Pharmacogenomics
Clinical Pharmacology & Therapeutics advance online publication 20 August 2014; doi: 10.1038/clpt.2014.137
Design and Anticipated Outcomes of the eMERGE-PGx Project: A Multicenter Pilot for Preemptive Pharmacogenomics in Electronic Health Record Systems
L J Rasmussen-Torvik1, S C Stallings2, A S Gordon3, B Almoguera4, M A Basford2, S J Bielinski5, A Brautbar6, M H Brilliant6, D S Carrell7, J J Connolly4, D R Crosslin3, K F Doheny8, C J Gallego9, O Gottesman10, D S Kim3, K A Leppig7, R Li11, S Lin12, S Manzi13, A R Mejia10, J A Pacheco14, V Pan14, J Pathak15, C L Perry13, J F Peterson16, C A Prows17,23, J Ralston7, L V Rasmussen1, M D Ritchie18, S Sadhasivam19,20, S A Scott21, M Smith14, A Vega22, A A Vinks20,23, S Volpi11, W A Wolf13,24, E Bottinger10, R L Chisholm14, C G Chute25, J L Haines26, J B Harley20,27,28, B Keating4, I A Holm13,24,29, I J Kullo30, G P Jarvik9, E B Larson7, T Manolio11, C A McCarty31, D A Nickerson3, S E Scherer32, M S Williams33, D M Roden34,35 and J C Denny16,35
- 1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- 2Vanderbilt Institute for Clinical and Translational Research, Nashville, Tennessee, USA
- 3Department of Genome Sciences, University of Washington, Seattle, Washington, USA
- 4Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- 5Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- 6Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA
- 7Group Health Research Institute, Seattle, Washington, USA
- 8Center for Inherited Disease Research, Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- 9Division of Medical Genetics, University of Washington, Seattle, Washington, USA
- 10The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- 11Division of Genomic Medicine, National Human Genome Research Institute, Bethesda, Maryland, USA
- 12Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA
- 13Division of Genetics and Genomics, Boston Children’s Hospital, Boston, Massachusetts, USA
- 14Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- 15Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- 16Department of Biomedical Informatics and Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- 17Division Human Genetics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- 18Department of Biochemistry and Molecular Biology, The Pennsylvania State University, State College, Pennsylvania, USA
- 19Department of Anesthesia, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- 20Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- 21Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- 22Mount Sinai Faculty Practice Associates Primary Care Program, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- 23Division of Clinical Pharmacology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- 24Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- 25Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- 26Center for Human Genetics Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- 27Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
- 28US Department of Veterans Affairs Medical Center, Cincinnati, Ohio, USA
- 29The Manton Center for Orphan Disease Research, Boston Children’s Hospital, Boston, Massachusetts, USA
- 30Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
- 31Essentia Institute of Rural Health, Duluth, Minnesota, USA
- 32Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
- 33Genomic Medicine Institute, Geisinger Health System, Danville, Pennsylvania, USA
- 34Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- 35Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
Correspondence: L J Rasmussen-Torvik, (ljrtorvik@northwestern.edu)
Received 28 February 2014; Accepted 13 June 2014
Accepted article preview online 24 June 2014; Advance online publication 20 August 2014
Accepted article preview online 24 June 2014; Advance online publication 20 August 2014
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Abstract
We describe here the design and initial implementation of the eMERGE-PGx project. eMERGE-PGx, a partnership of the Electronic Medical Records and Genomics Network and the Pharmacogenomics Research Network, has three objectives: (i) to deploy PGRNseq, a next-generation sequencing platform assessing sequence variation in 84 proposed pharmacogenes, in nearly 9,000 patients likely to be prescribed drugs of interest in a 1- to 3-year time frame across several clinical sites; (ii) to integrate well-established clinically validated pharmacogenetic genotypes into the electronic health record with associated clinical decision support and to assess process and clinical outcomes of implementation; and (iii) to develop a repository of pharmacogenetic variants of unknown significance linked to a repository of electronic health record–based clinical phenotype data for ongoing pharmacogenomics discovery. We describe site-specific project implementation and anticipated products, including genetic variant and phenotype data repositories, novel variant association studies, clinical decision support modules, clinical and process outcomes, approaches to managing incidental findings, and patient and clinician education methods.
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