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Kanegusuku ALG, Chan CW, O'Donnell PH, Yeo KTJ. Implementation of pharmacogenomics testing for precision medicine. Crit Rev Clin Lab Sci 2024; 61:89-106. [PMID: 37776898 DOI: 10.1080/10408363.2023.2255279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/31/2023] [Indexed: 10/02/2023]
Abstract
Great strides have been made in the past decade to lower barriers to clinical pharmacogenomics implementation. Nevertheless, PGx consultation prior to prescribing therapeutics is not yet mainstream. This review addresses the current climate surrounding PGx implementation, focusing primarily on strategies for implementation at academic institutions, particularly at The University of Chicago, and provides an up-to-date guide of resources supporting the development of PGx programs. Remaining challenges and recent strategies for overcoming these challenges to implementation are discussed.
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Affiliation(s)
| | - Clarence W Chan
- Departments of Pathology, The University of Chicago, Chicago, IL, USA
| | - Peter H O'Donnell
- Department of Medicine, The University of Chicago, Chicago, IL, USA
- Center for Personalized Therapeutics, The University of Chicago, Chicago, IL, USA
| | - Kiang-Teck J Yeo
- Departments of Pathology, The University of Chicago, Chicago, IL, USA
- Center for Personalized Therapeutics, The University of Chicago, Chicago, IL, USA
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Murry LT, Hillman LA, Allen JD, Bishop JR. Intersection and Considerations for Patient-Centered Care, Patient Experience, and Medication Experience in Pharmacogenomics. PHARMACY 2023; 11:146. [PMID: 37736918 PMCID: PMC10514786 DOI: 10.3390/pharmacy11050146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
As healthcare continues to embrace the concept of person- and patient-centered care, pharmacogenomics, patient experience, and medication experience will continue to play an increasingly important role in care delivery. This review highlights the intersection between these concepts and provides considerations for patient-centered medication and pharmacogenomic experiences. Elements at the patient, provider, and system level can be considered in the discussion, supporting the use of pharmacogenomics, with components of the patient and medication experience contributing to the mitigation of barriers surrounding patient use and the valuation of pharmacogenomic testing.
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Affiliation(s)
- Logan T. Murry
- College of Pharmacy, The University of Iowa, Iowa City, IA 52242, USA
| | - Lisa A. Hillman
- College of Pharmacy, The University of Minnesota, Minneapolis, MN 55455, USA; (L.A.H.); or (J.D.A.); (J.R.B.)
| | - Josiah D. Allen
- College of Pharmacy, The University of Minnesota, Minneapolis, MN 55455, USA; (L.A.H.); or (J.D.A.); (J.R.B.)
- Department of Pharmacy, St. Elizabeth Healthcare, Edgewood, KY 41017, USA
| | - Jeffrey R. Bishop
- College of Pharmacy, The University of Minnesota, Minneapolis, MN 55455, USA; (L.A.H.); or (J.D.A.); (J.R.B.)
- Medical School, The University of Minnesota, Minneapolis, MN 55455, USA
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A Theory-Informed Systematic Review of Barriers and Enablers to Implementing Multi-Drug Pharmacogenomic Testing. J Pers Med 2022; 12:jpm12111821. [PMID: 36579514 PMCID: PMC9696651 DOI: 10.3390/jpm12111821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
PGx testing requires a complex set of activities undertaken by practitioners and patients, resulting in varying implementation success. This systematic review aimed (PROSPERO: CRD42019150940) to identify barriers and enablers to practitioners and patients implementing pharmacogenomic testing. We followed PRISMA guidelines to conduct and report this review. Medline, EMBASE, CINAHL, PsycINFO, and PubMed Central were systematically searched from inception to June 2022. The theoretical domain framework (TDF) guided the organisation and reporting of barriers or enablers relating to pharmacogenomic testing activities. From the twenty-five eligible reports, eleven activities were described relating to four implementation stages: ordering, facilitating, interpreting, and applying pharmacogenomic testing. Four themes were identified across the implementation stages: IT infrastructure, effort, rewards, and unknown territory. Barriers were most consistently mapped to TDF domains: memory, attention and decision-making processes, environmental context and resources, and belief about consequences.
