Citations 2
Development of an Electronic Health Record–Based Clinical Decision Support Tool for Patients With Lynch Syndrome
Lau‐Min, Kelsey S. , Bleznuck, Joseph, Wollack, Colin, McKenna, Danielle , Long, Jessica M. , Hubert, Anna P. , Johnson, Mariah, Rochester, Shavon E., Constantino, Gillain , Dudzik, Christina , Doucette, Abigail , Wangensteen, Kirk J. , Landgraf, Jeffrey, Chen, Jessica , Nathanson, Katherine L. , McKenna, Danielle B , Wangensteen, Kirk J , Domchek, Susan M , Nathanson, Katherine L , Katona, Bryson W , Domchek, Susan M.
JCO Clinical Cancer Informatics | August 28, 2023 | Volume: No volume available | Issue: 7 | Pages: No page available
PURPOSE To develop an electronic health record (EHR)–based clinical decision support (CDS) tool to promote guideline-recommended cancer risk management among patients with Lynch syndrome (LS), an inherited cancer syndrome that confers an increased risk of colorectal and other cancer types. MATERIALS AND METHODS We conducted a cross-sectional study to determine the baseline prevalence and predictors of guideline-recommended colonic surveillance and annual genetics program visits among patients with LS. Multivariable log-binomial regressions estimated prevalence ratios (PRs) of cancer risk management adherence by baseline sociodemographic and clinical characteristics. These analyses provided rationale for the development of an EHR-based CDS tool to support patients and clinicians with LS-related endoscopic surveillance and annual genetics program visits. The CDS leverages an EHR platform linking discrete genetic data to LS Genomic Indicators, in turn driving downstream clinician- and patient-facing CDS. RESULTS Among 323 patients with LS, cross-sectional adherence to colonic surveillance and annual genetics program visits was 69.3% and 55.4%, respectively. Patients with recent electronic patient portal use were more likely to be adherent to colonic surveillance (PR, 1.67; 95% CI, 1.11 to 2.52). Patients more recently diagnosed with LS were more likely to be adherent to annual genetics program visits (PR, 0.58; 95% CI, 0.44 to 0.76 for 2-4 years; PR, 0.62; 95% CI, 0.51 to 0.75 for ≥4 compared with <2 years). Our EHR-based CDS tool is now active for 421 patients with LS throughout our health system. CONCLUSION We have successfully developed an EHR-based CDS tool to promote guideline-recommended cancer risk management among patients with LS.
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Dihydropyrimidine Dehydrogenase Genotype and Fluoropyrimidine Dosing: 2017 Update
Amstutz, Ursula , Henricks, Linda M. , Offer, Steven M. , Barbarino, Julia M., Schellens, Jan H.M. , Swen, Jesse J. , McLeod, Howard L. , Caudle, Kelly E. , Diasio, Robert B. , Schwab, Matthias , Lau‐Min, Kelsey S. , Klein, Teri E. , Offer, Steven M , Schwab, Matthias
Clinical Pharmacology & Therapeutics | November 20, 2017 | Volume: 103 | Issue: 2 | Pages: 210-216
The purpose of this guideline is to provide information for the interpretation of clinical dihydropyrimidine dehydrogenase ( DPYD ) genotype tests so that the results can be used to guide dosing of fluoropyrimidines (5‐fluorouracil and capecitabine). Detailed guidelines for the use of fluoropyrimidines, their clinical pharmacology, as well as analyses of cost‐effectiveness are beyond the scope of this document. The Clinical Pharmacogenetics Implementation Consortium (CPIC ® ) guidelines consider the situation of patients for which genotype data are already available (updates available at https://cpicpgx.org/guidelines/guideline‐for‐fluoropyrimidines‐and‐dpyd/ ).