ArticleJournal of the American Medical Informatics Association : JAMIA2014
Development and use of active clinical decision support for preemptive pharmacogenomics.
Article in Journal of the American Medical Informatics Association : JAMIA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
114 citing papers in PubMed, 7 syntheses or guidelines pooled it, 205 citations in OpenAlex.
- The Clinical Pharmacogenetics Implementation Consortium's consensus-based framework for assigning allele function.American journal of human genetics · 2025Guideline
- Genetically guided precision medicine clinical decision support tools: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Understanding the barriers and enablers of pharmacogenomic testing in primary care: a qualitative systematic review with meta-aggregation synthesis.Pharmacogenomics · 2022Pooled it
- Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy.Clinical pharmacology and therapeutics · 2021Guideline
- Medication safety alert fatigue may be reduced via interaction design and clinical role tailoring: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2019Pooled it
- Impact of SLCO1B1 Pharmacogenetic Testing on Patient and Healthcare Outcomes: A Systematic Review.Clinical pharmacology and therapeutics · 2019Pooled it
- Primary-care providers' perceived barriers to integration of genetics services: a systematic review of the literature.Genetics in medicine : official journal of the American College of Medical Genetics · 2015Pooled it
- How the presentation of patient information and decision-support advisories influences opioid prescribing behavior: A simulation study.Journal of the American Medical Informatics Association : JAMIA · 2020Trial
- A Pilot Randomized Controlled Trial of Outcomes Associated with Parent-Nurse Controlled Analgesia vs. Continuous Opioid Infusion in the Neonatal Intensive Care Unit.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2020Trial
- Drug-gene and drug-drug interactions associated with tramadol and codeine therapy in the INGENIOUS trial.Pharmacogenomics · 2019Trial
- Trial
- Development and validation of an open data model for pharmacogenetics to enable semantic interoperability in clinical practice.The pharmacogenomics journal · 2026Article
- Bridging the Gap Between Pharmacogenomic Discovery and Clinical Implementation: Insights from Selected Studies on Inter-Individual Variability in Drug Response.Journal of personalized medicine · 2026Article
- Discordance in Drug-Drug Interaction Alerts for Antidotes: Comparative Analysis of Electronic Databases and Interpretive Insights from AI Tools.Drug design, development and therapy · 2025Article
- Pharmacogenetics Clinical Decision Support Systems for Primary Care in England: Co-Design Study.Journal of medical Internet research · 2024Article
- Improvements in appropriate placement of dental sealants after implementation of a clinical decision support system.Journal of the American Dental Association (1939) · 2024Article
- Overcoming Barriers to Discovery and Implementation of Equitable Pharmacogenomic Testing in Oncology.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Review
- PillHarmonics: An Orchestrated Pharmacogenetics Medication Clinical Decision Support Service.Applied clinical informatics · 2024Article
- The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S.Pharmacy (Basel, Switzerland) · 2023Review
- The Application of Dental Fluoride Varnish in Children: A Low Cost, High-Value Implementation Aided by Passive Clinical Decision Support.Applied clinical informatics · 2023Article
54 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundActive clinical decision support (CDS) delivered through an electronic health record (EHR) facilitates gene-based drug prescribing and other applications of genomics to patient care.
objectiveWe describe the development, implementation, and evaluation of active CDS for multiple pharmacogenetic test results reported preemptively. MATERIALS AND
methodsClinical pharmacogenetic test results accompanied by clinical interpretations are placed into the patient's EHR, typically before a relevant drug is prescribed. Problem list entries created for high-risk phenotypes provide an unambiguous trigger for delivery of post-test alerts to clinicians when high-risk drugs are prescribed. In addition, pre-test alerts are issued if a very-high risk medication is prescribed (eg, a thiopurine), prior to the appropriate pharmacogenetic test result being entered into the EHR. Our CDS can be readily modified to incorporate new genes or high-risk drugs as they emerge.
resultsThrough November 2012, 35 customized pharmacogenetic rules have been implemented, including rules for TPMT with azathioprine, thioguanine, and mercaptopurine, and for CYP2D6 with codeine, tramadol, amitriptyline, fluoxetine, and paroxetine. Between May 2011 and November 2012, the pre-test alerts were electronically issued 1106 times (76 for thiopurines and 1030 for drugs metabolized by CYP2D6), and the post-test alerts were issued 1552 times (1521 for TPMT and 31 for CYP2D6). Analysis of alert outcomes revealed that the interruptive CDS appropriately guided prescribing in 95% of patients for whom they were issued.
conclusionsOur experience illustrates the feasibility of developing computational systems that provide clinicians with actionable alerts for gene-based drug prescribing at the point of care.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.