Toward the implementation of genomic applications for smoking cessation and smoking-related diseases.
Toward the implementation of genomic applications for smoking cessation and smoking-related diseases.
复制标题
致力于实施戒烟和吸烟相关疾病的基因组应用。
DOI：
10.1093/tbm/ibx060
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发表时间：
2018
影响因子：
3.6
通讯作者：
Bierut,LauraJ
中科院分区：
文献类型：
--
作者：
Ramsey,AlexT;Chen,Li-Shiun;Hartz,SarahM;Saccone,NancyL;Fisher,SherriL;Proctor,EnolaK;Bierut,LauraJ
The incorporation of genomic information into routine care settings is a burgeoning area for investigation in behavioral medicine. The past decade has witnessed rapid advancements in knowledge of genetic biomarkers associated with smoking behaviors and tobacco-related morbidity and mortality, providing the basis for promising genomic applications in clinical and community settings. We assessed the current state of readiness for implementing genomic applications involving variation in the α5 nicotinic cholinergic receptor subunit geneCHRNA5and smoking outcomes (behaviors and related diseases) using a process that could be translatable to a wide range of genomic applications in behavioral medicine. We reviewed the scientific literature involvingCHRNA5genetic variation and smoking cessation, and then summarized and synthesized a chain of evidence according to analytic validity, clinical validity, clinical utility, and ethical, legal, and social implications (ACCE), a well-established set of criteria used to evaluate genomic applications. Our review identified at least three specific genomic applications for which implementation may be considered, including the use ofCHRNA5genetic test results for informing disease risk, optimizing smoking cessation treatment, and motivating smoking behavior change. For these genomic applications, we rated analytic validity asconvincing, clinical validity asadequate, and clinical utility and ethical, legal, and social implications asinadequate. For clinical genomic applications involvingCHRNA5variation and smoking outcomes, research efforts now need to focus on establishing clinical utility. This approach is compatible with pre-implementation research, which is also needed to accelerate translation, improve innovation design, and understand and refine system processes involved in implementation. This study informs the readiness to incorporate smoking-related genomic applications in real-world settings and facilitates cross-disciplinary collaboration to accelerate the integration of evidence-based genomics in behavioral medicine.
