title: Implementing Algorithm-Guided Warfarin Dosing in an Ethnically Diverse Patient Population Using Electronic Health Records and Preemptive CYP2C9 and VKORC1 Genetic Testing.
abstract: Implementation of pharmacogenetic-guided warfarin dosing has been hindered by inconsistent results from reported clinical trials and a lack of available algorithms that include alleles prevalent in non-white populations. However, current evidence indicates that algorithm-guided dosing is more accurate than empirical dosing. To facilitate multiethnic algorithm-guided warfarin dosing using preemptive genetic testing, we developed a strategy that accounts for the complexity of race and leverages electronic health records for algorithm variables and deploying point-of-care dose recommendations.
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. aniwaa.owusu-obeng@mssm.edu.|Department of Pharmacy, Mount Sinai Medical Center, New York, New York, USA. aniwaa.owusu-obeng@mssm.edu.
authors.forename: A Owusu
authors.initials: AO
authors.lastname: Obeng
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kaszemacher
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Abul-Husn
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: O
authors.initials: O
authors.lastname: Gottesman
authors.affiliation: Mount Sinai Faculty Practice Associates Primary Care Program, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: A
authors.initials: A
authors.lastname: Vega
authors.affiliation: Mount Sinai Faculty Practice Associates Primary Care Program, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: E
authors.initials: E
authors.lastname: Waite
authors.affiliation: Information Technology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: K
authors.initials: K
authors.lastname: Myers
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Medicine, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: J
authors.initials: J
authors.lastname: Cho
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Berlin Institute of Health, Berlin, Germany.
authors.forename: E P
authors.initials: EP
authors.lastname: Bottinger
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Ellis
authors.affiliation: The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. stuart.scott@mssm.edu.|Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA. stuart.scott@mssm.edu.
authors.forename: S A
authors.initials: SA
authors.lastname: Scott
mesh_terms: D000465:Algorithms; D000925:Anticoagulants / Q000008:administration & dosage; D065729:Cytochrome P-450 CYP2C9 / Q000235:genetics*; D004305:Dose-Response Relationship, Drug; D054796:Drug Dosage Calculations; D057286:Electronic Health Records; D005006:Ethnicity; D005820:Genetic Testing; D006801:Humans; D010597:Pharmacogenetics / Q000379:methods; D011110:Polymorphism, Genetic; D064417:Vitamin K Epoxide Reductases / Q000235:genetics*; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D065729:Cytochrome P-450 CYP2C9; C578523:VKORC1 protein, human; D064417:Vitamin K Epoxide Reductases