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      Assessment of the current status of real-world pharmacogenomic testing: informed consent, patient education, and related practices

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          Abstract

          Introduction: The practice of informed consent (IC) for pharmacogenomic testing in clinical settings varies, and there is currently no consensus on which elements of IC to provide to patients. This study aims to assess current IC practices for pharmacogenomic testing.

          Methods: An online survey was developed and sent to health providers at institutions that offer clinical germline pharmacogenomic testing to assess current IC practices.

          Results: Forty-six completed surveys representing 43 clinical institutions offering pharmacogenomic testing were received. Thirty-two (74%) respondents obtain IC from patients with variability in elements incorporated. Results revealed that twenty-nine (67%) institutions discuss the benefits, description, and purpose of pharmacogenomic testing with patients. Less commonly discussed elements included methodology and accuracy of testing, and laboratory storage of samples.

          Discussion: IC practices varied widely among survey respondents. Most respondents desire the establishment of consensus IC recommendations from a trusted pharmacogenomics organization to help address these disparities.

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          Most cited references72

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          Information bias in health research: definition, pitfalls, and adjustment methods

          As with other fields, medical sciences are subject to different sources of bias. While understanding sources of bias is a key element for drawing valid conclusions, bias in health research continues to be a very sensitive issue that can affect the focus and outcome of investigations. Information bias, otherwise known as misclassification, is one of the most common sources of bias that affects the validity of health research. It originates from the approach that is utilized to obtain or confirm study measurements. This paper seeks to raise awareness of information bias in observational and experimental research study designs as well as to enrich discussions concerning bias problems. Specifying the types of bias can be essential to limit its effects and, the use of adjustment methods might serve to improve clinical evaluation and health care practice.
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            Sequencing technologies and genome sequencing

            The high-throughput - next generation sequencing (HT-NGS) technologies are currently the hottest topic in the field of human and animals genomics researches, which can produce over 100 times more data compared to the most sophisticated capillary sequencers based on the Sanger method. With the ongoing developments of high throughput sequencing machines and advancement of modern bioinformatics tools at unprecedented pace, the target goal of sequencing individual genomes of living organism at a cost of $1,000 each is seemed to be realistically feasible in the near future. In the relatively short time frame since 2005, the HT-NGS technologies are revolutionizing the human and animal genome researches by analysis of chromatin immunoprecipitation coupled to DNA microarray (ChIP-chip) or sequencing (ChIP-seq), RNA sequencing (RNA-seq), whole genome genotyping, genome wide structural variation, de novo assembling and re-assembling of genome, mutation detection and carrier screening, detection of inherited disorders and complex human diseases, DNA library preparation, paired ends and genomic captures, sequencing of mitochondrial genome and personal genomics. In this review, we addressed the important features of HT-NGS like, first generation DNA sequencers, birth of HT-NGS, second generation HT-NGS platforms, third generation HT-NGS platforms: including single molecule Heliscope™, SMRT™ and RNAP sequencers, Nanopore, Archon Genomics X PRIZE foundation, comparison of second and third HT-NGS platforms, applications, advances and future perspectives of sequencing technologies on human and animal genome research.
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              ACMG SF v3.0 list for reporting of secondary findings in clinical exome and genome sequencing: a policy statement of the American College of Medical Genetics and Genomics (ACMG)

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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2576533/overviewRole: Role: Role: Role: Role: Role: Role:
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                Journal
                Front Pharmacol
                Front Pharmacol
                Front. Pharmacol.
                Frontiers in Pharmacology
                Frontiers Media S.A.
                1663-9812
                08 February 2024
                2024
                : 15
                : 1355412
                Affiliations
                [1] 1 Marshfield Clinic Research Institute , Center for Precision Medicine Research , Marshfield Clinic Health Systems , Marshfield, WI, United States
                [2] 2 Division of Genetics and Metabolism , Department of Pediatrics , School of Medicine and Public Health , University of Wisconsin-Madison , Madison, WI, United States
                [3] 3 Department of Pharmacy and Pharmaceutical Sciences , St. Jude Children’s Research Hospital , Memphis, TN, United States
                [4] 4 Program in Precision Medicine , Department of Medicine , School of Medicine , Duke University , Durham, NC, United States
                [5] 5 Medical Genetics , Marshfield Clinic Health Systems , Marshfield, WI, United States
                [6] 6 Center for Human Genomics and Precision Medicine , Wisconsin Institute for Medical Research , University of Wisconsin-Madison , Madison, WI, United States
                Author notes

                Edited by: Pawel Mroz, University of Minnesota Twin Cities, United States

                Reviewed by: Otito Frances Iwuchukwu, Fairleigh Dickinson University, United States

                Simran D. S. Maggo, Children’s Hospital of Los Angeles, United States

                *Correspondence: Emili J. W. Leary, ejwleary@ 123456gmail.com
                Article
                1355412
                10.3389/fphar.2024.1355412
                10895424
                38410134
                11899525-9f20-4299-8949-232920035c9e
                Copyright © 2024 Pereira, Haidar, Haga, Cisler, Hall, Shukla, Hebbring and Leary.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 December 2023
                : 24 January 2024
                Funding
                Funded by: Marshfield Clinic Research Institute , doi 10.13039/100011625;
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding for this project was provided in part by UW ICTR, grant UL1TR002373, from the Clinical and Translational Science Award of the NCATS/NIH and philanthropic support of Marshfield Clinic Research Institute led by the Marshfield Clinic Health System Foundation through the Dr. James Weber Endowment in Human Genetics Research.
                Categories
                Pharmacology
                Original Research
                Custom metadata
                Pharmacogenetics and Pharmacogenomics

                Pharmacology & Pharmaceutical medicine
                clinical implementation,genetic counseling,genetic testing,informed consent,pharmacogenetics,pharmacogenomics

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