To report the design and implementation of the Right Drug, Right Dose, Right Time-Using Genomic Data to Individualize Treatment protocol that was developed to test the concept that prescribers can deliver genome-guided therapy at the point of care by using preemptive pharmacogenomics (PGx) data and clinical decision support (CDS) integrated into the electronic medical record (EMR).We used a multivariate prediction model to identify patients with a high risk of initiating statin therapy within 3 years. The model was used to target a study cohort most likely to benefit from preemptive PGx testing among the Mayo Clinic Biobank participants, with a recruitment goal of 1000 patients. We used a Cox proportional hazards model with variables selected through the Lasso shrinkage method. An operational CDS model was adapted to implement PGx rules within the EMR.The prediction model included age, sex, race, and 6 chronic diseases categorized by the Clinical Classifications Software for International Classification of Diseases, Ninth Revision codes (dyslipidemia, diabetes, peripheral atherosclerosis, disease of the blood-forming organs, coronary atherosclerosis and other heart diseases, and hypertension). Of the 2000 Biobank participants invited, 1013 (51

作者：Suzette J, Bielinski；Janet E, Olson；Jyotishman, Pathak；Richard M, Weinshilboum；Liewei, Wang；Kelly J, Lyke；Euijung, Ryu；Paul V, Targonski；Michael D, Van Norstrand；Matthew A, Hathcock；Paul Y, Takahashi；Jennifer B, McCormick；Kiley J, Johnson；Karen J, Maschke；Carolyn R, Rohrer Vitek；Marissa S, Ellingson；Eric D, Wieben；Gianrico, Farrugia；Jody A, Morrisette；Keri J, Kruckeberg；Jamie K, Bruflat；Lisa M, Peterson；Joseph H, Blommel；Jennifer M, Skierka；Matthew J, Ferber；John L, Black；Linnea M, Baudhuin；Eric W, Klee；Jason L, Ross；Tamra L, Veldhuizen；Cloann G, Schultz；Pedro J, Caraballo；Robert R, Freimuth；Christopher G, Chute；Iftikhar J, Kullo

来源：Mayo Clinic proceedings 2014 年 89卷 1期