title: A surveillance tool to support quality assurance and research in personalized medicine.
abstract: Developing effective methods to enable the practice of personalized medicine is a national priority for translational science. By leveraging modern genotyping technology and health information technologies, prescribing therapies based on genotype becomes an achievable goal. Within this manuscript, we describe the development, implementation, and piloting of a surveillance tool to assure the quality of clinical decision making in the context of new pharmacogenetic information. The surveillance tool allows a quality assurance (QA) team to review significant genotyping results and deliver focused educational interventions to providers. We report on the first eight patients undergoing genotyping to support antiplatelet therapy selection after drug-eluting stent placement. The collected pilot data supports an informatics approach to QA process management, as our tool delivered actionable patient information. It also enabled providers to tailor antiplatelet therapy to individual patients' genotypes. Our expectation is to continue collecting surveillance reports to perform an in-depth analysis of our tool.
authors.affiliation: Dept. of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Naqi A
authors.initials: NA
authors.lastname: Khan
authors.forename: Josh F
authors.initials: JF
authors.lastname: Peterson
mesh_terms: D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D035843:Biomedical Research; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D004360:Drug Therapy, Computer-Assisted; D054855:Drug-Eluting Stents; D005838:Genotype; D006801:Humans; D010597:Pharmacogenetics; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D057285:Precision Medicine; D011785:Quality Assurance, Health Care; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014584:User-Computer Interface
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine