title: Clinical decision support for genetically guided personalized medicine: a systematic review.
abstract: OBJECTIVE
  To review the literature on clinical decision support (CDS) for genetically guided personalized medicine (GPM).
  
  
  METHODS
  MEDLINE and Embase were searched from 1990 to 2011. The manuscripts included were summarized, and notable themes and trends were identified.
  
  
  RESULTS
  Following a screening of 3416 articles, 38 primary research articles were identified. Focal areas of research included family history-driven CDS, cancer management, and pharmacogenomics. Nine randomized controlled trials of CDS interventions for GPM were identified, seven of which reported positive results. The majority of manuscripts were published on or after 2007, with increased recent focus on genotype-driven CDS and the integration of CDS within primary clinical information systems.
  
  
  CONCLUSIONS
  Substantial research has been conducted to date on the use of CDS to enable GPM. In a previous analysis of CDS intervention trials, the automatic provision of CDS as a part of routine clinical workflow had been identified as being critical for CDS effectiveness. There was some indication that CDS for GPM could potentially be effective without the CDS being provided automatically, but we did not find conclusive evidence to support this hypothesis.
  
  
  CONCLUSIONS
  To maximize the clinical benefits arising from ongoing discoveries in genetics and genomics, additional research and development is recommended for identifying how best to leverage CDS to bridge the gap between the promise and realization of GPM.
authors.affiliation: Department of Biomedical Informatics and Program in Personalized Health Care, University of Utah, Salt Lake City, UT 84092, USA.
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Welch
authors.forename: Kensaku
authors.initials: K
authors.lastname: Kawamoto
mesh_terms: D015706:Bibliometrics; D035843:Biomedical Research / Q000639:trends; D020000:Decision Support Systems, Clinical / Q000639:trends; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D010597:Pharmacogenetics; D057285:Precision Medicine / Q000639:trends