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Truong TM, Apfelbaum JL, Schierer E, Danahey K, Borden BA, Karrison T, Shahul S, Anitescu M, Gerlach R, Knoebel RW, Meltzer DO, Ratain MJ, O’Donnell PH. Anesthesia providers as stakeholders to adoption of pharmacogenomic information in perioperative care. Pharmacogenet Genomics 2022; 32:79-86. [PMID: 34570085 PMCID: PMC8940738 DOI: 10.1097/fpc.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Integration of pharmacogenomics into clinical care is being studied in multiple disciplines. We hypothesized that understanding attitudes and perceptions of anesthesiologists, critical care and pain medicine providers would uncover unique considerations for future implementation within perioperative care. METHODS A survey (multiple choice and Likert-scale) was administered to providers within our Department of Anesthesia and Critical Care prior to initiation of a department-wide prospective pharmacogenomics implementation program. The survey addressed knowledge, perceptions, experiences, resources and barriers. RESULTS Of 153 providers contacted, 149 (97%) completed the survey. Almost all providers (92%) said that genetic results influence drug therapy, and few (22%) were skeptical about the usefulness of pharmacogenomics. Despite this enthusiasm, 87% said their awareness about pharmacogenomic information is lacking. Feeling well-informed about pharmacogenomics was directly related to years in practice/experience: only 38% of trainees reported being well-informed, compared to 46% of those with 1-10 years of experience, and nearly two-thirds with 11+ years (P < 0.05). Regarding barriers, providers reported uncertainty about availability of testing, turnaround time and whether testing is worth financial costs. CONCLUSIONS Anesthesiology, critical care and pain medicine providers are optimistic about the potential clinical utility of pharmacogenomics, but are uncertain about practical aspects of testing and desire clear guidelines on the use of results. These findings may inform future institutional efforts toward greater integration of genomic results to improve medication-related outcomes.
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Affiliation(s)
- Tien M. Truong
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
- Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, IL, USA
| | - Jeffrey L. Apfelbaum
- Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, IL, USA
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA
| | - Emily Schierer
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
| | - Keith Danahey
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
- Center for Research Informatics, University of Chicago, Chicago, IL, USA
| | - Brittany A. Borden
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
| | - Theodore Karrison
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Sajid Shahul
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA
| | - Magdalena Anitescu
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA
| | - Rebecca Gerlach
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA
| | - Randall W. Knoebel
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
- Department of Pharmacy, University of Chicago, Chicago, IL, USA
| | | | - Mark J. Ratain
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
- Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, IL, USA
| | - Peter H. O’Donnell
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Center for Personalized Therapeutics, University of Chicago, Chicago, IL, USA
- Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, IL, USA
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Underrepresented patient views and perceptions of personalized medication treatment through pharmacogenomics. NPJ Genom Med 2021; 6:90. [PMID: 34725343 PMCID: PMC8560901 DOI: 10.1038/s41525-021-00253-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
Within an institutional pharmacogenomics implementation program, we surveyed 463 outpatients completing preemptive pharmacogenomic testing whose genetic results were available to providers for guiding medication treatment. We compared views and experiences from self-reported White and Black patients, including education level as a covariate across analyses. Black patients were less confident about whether their providers made personalized treatment decisions, and overwhelmingly wanted a greater role for their genetic information in clinical care. Both groups similarly reported that providers asked their opinions regarding medication changes, but White patients were more likely (59% vs. 49%, P = 0.005) to discuss the impact of personal/genetic makeup on medication response with providers, and Black patients reported initiating such discussions much less frequently (4% vs. 15%, P = 0.037). Opportunities exist for enhanced communication with underrepresented patients around personalized care. Tailored communication strategies and development of support tools employed in diverse healthcare settings may facilitate pharmacogenomically guided medication treatment that equitably benefits minority patient populations.
