Knowledge Synthesis Center for Genomic Applications

描述：人类基因组计划后，基因组应用的快速发展创造了机遇和挑战。虽然这些测试可以让我们筛选个人的疾病易感性和定制的预防措施和治疗，以最大限度地提高效益和减少伤害，但基因组学研究的快速步伐和缺乏监管监督意味着新测试的效用往往缺乏证据。基因组应用和由此产生的临床干预措施的成本可能很高，在越来越注重成本和有效性的政策环境中，有关临床效用的信息至关重要。该项目将通过建立一个基因组学知识综合（KS）中心来应对这些挑战，以综合现有和新兴基因检测的证据，支持将证据转化为临床和政策建议，并向决策者传播证据摘要。我们的建议是建立在我们在健康研究中心（Center for Health Research）的调查团队的丰富经验的基础上的。我们一直是俄勒冈州循证实践中心的成员，支持美国预防服务工作组（USPSTF）在过去的10年里，指导科学资源中心（SRC）的一个重要部分，支持AHRQ的有效医疗保健（EHC）计划的活动，并接受ARRA资金进行比较有效性研究，重点是预防，行为干预和护理提供。通过ARRA基金，我们正在开展一项由NCI资助的癌症基因组应用计划（CERGEN）。在我们为USPSTF和其他机构开展的工作中，我们优先考虑并定义了审查主题，开发并记录了新的审查方法，并对广泛的临床主题进行了系统性和有针对性的审查。与CDC和EGAPP工作组合作，我们建议：目标1：建立一个基因组学KS中心，为医疗保健实践和政策中的不同利益相关者计划，进行和传播基因组证据的审查。目标二：对确定的基因组研究问题进行系统的证据审查，以支持临床决策，并确定需要新研究的证据差距。目标3：对新出现的应用程序进行有针对性的审查并更新审查结果，并将专题简介张贴到全球农业行动计划网。目标4：制定进行证据审查的新方法，并将其记录在程序手册中。KS中心的产品将通过同行评审的出版物和互联网帖子在公共领域迅速传播。我们将描述特定应用的证据状态，支持临床决策者实施有效的护理，并帮助实现基因组学和个性化医疗的承诺。

DESCRIPTION: The rapid development of genomic applications in the wake of the Human Genome Project creates both opportunities and challenges. While these tests may allow us to screen individuals for disease susceptibility and tailor prevention measures and treatments to maximize benefit and minimize harm, the swift pace of genomics research and lack of regulatory oversight mean that evidence on the utility of new tests is often lacking. The costs of genomic applications and resulting clinical interventions can be high, and in a policy environment increasingly focused on costs as well as effectiveness, information on clinical utility is critical. This project will address these challenges by establishing a Knowledge Synthesis (KS) Center in Genomics to synthesize evidence on established and emerging genetic tests, support translation of evidence into clinical and policy recommendations, and disseminate evidence summaries to decision-makers. Our proposal builds on the substantial experience of our investigative team at the Center for Health Research (CHR). We have been a member of the Oregon Evidence-Based Practice Center supporting the U.S. Preventive Services Task Force (USPSTF) for the past 10 years, directing a substantial segment of a Scientific Resource Center (SRC) that supports the activities of AHRQ's Effective Health Care (EHC) Program, and receiving ARRA funds to conduct comparative effectiveness research concentrating on prevention, behavioral interventions, and care delivery. Through ARRA funds, we are conducting an NCI-funded program on genomic applications in cancer (CERGEN). In our work for the USPSTF and others, we have prioritized and defined topics for review, developed and documented new review methods, and conducted both systematic and targeted reviews on a wide range of clinical topics. In partnership with the CDC and the EGAPP Working Group, we propose to: Aim 1: Establish a KS Center in Genomics to plan, conduct, and disseminate reviews of genomic evidence for diverse stakeholders in health care practice and policy. Aim 2: Conduct systematic evidence reviews for defined genomic research questions to support clinical decision-making and identify gaps in evidence requiring new research. Aim 3: Conduct and update targeted reviews on emerging applications and post topic briefs to GAPPNet. Aim 4: Develop novel methods for conducting evidence reviews, and document them in a Procedure Manual. The KS Center's products will be rapidly disseminated in the public domain through peer-reviewed publication, and internet postings. We will describe the state of evidence for specific applications, support clinical decision- makers in implementing effective care, and help to realize the promise of genomics and personalized medicine.