Scoping Review Maps Current State of Pharmacogenomic Clinical Decision Support
This scoping review aggregated data from 15 institutions implementing pharmacogenomic clinical decision support, finding that interruptive post-test alerts were the most common tool but with widely variable effectiveness (clinical response 12-73%). Most programmes operated at academic medical centres, revealing a gap in community and primary care settings. The findings underscore the need for standardised CDS design, usability testing, and outcome tracking as labs scale up pharmacogenomic reporting.
The original study
Pharmacogenomic Clinical Decision Support: A Scoping Review.
- Authors
- Smith DM, Wake DT, Dunnenberger HM
- Journal
- Clinical pharmacology and therapeutics
- Type
- Journal Article, Research Support, Non-U.S. Gov't, Scoping Review
- PMID
- 35838358
Original abstract
Clinical decision support (CDS) is often cited as an essential part of pharmacogenomics (PGx) implementations. A multitude of strategies are available; however, it is unclear which strategies are effective and which metrics are used to quantify clinical utility. The objective of this scoping review was to aggregate previous studies into a cohesive depiction of the current state of PGx CDS implementations and identify areas for future research on PGx CDS. Articles were included if they (i) described electronic CDS tools for PGx and (ii) reported metrics related to PGx CDS. Twenty of 3,449 articles were included and provided data on PGx CDS metrics from 15 institutions, with 93% of programs located at academic medical centers. The most common tools in CDS implementations were interruptive post-test alerts. Metrics for clinical response and alert response ranged from 12-73% and 21-98%, respectively. Few data were found on changes in metrics over time and measures that drove the evolution of CDS systems. Relatively few data were available regarding support of optimal approaches for PGx CDS. Post-test alerts were the most widely studied approach, and their effectiveness varied greatly. Further research on the usability, effectiveness, and optimization of CDS tools is needed.