Translational research is a key to nongeneticist physicians' genomics education.
Translational research is a key to nongeneticist physicians' genomics education.
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DOI：
10.1038/gim.2014.67
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发表时间：
2014-12
期刊：
影响因子：
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通讯作者：
Khoury MJ
中科院分区：
文献类型：
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作者：
Feero WG;Manolio TA;Khoury MJ
FEERO等b|转化研究：基因组学教育支持其使用的关键；2级申请有足够的证据支持临床应用；第三类包括几乎没有（如果有的话）证据支持有益或现有指南建议不使用的技术。目前，第一级主要是癌症相关的基因组应用。消费者对健康相关技术的信息需求似乎很可能会推动医生更多地寻求信息。医生和其他卫生专业人员已经有很多工作要做，以提高他们对基因组学的理解。现有的研究表明，开发和维护免费提供的高质量基因组学参考和教育材料可能不足以确保非遗传学家卫生服务提供者的基因组学能力有意义的提高。8,9基因组学能力的有意义的提高将需要文化和基础设施的改变，以培养和维持对能够改善以患者为导向的结果的基因组学进步知识的需求。对于卫生专业人员来说，任何主要的基因组学教育努力的成功都将取决于有效解决任何试图在美国广泛采用的新卫生保健技术所面临的三个现实问题的能力：缺乏证明价值的证据，卫生信息技术/电子健康记录系统的不兼容性，以及卫生专业人员在诊所面临的日益增长的时间负担（图1）。首先，当前的医疗改革努力以合理的成本（价值）作为核心原则，改善了结果。越来越多的医疗保健专业人员期望和激励选择高价值的干预措施；那些价值低或不明确的药物不太可能在临床应用中竞争，这是一个明显的驱动因素
FEERO et al| Translational research: a key to genomics education supporting their use; tier 2 applications have sufficient evidence supporting clinical utility to consider use; tier 3 includes technologies for which there is little, if any, evidence supporting benefit or existing guidelines recommending against use. Tier 1 is, at this time, dominated by cancer-related genomic applications. 7 It seems quite likely that consumer information demand for healthrelated technologies will drive increased information seeking on the part of physicians. Physicians and other health professionals already have much catching up to do to improve their understanding of genomics.Available studies suggest that development and maintenance of freely available, high-quality genomics reference and educational materials is likely insufficient to ensure a meaningful increase in genomics competency among nongeneticist health providers. 8, 9 Meaningful increases in genomics competency will require both cultural and infrastructure changes that nurture and sustain a demand for knowledge regarding genomic advances capable of improving patient-oriented outcomes. The success of any major genomics educational effort for health professionals will hinge on the ability to effectively negotiate three realities that confront any new health-care technology attempting to gain wide adoption in the United States: lack of evidence demonstrating value, incompatibility across health information technology/electronic health record systems, and the ever-growing time burden facing health professionals in the clinic (Figure 1). First, current health-care reform efforts have improved outcomes at a reasonable cost (value) as a core principle. Healthcare professionals are increasingly expected and incentivized to choose high-value interventions; those with low or unclear value are unlikely to compete well for clinical use, an obvious driver