Clinical decision support or genetically guided personalized medicine: a systematic review
Genetically guided personalized medicine (GPM) is currently undergoing growing pains as does any new advancement in medicine or technology and more so when both come together. As technology in genetics advances, the demand for genetic information becomes greater. Among the 3,000 board certified geneticists, 1200 reside in the US. There are approximately 2,500 genetic tests available for clinical use, and as this number grows, it will become unreasonable to ask clinicians to remember every possible test. However, health information technology has the potential to overcome those problems and help create positive outcomes of GPM.
Research began by gathering articles from "1990-2011 using a search strategy adapted from previous systematic reviews of CDS and genetic health services" Articles had to meet inclusion criteria of the potential 3416 articles only 37 met full criteria and of those 37 majority were published on or after 2007. These articles focused on CDS systems for genetically guided cancer management and within those they did have more specific type of cancer i.e. breast, colon, and some focused on family history of cancer.
Researchers found that through this process, many CDS were stand alone and many also shifted to an integrated CDS system. Though CDS and GPM are still in their infancy, many are seeing the promise that the two have to offer. Only a few facilities have this integration, but they are seeing the positive impact; it has shown promise of growth, research, and many new findings.
If this is a growing field, I'm curious as to how both CDS and GPM come together to produce alerts, and how can this be done on a select patients. Does the system they are working with have the capability of being highly selective and only alert in that particular setting? Medicine and it's ever changing findings and discoveries never ceases to amaze me and I realize how much left there is to learn.
- Welch BM, Kawamoto K, 22August2012, Clinical decision support for genetically guided personalized medicine: a systematic review, J AM Med Inform Assoc,2013,29:388-400,http://jamia.oxfordjournals.org/content/20/2/388