title: Assessment of pharmacogenetic tests: presenting measures of clinical validity and potential population impact in association studies.
abstract: The progressing discovery of genetic variants associated with drug-related adverse events has raised expectations for pharmacogenetic tests to improve drug efficacy and safety. To further the use of pharmacogenetics in health care, tests with sufficient potential to improve efficacy and safety, as reflected by good clinical validity and population impact, need to be identified. The potential benefit of pharmacogenetic tests is often concluded from the strength of the association between the variant and the adverse event; measures of clinical validity are generally not reported. This paper describes measures of clinical validity and potential population health impact that can be calculated from association studies. We explain how these measures are influenced by the strength of the association and by the frequencies of the variant and the adverse event. The measures are illustrated using examples of testing for HLA-B*5701 associated with abacavir-induced hypersensitivity and SLCO1B1 c.521T>C (*5) associated with simvastatin-induced adverse events.
authors.affiliation: Department of Clinical Genetics/EMGO Institute for Health and Care Research, Section Community Genetics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: E C M
authors.initials: ECM
authors.lastname: Tonk
authors.affiliation: Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Gurwitz
authors.affiliation: Utrecht Institute of Pharmaceutical Sciences, Division of Pharmacoepidemiology &Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
authors.forename: A-H
authors.initials: AH
authors.lastname: Maitland-van der Zee
authors.affiliation: Department of Clinical Genetics/EMGO Institute for Health and Care Research, Section Community Genetics, VU University Medical Center, Amsterdam, The Netherlands.|Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: A C J W
authors.initials: ACJW
authors.lastname: Janssens
mesh_terms: D015224:Dideoxynucleosides / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000235:genetics; D064420:Drug-Related Side Effects and Adverse Reactions / Q000235:genetics*; D005820:Genetic Testing / Q000379:methods; D014644:Genetic Variation / Q000235:genetics; D015235:HLA-B Antigens / Q000235:genetics; D006801:Humans; D010597:Pharmacogenetics / Q000379:methods; D019821:Simvastatin / Q000009:adverse effects; D000099227:Abacavir
chemical_list: D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D019821:Simvastatin; D000099227:Abacavir