creatorcontrib>Peterson, J F</creatorcontrib><creatorcontrib>Bernard, G R</creatorcontrib><creatorcontrib>Vnencak-Jones, C L</creatorcontrib><creatorcontrib>Ramirez, A H</creatorcontrib><creatorcontrib>Delaney, J T</creatorcontrib><creatorcontrib>Bowton, E</creatorcontrib><creatorcontrib>Brothers, K</creatorcontrib><creatorcontrib>Johnson, K</creatorcontrib><creatorcontrib>Crawford, D C</creatorcontrib><creatorcontrib>Schildcrout, J</creatorcontrib><creatorcontrib>Masys, D R</creatorcontrib><creatorcontrib>Dilks, H H</creatorcontrib><creatorcontrib>Wilke, R A</creatorcontrib><creatorcontrib>Clayton, E W</creatorcontrib><creatorcontrib>Shultz, E</creatorcontrib><creatorcontrib>Laposata, M</creatorcontrib><creatorcontrib>McPherson, J</creatorcontrib><creatorcontrib>Jirjis, J N</creatorcontrib><creatorcontrib>Roden, D M</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical pharmacology and therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pulley, J M</au><au>Denny, J C</au><au>Peterson, J F</au><au>Bernard, G R</au><au>Vnencak-Jones, C L</au><au>Ramirez, A H</au><au>Delaney, J T</au><au>Bowton, E</au><au>Brothers, K</au><au>Johnson, K</au><au>Crawford, D C</au><au>Schildcrout, J</au><au>Masys, D R</au><au>Dilks, H H</au><au>Wilke, R A</au><au>Clayton, E W</au><au>Shultz, E</au><au>Laposata, M</au><au>McPherson, J</au><au>Jirjis, J N</au><au>Roden, D M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Operational Implementation of Prospective Genotyping for Personalized Medicine: The Design of the Vanderbilt PREDICT Project</atitle><jtitle>Clinical pharmacology and therapeutics</jtitle><addtitle>Clinical Pharmacology & Therapeutics</addtitle><date>2012-07</date><risdate>2012</risdate><volume>92</volume><issue>1</issue><spage>87</spage><epage>95</epage><pages>87-95</pages><issn>0009-9236</issn><eissn>1532-6535</eissn><coden>CLPTAT</coden><notes>Supplementary Figure S1</notes><notes>ark:/67375/WNG-J9FZ2ZWW-0</notes><notes>istex:18D107DB999C69D2FCA5A26154FBEF9C4D187294</notes><notes>ArticleID:CPTCLPT2011371</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>Contributed equally</notes><abstract>The promise of “personalized medicine” guided by an understanding of each individual's genome has been fostered by increasingly powerful and economical methods to acquire clinically relevant information. We describe the operational implementation of prospective genotyping linked to an advanced clinical decision‐support system to guide individualized health care in a large academic health center. This approach to personalized medicine entails engagement between patient and health‐care provider, identification of relevant genetic variations for implementation, assay reliability, point‐of‐care decision support, and necessary institutional investments. In one year, approximately 3,000 patients, most of whom were scheduled for cardiac catheterization, were genotyped on a multiplexed platform that included genotyping for CYP2C19 variants that modulate response to the widely used antiplatelet drug clopidogrel. These data are deposited into the electronic medical record (EMR), and point‐of‐care decision support is deployed when clopidogrel is prescribed for those with variant genotypes. The establishment of programs such as this is a first step toward implementing and evaluating strategies for personalized medicine.
Clinical Pharmacology & Therapeutics (2012); 92 1, 87–95. doi:10.1038/clpt.2011.371</abstract><cop>Basingstoke</cop><pub>Blackwell Publishing Ltd</pub><pmid>22588608</pmid><doi>10.1038/clpt.2011.371</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Clinical pharmacology and therapeutics, 2012-07, Vol.92 (1), p.87-95 |
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| language | eng |
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| source | Wiley-Blackwell Journals |
| subjects | Aryl Hydrocarbon Hydroxylases - genetics Biological and medical sciences Cardiac Catheterization - drug effects Cardiac Catheterization - methods Clopidogrel Computer-Aided Design Cytochrome P-450 CYP2C19 Decision Support Systems, Clinical Genetic Variation Genotyping Techniques - methods Humans Medical sciences Patient Selection Pharmacogenetics - methods Pharmacogenetics - trends Pharmacology. Drug treatments Platelet Aggregation Inhibitors - therapeutic use Precision Medicine - methods Precision Medicine - trends Ticlopidine - analogs & derivatives Ticlopidine - therapeutic use |
| title | Operational Implementation of Prospective Genotyping for Personalized Medicine: The Design of the Vanderbilt PREDICT Project |
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