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Ayati N, Afzali M, Hasanzad M, Kebriaeezadeh A, Rajabzadeh A, Nikfar S. Pharmacogenomics Implementation and Hurdles to Overcome; In the Context of a Developing Country. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2021; 20:92-106. [PMID: 35194431 PMCID: PMC8842599 DOI: 10.22037/ijpr.2021.114899.15091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Having multiple dimensions, uncertainties and several stakeholders, the costly pharmacogenomics (PGx) is associated with dynamic implementation complexities. Identification of these challenges is critical to harness its full potential, especially in developing countries with fragile healthcare systems and scarce resources. This is the first study aimed to identify most salient challenges related to PGx implementation, with respect to the experiences of early-adopters and local experts' prospects, in the context of a developing country in the Middle East. To perform a comprehensive reconnaissance on PGx adoption challenges a scoping literature review was conducted based on national drug policy components: efficacy/safety, access, affordability and rational use of medicine (RUM). Strategic option development and analysis workshop method with cognitive mapping as the technique was used to evaluate challenges in the context of Iran. The cognitive maps were face-validated and analyzed via Decision Explorer XML. The findings indicated a complex network of issues relative to PGx adoption, categorized in national drug policy indicators. In the rational use of medicine category, ethics, education, bench -to- bedside strategies, guidelines, compliance, and health system issues were found. Clinical trial issues, test's utility, and biomarker validation were identified in the efficacy group. Affordability included pricing, reimbursement, and value assessment issues. Finally, access category included regulation, availability, and stakeholder management challenges. The current study identified the most significant challenges ahead of clinical implementation of PGx in a developing country. This could be the basis of a policy-note development in future work, which may consolidate vital communication among stakeholders and accelerate the efficient implementation in developing new-comer countries.
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Affiliation(s)
- Nayyereh Ayati
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Monireh Afzali
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Mandana Hasanzad
- Medical Genomics Research Center, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. ,Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Kebriaeezadeh
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran. ,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Ali Rajabzadeh
- Department of Department of Industrial Management, Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran.
| | - Shekoufeh Nikfar
- Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran. ,Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. ,Corresponding author: E-mail:
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Christian C, Borden BA, Danahey K, Yeo KTJ, van Wijk XM, Ratain MJ, O’Donnell PH. Pharmacogenomic-Based Decision Support to Predict Adherence to Medications. Clin Pharmacol Ther 2020; 108:368-376. [PMID: 32236960 PMCID: PMC7363565 DOI: 10.1002/cpt.1838] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 03/13/2020] [Indexed: 02/03/2023]
Abstract
Poor adherence is associated with worse disease outcomes. Pharmacogenomics provides a possible intervention to address adherence. We hypothesized that pharmacogenomic-informed care could increase adherence. Patients in a prospective case-control study underwent preemptive pharmacogenomic genotyping with results available for provider use at the point of care; controls (not genotyped) were treated by the same providers. Over 6,000 e-prescriptions for 39 medications with actionable pharmacogenomic information were analyzed. Composite adherence, measured by modified proportion of days covered (mPDC), was compared between cases/controls and genomically concordant vs. genomically higher-risk medications. Overall, 536 patients were included. No difference in mean mPDC was observed due to availability of pharmacogenomic guidance. However, case patients prescribed high-risk pharmacogenomic medications were more than twice as likely to have low mPDC for these medications compared with genomically concordant prescriptions (odds ratio = 2.4 (1.03-5.74), P < 0.05). This study is the first to show that composite pharmacogenomic information predicts adherence.
