Analyzing Precision Medicine Utilization with Real-World Data: A Scoping Review.

Analyzing Precision Medicine Utilization with Real-World Data: A Scoping Review.
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DOI:
10.3390/jpm12040557
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发表时间:
2022-04-01
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中科院分区:
医学4区
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精准医学(PM),特别是基于基因的检测,目前已用于超过14万项个体检测,为疾病的临床管理提供信息。虽然有几个数据库(例如,NIH基因检测登记处)证明了这些基于测序的测试的可用性,但我们目前不了解这些测试的使用程度。需要综合描述基于测序的测试的使用的真实世界数据(RWD)的主体,以告知其适当的使用。为了实现这一目标,我们进行了范围审查,以检查2015年1月至2021年8月期间在PM利用研究中使用了哪些RWD来源,以表征基因组测序(GS)、外显子组测序(ES)、肿瘤测序(TS)、下一代基于测序的面板(NGS)、基因表达谱(GEP)和药物基因组学(PGx)面板的使用。我们提取了描述这些类型测试使用的变量,并进行了描述性统计分析。我们在检索中识别了440篇文章,并在我们的研究中纳入了72篇文章。基于登记数据库的出版物最常见,其次是基于私人保险公司行政索赔的研究。略多于三分之一(38%)的人使用综合数据集。三分之二(67%)的研究集中在肿瘤临床应用的测试。我们总结了同行评审文献中关于PM使用的RWD来源。我们的研究结果将有助于改善未来的研究设计,鼓励使用集中的数据库和注册表来跟踪PM的实施和使用。
Precision medicine (PM), specifically genetic-based testing, is currently used in over 140,000 individual tests to inform the clinical management of disease. Though several databases (e.g., the NIH Genetic Testing Registry) demonstrate the availability of these sequencing-based tests, we do not currently understand the extent to which these tests are used. There exists a need to synthesize the body of real-world data (RWD) describing the use of sequencing-based tests to inform their appropriate use. To accomplish this, we performed a scoping review to examine what RWD sources have been used in studies of PM utilization between January 2015 and August 2021 to characterize the use of genome sequencing (GS), exome sequencing (ES), tumor sequencing (TS), next-generation sequencing-based panels (NGS), gene expression profiling (GEP), and pharmacogenomics (PGx) panels. We abstracted variables describing the use of these types of tests and performed a descriptive statistical analysis. We identified 440 articles in our search and included 72 articles in our study. Publications based on registry databases were the most common, followed by studies based on private insurer administrative claims. Slightly more than one-third (38%) used integrated datasets. Two thirds (67%) of the studies focused on the use of tests for oncological clinical applications. We summarize the RWD sources used in peer-reviewed literature on the use of PM. Our findings will help improve future study design by encouraging the use of centralized databases and registries to track the implementation and use of PM.
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