Evidence map›Paper›PMID 26642939›Full record

ArticleInternational journal of medical informatics2016

Physician perspectives of CYP2C19 and clopidogrel drug-gene interaction active clinical decision support alerts.

Adam A Nishimura, Brian H Shirts, Joseph Salama, Joe W Smith, Beth Devine, Peter Tarczy-Hornoch

Abstract read
In one paragraph

Article in International journal of medical informatics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Evaluation of CYP2C19 Clinical Decision Support Alerts to Guide P2YClinical pharmacology and therapeutics · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Approaches to assessing the provider experience with clinical pharmacogenomic information: a scoping review.Genetics in medicine : official journal of the American College of Medical Genetics · 2021
    Article
  9. Article
  10. Article
  11. Design and evaluation of a pharmacogenomics information resource for pharmacists.Journal of the American Medical Informatics Association : JAMIA · 2017
    Article
  12. Genomic decision support needs in pediatric primary care.Journal of the American Medical Informatics Association : JAMIA · 2017
    Article
  13. Article
  14. Integrating pharmacogenetic testing into primary care.Expert review of precision medicine and drug development · 2017
    Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Adam A NishimuraDepartment of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA. Electronic address: adamnish@uw.edu.
Brian H ShirtsDepartment of Laboratory Medicine, University of Washington, Seattle, WA, USA.
Joseph SalamaDepartment of Medicine, Division of Medical Genetics, University of Washington, Seattle, WA, USA.
Joe W SmithDepartment of Pharmacy, University of Washington, Seattle, WA, USA.
Beth DevineDepartment of Pharmacy, University of Washington, Seattle, WA, USA.
Peter Tarczy-HornochDepartment of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA; Department of Computer Science and Engineering, University of Washington, Seattle, WA, USA.
University of Washington · USUniversity of Washington Medical Center · US

Funding

Clinical sequencing in cancer: Clinical ethical and technological studiesU01HG006507 · NHGRI · UNIVERSITY OF WASHINGTON · PI JARVIK, GAIL PAIRITZ · 2012 to 2016
$10.6M
NRSA Training CoreTL1TR002318 · NCATS · UNIVERSITY OF WASHINGTON · PI Megan Moore · 2017 to 2026
$8.4M
Evolving Our Partnership: The CSER2 Centralized Support Coordinating CenterU24HG007307 · NHGRI · UNIVERSITY OF WASHINGTON · PI FULLERTON, STEPHANIE MALIA, JARVIK, GAIL PAIRITZ · 2017 to 2021
$5.8M
CSER RoRC Centralized Support Coordinating CenterU01HG007307 · NHGRI · UNIVERSITY OF WASHINGTON · PI BURKE, WYLIE G., JARVIK, GAIL PAIRITZ · 2013 to 2016
$3.6M
Institute of Translational Health SciencesTL1TR000422 · NCATS · UNIVERSITY OF WASHINGTON · PI DISIS, MARY L. · 2012 to 2016
$2.1M
NCATS NIH HHS TL1 TR000422NCATS NIH HHS TL1TR000422NCATS NIH HHS TL1 TR002318NHGRI NIH HHS U01 HG006507NHGRI NIH HHS U01HG006507CSERNHGRI NIH HHS U01 HG007307NHGRI NIH HHS U01HG007307
6 · The paper itself

Abstract

objectiveTo determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness. MATERIALS AND

methods52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction.

resultsOnly 4% of participants stated they would override the alert. 92% agreed that the alerts were useful. 87% found the visual interface appropriate, 91% felt the timing of the alert was appropriate and 75% were unfamiliar with the specific drug-gene interaction. 80% of providers preferred the ability to order the recommended medication within the alert. Qualitative responses suggested that supplementary information is important, but should be provided as external links, and that the utility of pharmacogenomic alerts depends on the broader ecosystem of alerts. PRINCIPAL

conclusionsPharmacogenomic alerts would be welcomed by many physicians, can be built with minimalist design principles, and are appropriately placed at the end of the prescribing process. Since many physicians lack familiarity with pharmacogenomics but have limited time, information and educational resources within the alert should be carefully selected and presented in concise ways.

Indexed as

AdultAdverse Drug Reaction Reporting SystemsClopidogrelCytochrome P-450 CYP2C19Decision Support Systems, ClinicalDrug InteractionsDrug-Related Side Effects and Adverse ReactionsDrug Therapy, Computer-AssistedFemaleHumansMaleMedical Order Entry SystemsMedication ErrorsMiddle AgedPharmacogeneticsPlatelet Aggregation InhibitorsClopidogrelCytochrome P-450 CYP2C19Platelet Aggregation InhibitorsTiclopidineClinical decision supportClinical informaticsElectronic medical recordsGenomic medicinePharmacogenomics

Identifiers

PMID26642939
PMCPMC4704682
OpenAlexW2138317359

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.