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Affiliation(s)
- Carlton Christian
- The University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Brittany A. Borden
- The University of Chicago Center for Personalized Therapeutics, Chicago, IL, USA
| | - Keith Danahey
- The University of Chicago Center for Personalized Therapeutics, Chicago, IL, USA
- The University of Chicago Center for Research Informatics, Chicago, IL, USA
| | - Kiang-Teck J. Yeo
- The University of Chicago Center for Personalized Therapeutics, Chicago, IL, USA
- The University of Chicago Department of Pathology, Chicago, IL, USA
- UChicago Advanced Technology Clinical Laboratory, Chicago, IL, USA
- The University of Chicago Committee on Clinical Pharmacology and Pharmacogenomics, Chicago, IL, USA
| | - Xander M.R. van Wijk
- The University of Chicago Department of Pathology, Chicago, IL, USA
- UChicago Advanced Technology Clinical Laboratory, Chicago, IL, USA
| | - Mark J. Ratain
- The University of Chicago Center for Personalized Therapeutics, Chicago, IL, USA
- The University of Chicago Committee on Clinical Pharmacology and Pharmacogenomics, Chicago, IL, USA
- The University of Chicago Department of Medicine, Chicago, IL, USA
| | - Peter H. O’Donnell
- The University of Chicago Center for Personalized Therapeutics, Chicago, IL, USA
- The University of Chicago Committee on Clinical Pharmacology and Pharmacogenomics, Chicago, IL, USA
- The University of Chicago Department of Medicine, Chicago, IL, USA
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L Rogers S, Keeling NJ, Giri J, Gonzaludo N, Jones JS, Glogowski E, Formea CM. PARC report: a health-systems focus on reimbursement and patient access to pharmacogenomics testing. Pharmacogenomics 2020; 21:785-796. [DOI: 10.2217/pgs-2019-0192] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Pharmacogenomics test coverage and reimbursement are major obstacles to clinical uptake. Several early adopter programs have been successfully initiated through dedicated investments by federal and institutional research funding. As a result of research endeavors, evidence has grown sufficiently to support development of pharmacogenomics guidelines. However, clinical uptake is still limited. Third-party payer support plays an important role in increasing adoption, which to date has been limited to reactive single-gene testing. Access to and interest in direct-to-consumer genetic testing are driving demand for increasing healthcare providers and third-party awareness of this burgeoning field. Pharmacogenomics implementation models developed by early adopters promise to expand patient access and options, as testing continues to increase due to growing consumer interest and falling test prices.
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Affiliation(s)
- Sara L Rogers
- American Society of Pharmacovigilance, PO Box 20433, Houston, TX 77225, USA
| | - Nicholas J Keeling
- Department of Pharmacy Administration, The University of Mississippi School of Pharmacy, 223 Faser Hall, MS 38677, USA
| | - Jyothsna Giri
- Center for Individualized Medicine, Mayo Clinic, 200 First Street SW, MN 55905, USA
| | - Nina Gonzaludo
- Illumina, Inc., 200 Lincoln Centre Drive, Foster City, CA 94404, USA
| | - J Shawn Jones
- Texas Tech University Health Sciences Center, Jerry H. Hodge School of Pharmacy, 5920 Forest Park Rd, Suite 500, Dallas, TX 75235, USA
| | | | - Christine M Formea
- Center for Individualized Medicine, Mayo Clinic, 200 First Street SW, MN 55905, USA
- Department of Pharmacy Services & Intermountain Precision Genomics, Intermountain Healthcare Pharmacy Services, 4393 S. Riverboat Road, Taylorsville, UT 84123, USA
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van der Wouden CH, Paasman E, Teichert M, Crone MR, Guchelaar HJ, Swen JJ. Assessing the Implementation of Pharmacogenomic Panel-Testing in Primary Care in the Netherlands Utilizing a Theoretical Framework. J Clin Med 2020; 9:jcm9030814. [PMID: 32192029 PMCID: PMC7141350 DOI: 10.3390/jcm9030814] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022] Open
Abstract
Despite overcoming many implementation barriers, pharmacogenomic (PGx) panel-testing is not routine practice in the Netherlands. Therefore, we aim to study pharmacists' perceived enablers and barriers for PGx panel-testing among pharmacists participating in a PGx implementation study. Here, pharmacists identify primary care patients, initiating one of 39 drugs with a Dutch Pharmacogenetic Working Group (DPWG) recommendation and subsequently utilizing the results of a 12 gene PGx panel test to guide dose and drug selection. Pharmacists were invited for a general survey and a semi-structured interview based on the Tailored Implementation for Chronic Diseases (TICD) framework, aiming to identify implementation enablers and barriers, if they had managed at least two patients with actionable PGx results. In total, 15 semi-structured interviews were performed before saturation point was reached. Of these, five barrier themes emerged: (1) unclear procedures, (2) undetermined reimbursement for PGx test and consult, (3) insufficient evidence of clinical utility for PGx panel-testing, (4) infrastructure inefficiencies, and (5) HCP PGx knowledge and awareness; and two enabler themes: (1) pharmacist perceived role in delivering PGx, and (2) believed clinical utility of PGx. Despite a strong belief in the beneficial effects of PGx, pharmacists' barriers remain, an these hinder implementation in primary care.
