lunes, 19 de agosto de 2013

Faculty research highlights | Duke Center for Personalized and Precision Medicine

Faculty research highlights | Duke Center for Personalized and Precision Medicine

Four new CPPM pilot projects focus on adopting personalized medicine concepts and mHealth tools to promote health

The Duke Center for Personalized and Precision Medicine’s vision is to transform the Duke University Health System by optimizing and delivering personalized medicine strategies for mainstream healthcare. To implement this vision, the CPPM is funding four pilot projects in its 2nd RFA that will advance the application of medical interventions or therapies that are individualized to patient characteristics or preferences. In this iteration of the call, the CPPM requested proposals address one of the four topics of use of IT and/or social media; policy and implementation; adoption of PM concepts and paradigms in the clinical setting; and Education.
We are pleased to announce the four scientists who are receiving funds for implementation of their projects:

“Healthyme”: a feasibility pilot of electronic clinical decision support for pediatric obesity treatment

Sarah Armstrong, MD, Department of Pediatrics
Dr. Amstrong and her team will leverage the existing platform of MeTree, an electronic family health history collection and clinical decision support tool to address the health issue of childhood obesity. A module specifically designed for a pediatric population will be incorporated into MeTree that target three areas recommended in pediatric obesity clinical treatment: lifestyle modification, support for patient-self management, and risk factor screening. The goal of this project is to develop and pilot test the usability, acceptability and perceived value of an electronic decision-support tool in an outpatient childhood obesity clinic.

Assessing feasibility and utility of enhancing medication therapy management with pharmacist-delivered pharmacogenetic (PGx) testing

Susanne B. Haga, PhD, Institute for Genome Sciences and Policy
Dr. Haga and her colleagues will investigate the adoption of personalized medicine concepts and paradigms in the clinical setting in the field of PGx testing. This project will investigate the benefit and feasibility of delivering PGx testing through a pharmacist-assisted intervention in a clinic setting, by assessing the benefit of PGx testing for a high-risk patient population as part of a medication therapy management service, and also assessing the feasibility of pharmacist-delivered PGx testing in the clinic setting.

The mobile health (mHealth) platform: development and feasibility evaluation

Ryan J. Shaw, PhD, RN and Hayden B. Bosworth, PhD, Health Services Research and Development, Department of Internal Medicine
Drs. Shaw and Bosworth and their team will develop and pilot test a mobile health platform that will collect data representing multiple health domains from a host of mobile and wireless technologies in one place, with the goal to create the initial interface of this platform, and then to test it through a single-case study design. This initial interface will allow patients to report and receive data representing multiple health domains, including blood pressure, glucose values, weight, physical activity, calories burned, sleep, and psychological survey measures such as pain and fatigue.

The evolution of evidence-based decision making: development of a personalized tool from an evidence-based decision model

Richard C. Mather III, MD, Department of Orthopaedic Surgery
Dr. Mather and his colleagues will create a comprehensive personalized decision tool using the case of shoulder dislocation. Building on a published and validated decision model that combines the medical evidence for shoulder instability, they will provide a personalized, evidence-based profile on expected outcomes that will add patient preferences to the model outcomes and also build a delivery vehicle to facilitate clinical implementation.
Dr. Ginsburg, Director of the Center for Personalized and Precision Medicine applauds the efforts of these researchers to advance the field. "The CPPM pilot projects program has been an important catalyst for bringing expertise from multiple disciplines together to develop innovative ideas to the point where they can attract significant funding. We've been successful in the past in doing this and have every reason to believe this group of proposals with a heavy foot print in data enabling technologies will do the same to advance personalized and precision medicine."

Additional Center for Personalized and Precision Medicine-funded research projects

The Genomedical Connection

Dr. Lori Orlando, Duke University
A collaboration between Cone Health, University of North Carolina Greensboro, and Duke University, has integrated successfully a computerized family health history (FHH) system into the processes of routine well-visit appointments at two test clinics in the Cone Health system. This FHH tool streamlines the collection of an individual’s family health history and provides clinical decision support to primary care providers, based on that history. While participant recruitment has ended, there is a vast amount of data that is in the process of being analyzed and prepared for publication. The protocol was published in October 2011 in BMC Health Services Research.

Effects of Type 2 Diabetes Genetic Risk Information on Health Behaviors and Outcomes

Dr. Alex Cho, Dr. Allison Vorderstrasse and Dr. Geoffrey Ginsburg, Duke University
The first study to investigate the incorporation of research genetic testing into a primary care setting and understand the barriers, but it primarily was designed to assess the clinical utility of a genetic test for T2DM risk based on four genes in combination with a standardized risk assessment compared with a standardized risk assessment alone. The study rationale, development and design was published in BMC Health Services Research in Jan 2012.

Genetically Tailored Statin Therapy to Improve Medication Adherence

Dr. Deepak Voora, Duke University
This study aims to answer the question about whether genetically tailored statin-prescribing improves statin adherence in patients with an indication for statin therapy but with a history of or a concern for statin-induced side effects.

Exploring the Effects of Genetic Susceptibility Testing among College Smokers

Dr. Isaac Lipkus, Duke University
This proposal will explore issues related to conveying results of genetic susceptibility testing for nicotine addiction to promote cessation among nondaily and light college cigarette smokers. It aims to understand in greater depth how college smokers: 1) view nicotine addiction, including the role of genetics, and 2) react to genetic test results of susceptibility to addiction.

Personalized Medicine in Women’s Obesity Prevention

Dr. Leigh Ann Simmons, Duke University
The primary aim of this pilot study is to test the feasibility and effectiveness of a personalized health planning with integrative health coaching (PHP-IHC) intervention to prevent postpartum weight retention (PPWR) in women, a documented risk factor for mid-life obesity and related morbidities. A secondary aim is to develop for future validation a preliminary risk profile for PPWR that includes molecular data, which will enable better prediction – and thus prevention – of PPWR, thereby further enhancing the capabilities of PHP-IHC.

Integrative Health Coaching in Primary Care: A Multidisciplinary Approach to Personalized Medicine

Dr. Ruth Wolever and Dr. Allison Vorderstrasse, Duke University
The purpose of this pilot randomized controlled trial is to test the feasibility and logistics of incorporating genetic risk information (9p21 testing) into standard coronary heart disease (CHD) risk counseling or a health coaching intervention (or both) in primary care. In addition, the resulting changes in health behaviors or metabolic outcomes in adult primary care patients at risk for CHD will be explored.  Learn more....

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