Physician perspectives of CYP2C19 and clopidogrel drug-gene interaction active clinical decision support alerts.

Objective: To determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness.

Materials And Methods: 52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction.

Results: Only 4% of participants stated they would override the alert.

Pragmatic and Ethical Challenges of Incorporating the Genome into the Electronic Medical Record.

Recent successes in the use of gene sequencing for patient care highlight the potential of genomic medicine. For genomics to become a part of usual care, pertinent elements of a patient's genomic test must be communicated to the most appropriate care providers. Electronic medical records may serve as a useful tool for storing and disseminating genomic data.

Development of clinical decision support alerts for pharmacogenomic incidental findings from exome sequencing.

Purpose: Electronic health records (EHRs) and their associated decision support tools are potentially important means of disseminating a patient's pharmacogenomic profile to his or her health-care providers. We sought to create a proof-of-concept decision support alert system generated from pharmacogenomic incidental findings from exome sequencing.

Methods: A pipeline for alerts from exome sequencing tests was created for patients in the New EXome Technology in (NEXT) Medicine study at the University of Washington.

Improving understanding in the research informed consent process: a systematic review of 54 interventions tested in randomized control trials.

Background: Obtaining informed consent is a cornerstone of biomedical research, yet participants comprehension of presented information is often low. The most effective interventions to improve understanding rates have not been identified.

Purpose: To systematically analyze the random controlled trials testing interventions to research informed consent process.

Patients who complete advance directives and what they prefer.

Objective: To determine health care preferences expressed by patients in advance directives (ADs) and to identify characteristics of patients who completed them.

Patients And Methods: A computer-generated random sample of 500 patients was selected from the 25,865 (margin of error, +/- 4.34%) unique patients who submitted ADs to Mayo Clinic Rochester between January 1, 2004, and July 1, 2005.