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利用电子病历推进基因组医学

Using Electronic Medical Records to advance genomic medicine
课程网址: http://videolectures.net/mdo2014_denny_genomic_medicine/  
主讲教师: Joshua C Denny
开课单位: 范德比尔特大学
开课时间: 2014-07-21
课程语种: 英语
中文简介:
个性化医疗为改善诊断和提供更有效、针对患者的治疗提供了希望。通常,这类研究是通过研究队列进行的。在范德比尔特,我们创建了一个DNA生物库,BioVU,现在有将近18万个样本与去鉴定电子病历(EMR)相关。BioVU允许使用真实的临床数据研究基因组和药物基因组的关联。在EMR中寻找表型可能是一个挑战,但是账单数据、实验室数据、药物暴露和自然语言处理的结合使得基因组和药物基因组表型的研究成为可能。EMR还可以进行反向实验——从基因型开始,发现与之相关的所有表型——全表型关联研究(PHEIS)。PHEIS需要密集的表型群体,如EMR中发现的。我们利用PheWAS复制了超过200个基因型-表型关联,描述了多效性,并发现了新的关联。最后,这些发现的努力是实施一个前瞻性的个性化药物的基础,基因型的人在共同的药物与药理学变体的风险。通过这个项目,我们已经对超过15000个个体进行了184种药物变体的基因分型。计算机化的决策支持已经被实施,以根据与氯吡格雷、华法林、硫嘌呤、他克莫司和他汀类药物相关的基因型来定制药物治疗。
课程简介: Personalized medicine offers the promise of improved diagnosis and for more effective, patient-specific therapies. Typically, such studies have been pursued using research cohorts. At Vanderbilt, we have created a DNA biobank, BioVU, which now has nearly 180,000 samples linked to de-identified electronic medical records (EMRs). BioVU allows study of genomic and pharmacogenomic associations using real-world clinical data. Finding phenotypes in the EMR can be challenging, but the combination of billing data, laboratory data, medication exposures, and natural language processing has enabled efficient study of genomic and pharmacogenomic phenotypes. The EMR also enables the inverse experiment - starting with a genotype and discovering all the phenotypes with which it is associated - a phenome-wide association study (PheWAS). PheWAS requires a densely phenotyped population such as found in the EMR. We have used PheWAS to replicate >200 genotype-phenotype associations, characterize pleiotropy, and discover new associations. Finally, these discovery efforts have been the foundation for implementing a prospective personalized medicine that genotypes people at risk for common medications with pharmacogenetic variants. Through this program, we have genotyped >15,000 individuals at 184 pharmacovariants. Computerized decision support has been implemented to tailor medical therapy based on genotypes relevant to clopidogrel, warfarin, thiopurines, tacrolimus, and statins.
关 键 词: 个性化药物; 基因; 电子病历
课程来源: 视频讲座网
数据采集: 2020-12-28:yxd
最后编审: 2020-12-28:yxd
阅读次数: 93