Enabling Personalized Medicine through Clincal Decision Support

描述(由申请者提供)：这个为期五年的项目旨在将一名在临床决策支持(CDS)方面具有专业知识的临床医生-科学家培养成基因组和个性化医学的独立研究员。个性化医疗需要使用所有可用的临床、分子和遗传数据来优化患者的健康，而基因组医学-使用基因组数据来指导患者护理-是个性化医疗的一个组成部分。候选人是杜克大学临床信息学助理教授，拥有生物医学工程博士学位。他还将在颁奖开始前获得医学博士学位。候选人是杜克大学卫生系统疾病管理系统的架构师，也是CDS国际标准的作者。 候选人将接受以杜克大学基因组科学与政策研究所所长亨廷顿·威拉德博士为首的一组知名研究人员的指导。作为其职业发展活动的主要组成部分，候选人将进行一项有指导的研究项目，重点是使用CDS实现基因组医学。候选人还将从事教学和其他有组织的学习活动，特别是在基因组学方面；发展与个性化医疗相关的卫生信息技术标准方面的专业知识；并根据指导研究项目的结果准备手稿和R01拨款申请。 拟议培训活动的目标将是开发一个可扩展和可广泛部署的CDS系统，作为将基因组和个性化医学整合到临床实践中的可复制方法的原型。为了实现这一目标，这项研究将按照三个具体目标进行：(I)就如何根据药物基因组研究结果改进哮喘、高血压和血脂异常的药物治疗方案达成专家共识；(Ii)设计、开发和评估支持基因组医学实践的可扩展、可广泛部署的CDS系统的可用性；以及(Iii)通过可行性研究评估目标2中开发的个性化药物干预的临床可接受性和潜在影响。在目标2中开发并在目标3中进行评估的CDS系统将支持哮喘、高血压或血脂异常的个性化药物治疗。培训和研究将利用杜克大学现有的独特科学资源，并将在导师正在进行的研究项目的背景下进行。 该项目旨在通过调查基因组信息应如何用于个性化和优化向个人提供的卫生保健来改善公共卫生。该项目直接涉及卫生与公众服务部(利用健康信息技术实现个性化医疗)和国家人类基因组研究所(利用临床环境中的遗传信息改善保健)确定为机构优先事项的研究领域。

DESCRIPTION (provided by applicant): This five-year project seeks to develop a clinician-scientist with expertise in clinical decision support (CDS) into an independent investigator in genomic and personalized medicine. Personalized medicine entails the use of all available clinical, molecular, and genetic data to optimize patients' health, and genomic medicine - the use of genomic data to guide patient care - is an integral facet of personalized medicine. The candidate is an Assistant Professor of clinical informatics at Duke University with a Ph.D. in biomedical engineering. He will also earn an M.D. prior to the start of the award. The candidate is the architect of Duke University Health System's disease management system and the author of an international CDS standard. The candidate will be mentored by a group of established investigators headed by Dr. Huntington Willard, the Director of the Duke Institute for Genome Sciences & Policy. As the primary component of his career development activities, the candidate will pursue a mentored research project focused on the use of CDS to enable genomic medicine. The candidate will also pursue didactic and other structured learning activities, particularly in genomics; develop expertise in health IT standards relevant to personalized medicine; and prepare manuscripts and R01 grant applications based on the results of the mentored research project. The goal of the proposed training activities will be to develop a scalable and widely deployable CDS system that could serve as a prototype for a replicable approach to integrating genomic and personalized medicine into clinical practice. In pursuit of this goal, the research will be conducted in accordance with three specific aims: (i) to obtain expert consensus on how pharmacotherapy protocols for asthma, hypertension, and dyslipidemia could be enhanced based on the findings from pharmacogenomic research studies; (ii) to design, develop, and evaluate the usability of a scalable, widely deployable CDS system that supports the practice of genomic medicine; and (iii) to evaluate the clinical acceptability and potential impact of the personalized medicine intervention developed in aim 2 through a feasibility study. The CDS system developed in Aim 2 and evaluated in Aim 3 will support the personalized pharmacotherapy of asthma, hypertension, or dyslipidemia. The training and research will leverage unique scientific resources available at Duke University and will be conducted in the context of the mentors' ongoing research projects. This project seeks to improve public health by investigating how genomic information should be used to personalize and optimize the health care provided to individuals. The project directly addresses research areas identified as institutional priorities by the Department of Health and Human Services (the use of health information technology to enable personalized medicine) and by the National Human Genome Research Institute (the use of genetic information in clinical settings to improve health care).