A5058248149- Pharmacogenetics and Drug Metabolism
- Health Systems, Economic Evaluations, Quality of Life
- Antiplatelet Therapy and Cardiovascular Diseases
- Pharmaceutical studies and practices
- Cancer Genomics and Diagnostics
- Pharmaceutical Economics and Policy
- Cardiac, Anesthesia and Surgical Outcomes
- Lung Cancer Treatments and Mutations
- Hemoglobinopathies and Related Disorders
- Ethics in Clinical Research
- Sodium Intake and Health
- Nutrition, Genetics, and Disease
- BRCA gene mutations in cancer
- Hormonal Regulation and Hypertension
- Monoclonal and Polyclonal Antibodies Research
- Lipoproteins and Cardiovascular Health
- Health Policy Implementation Science
- Coronary Interventions and Diagnostics
- Parvovirus B19 Infection Studies
- Bioeconomy and Sustainability Development
- Acute Myocardial Infarction Research
- Atherosclerosis and Cardiovascular Diseases
- Radiomics and Machine Learning in Medical Imaging
- Biotin and Related Studies
- Clinical Nutrition and Gastroenterology
RTI Health Solutions
2023-2024
Duke University
2019-2022
Durham VA Health Care System
2021-2022
Durham VA Medical Center
2021
University of North Carolina at Chapel Hill
2016-2019
PharmacoGenetics (China)
2018
To evaluate medical policy determinations for pharmacogenetic (PGx) testing 65 clinically relevant drug-gene pairs and evidence cited to support across major US health plans laboratory benefit managers (LBMs). Landscape analysis of available PGx policies determine coverage status certain pairs. as February 1, 2024, were ascertained through Policy Reporter top national insurers, LBMs, the Palmetto GBA Molecular Diagnostic Services (MolDX) Program, which determines whether a molecular...
Determine whether using CYP2C19 genotype to optimize antiplatelet therapy selection is cost effective over the initial 30 days and 1-year following percutaneous coronary intervention.A cost-effectiveness analysis compared 30-day outcomes across three treatment strategies (universal clopidogrel, universal prasugrel, genotype-guided) in a hypothetical cohort.Base-case scenario results at indicated that incremental per major cardiovascular or bleeding event avoided for genotype-guided was...
ObjectiveTo evaluate the cost-effectiveness of multigene testing (CYP2C19, SLCO1B1, CYP2C9, VKORC1) compared with single-gene (CYP2C19) and standard care (no genotyping) in acute coronary syndrome (ACS) patients undergoing percutaneous intervention (PCI) from Medicare's perspective.MethodsA hybrid decision tree/Markov model was developed to simulate post-PCI for ACS requiring antiplatelet therapy (CYP2C19 guide selection), statin (SLCO1B1 anticoagulant those that develop atrial fibrillation...
The complexity of genomic medicine can be streamlined by implementing some form clinical decision support (CDS) to guide clinicians in how use and interpret personalized data; however, it is not yet clear which strategies are best suited for this purpose. In study, we used implementation science identify common applying provider-based CDS interventions across six research projects funded an NIH consortium. Each project's were elicited via a structured survey derived from typology strategies,...
Pharmacogenomics provides a personalized approach to pharmacotherapy by using genetic information guide drug dosing and selection. However, partly due lack of education, pharmacogenomic testing has not been fully implemented in clinical practice. With training patient accessibility, pharmacists are ideally suited apply pharmacogenomics care. Student (n = 222) participated an educational intervention that included voluntary personal genotyping 23andMe. Of these, 31% students completed both...
Gene therapies for sickle cell disease (SCD) may offer meaningful benefits patients and society. This study evaluated the cost-effectiveness of lovotibeglogene autotemcel (lovo-cel), a one-time gene therapy administered via autologous hematopoietic stem transplantation, compared with common care in United States (US) SCD aged ≥ 12 years 4 vaso-occlusive events (VOEs) past 24 months. We developed patient-level simulation model accounting lovo-cel SCD-related events, complications, mortality...
Aim: To determine the projected impact of a multigene pharmacogenetic (PGx) test on medication prescribing. Materials & methods: A retrospective analysis was conducted with 122 cardiac catheterization laboratory patients undergoing angiography for eligibility potential PGx-guided interventions that could have occurred if PGx information pre-emptively available at time procedure. Medication data and presence actionable at-risk genotypes were used to intervention. Results: 20% study population...
CYP2C19-guided P2Y12 inhibitor selection can reduce cardiovascular (CV) events and bleeding in patients with acute coronary syndromes (ACSs) post-percutaneous intervention (PCI). The 12-month cost-effectiveness of for Veterans post-ACS/PCI was evaluated from the Health Administration's (VHA) perspective. Using average annualized PCI volumes use VA data, a decision-analytic model simulated CYP2C19 testing vs. no outcomes 2800 hypothetical receiving PY212 12 months (74% clopidogrel, 5%...
Aim: The first Plan-Do-Study-Act cycle for the Veterans Affairs Pharmacogenomic Testing pharmacogenomic clinical testing program is described. Materials & methods: Surveys evaluating implementation resources and processes were distributed to teams, providers, laboratory health informatics staff. Survey responses mapped Consolidated Framework Implementation Research constructs identify barriers. Expert Recommendation Implementing Change strategies used address Results: response rate was...
The incorporation of precision medicine into the clinical setting is becoming increasingly feasible with availability more affordable genetic sequencing technologies and successful associations phenotypes, especially in pharmacogenomic field. Although substantial progress has been made to ensure uptake testing already, many challenges still remain for sustainable implementation. importance information patient care, identifying key barriers, proposed solutions advancing implementation will be...
Aim: This study assesses the technical performance and cost of a targeted next-generation sequencing (NGS) multigene pharmacogenetic (PGx) test. Materials & methods: A genetic test was developed for 21 PGx genes using molecular inversion probes to generate library fragments NGS. Performance this assessed 53 unique reference control cell lines from Genetic Testing Reference Coordination Program (GeT-RM). Results: 93.7% variants were successfully called repeatability rate 99.9%. calls...
There is a well-validated association between SLCO1B1 (rs4149056) and statin-associated muscle symptoms (SAMS). Preemptive pharmacogenetic (PGx) testing may diminish the incidence of SAMS by identifying individuals with increased genetic risk before statin initiation. Despite its potential clinical application, cost implications are largely unknown. We conducted cost-consequence analysis preemptive (PGx+) versus usual care (PGx-) among Veteran patients enrolled in Integrating...
Currently, there is sufficient evidence for the use of pharmacogenetic information to optimize medication prescribing, but why has this not been integrated into drug prescribing process improve patient care? A discussion about major contributing factors that have limited in process, solutions ensure widespread uptake, and a vision future field will be explored.
7075 Background: Tumor profiling identifies patients who are eligible for targeted anticancer therapies. Common tumor approaches include gene panel testing (TGPT), which tests common mutations in select genes, and multigene sequencing (MGPS), a broad range of comprehensive set genes. Our objective was to determine the lifetime cost-effectiveness MGPS TGPT compared no Veterans with metastatic lung adenocarcinoma from Health Administration’s (VHA) perspective. Methods: A decision analytic...
Both very low choline intake and intense exercise in healthy men can trigger peak muscle soreness a few days later rise of creatine kinase (CK) activity peripheral blood indicating damage. We wanted to know whether susceptible exercise‐induced damage have lower dietary than with more robust muscles their heightened fragility is associated lean body mass. investigated 58 Caucasian the increase CK three after 12 eccentric elbow flexors (Biodex 4, Biodex Medical Systems Inc., Shirley, NY)...