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Affiliation(s)
- Cathelijne H. van der Wouden
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Leiden Network for Personalised Therapeutics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Ellen Paasman
- Community Pharmacy De Klipper, 2692 AH ‘s Gravenzande, The Netherlands
| | - Martina Teichert
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Matty R. Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Leiden Network for Personalised Therapeutics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Jesse J. Swen
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Leiden Network for Personalised Therapeutics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence: ; Tel.: +31-(0)71-526-2790
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Truong TM, Lipschultz E, Danahey K, Schierer E, Ratain MJ, O'Donnell PH. Assessment of Patient Knowledge and Perceptions of Pharmacogenomics Before and After Using a Mock Results Patient Web Portal. Clin Transl Sci 2020; 13:78-87. [PMID: 31490020 PMCID: PMC6951853 DOI: 10.1111/cts.12681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/03/2019] [Indexed: 01/28/2023] Open
Abstract
Our objective was to build a mock pharmacogenomic (PGx) patient portal and assess its ability to disseminate test results and information to patients. The YourPGx Portal delivered four sample PGx results (omeprazole, simvastatin, clopidogrel, and codeine). We hosted two study groups to assess patient knowledge and perceptions of PGx before and after accessing the portal. Ten PGx-tested and 10 traditional care participants were included (average 61 years, 60% women, 50% African American, and 55% had a bachelor's/advanced degree). Participants scored significantly higher on the post-test compared with the pre-test, with no significant differences between baseline scores or score change between the groups. Patient perceptions also improved after accessing the portal-more patients wanted their providers to have access to test results, and more patients would encourage family/friends to get PGx testing. Patients would share their test results with their healthcare providers, spouse/partner, and family; none would share results with their friends or social media. Almost all patients (95%) said the portal was easy to use and 65% said it was easy to understand. In this pilot study, patients' knowledge and perceptions of PGx improved after accessing the YourPGx Portal.
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Affiliation(s)
- Tien M. Truong
- Committee on Clinical Pharmacology and PharmacogenomicsThe University of ChicagoChicagoIllinoisUSA
- Center for Personalized TherapeuticsThe University of ChicagoChicagoIllinoisUSA
| | - Elizabeth Lipschultz
- Center for Personalized TherapeuticsThe University of ChicagoChicagoIllinoisUSA
- Center for Research InformaticsThe University of ChicagoChicagoIllinoisUSA
| | - Keith Danahey
- Center for Personalized TherapeuticsThe University of ChicagoChicagoIllinoisUSA
- Center for Research InformaticsThe University of ChicagoChicagoIllinoisUSA
| | - Emily Schierer
- Center for Personalized TherapeuticsThe University of ChicagoChicagoIllinoisUSA
| | - Mark J. Ratain
- Committee on Clinical Pharmacology and PharmacogenomicsThe University of ChicagoChicagoIllinoisUSA
- Center for Personalized TherapeuticsThe University of ChicagoChicagoIllinoisUSA
- Department of MedicineThe University of ChicagoChicagoIllinoisUSA
| | - Peter H. O'Donnell
- Committee on Clinical Pharmacology and PharmacogenomicsThe University of ChicagoChicagoIllinoisUSA
- Center for Personalized TherapeuticsThe University of ChicagoChicagoIllinoisUSA
- Department of MedicineThe University of ChicagoChicagoIllinoisUSA
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