Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 6;17(1):81.
doi: 10.1186/s12911-017-0480-y.

Integrating clinical decision support systems for pharmacogenomic testing into clinical routine - a scoping review of designs of user-system interactions in recent system development

Marc Hinderer  1 , Martin Boeker  2 , Sebastian A Wagner  3 , Martin Lablans  4 , Stephanie Newe  5 , Jan L Hülsemann  6 , Michael Neumaier  7 , Harald Binder  8 , Harald Renz  9 , Till Acker  10 , Hans-Ulrich Prokosch  5 , Martin Sedlmayr  5
Affiliations

Integrating clinical decision support systems for pharmacogenomic testing into clinical routine - a scoping review of designs of user-system interactions in recent system development

Marc Hinderer et al. BMC Med Inform Decis Mak. .

Abstract

Background: Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS.

Methods: We searched PubMed for pharmacogenomic CDSS published between January 1, 2012 and November 15, 2016. Thirty-two out of 118 identified articles were summarized and included in the final analysis. We then compared the designs of user-system interactions of the 20 pharmacogenomic CDSS we had identified.

Results: Alerts are the most widespread tools for physician-system interactions, but need to be implemented carefully to prevent alert fatigue and avoid liabilities. Pharmacogenomic test results and override reasons stored in the local EHR might help communicate pharmacogenomic information to other internal care providers. Integrating patients into user-system interactions through patient letters and online portals might be crucial for transferring pharmacogenomic data to external health care providers. Inbox messages inform physicians about new pharmacogenomic test results and enable them to request pharmacogenomic consultations. Search engines enable physicians to compare medical treatment options based on a patient's genotype.

Conclusions: Within the last 5 years, several pharmacogenomic CDSS have been developed. However, most of the included articles are solely describing prototypes of pharmacogenomic CDSS rather than evaluating them. To support the development of prototypes further evaluation efforts will be necessary. In the future, pharmacogenomic CDSS will likely include prediction models to identify patients who are suitable for preemptive genotyping.

Keywords: Clinical decision support; Developments; Pharmacogenomic; Precision medicine; User-system interaction.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
PubMed search and process of article selection. CDSS: clinical decision support system
See this image and copyright information in PMC

References

    1. Stanek EJ, Sanders CL, Taber KA, et al. Adoption of Pharmacogenomic Testing by US Physicians: Results of a Nationwide Survey. Clin Pharmacol Ther. 2012;91(3):450–8. doi: 10.1038/clpt.2011.306. - DOI - PubMed
    1. Weinshilboum R. Inheritance and drug response. N Engl J Med. 2003;348(6):529–37. doi: 10.1056/NEJMra020021. - DOI - PubMed
    1. The Royal Society. Personalised medicines: hopes and realities. R Soc. 2005;52.
    1. Caudle KE, Klein TE, Hoffman JM, et al. Incorporation of pharmacogenomics into routine clinical practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process. Curr Drug Metab. 2014;15(2):209–17. doi: 10.2174/1389200215666140130124910. - DOI - PMC - PubMed
    1. Swen JJ, Nijenhuis M, de Boer A, et al. Pharmacogenetics: From Bench to Byte-An Update of Guidelines. Clin Pharmacol Ther. 2011;89(5):662–73. doi: 10.1038/clpt.2011.34. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources