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将个性化医学整合到临床实践中的障碍:定性分析。

Barriers for integrating personalized medicine into clinical practice: a qualitative analysis.

机构信息

Department of Medicine, Harvard Medical School, Boston, MA, USA.

出版信息

Am J Med Genet A. 2013 Apr;161A(4):758-63. doi: 10.1002/ajmg.a.35811. Epub 2013 Feb 26.

DOI:10.1002/ajmg.a.35811
PMID:23444119
Abstract

Personalized medicine-tailoring interventions based on individual's genetic information-will likely change routine clinical practice in the future. Yet, how practitioners plan to apply genetic information to inform medical decision making remains unclear. We aimed to investigate physician's perception about the future role of personalized medicine, and to identify the factors that influence their decision in using genetic testing in their practice. We conducted three semi-structured focus groups in three health regions (Fraser, Vancouver coastal, and Interior) in British Columbia, Canada. In the focus groups, participants discussed four topics on personalized medicine: (i) physicians' general understanding, (ii) advantages and disadvantages, (iii) potential impact and role in future clinical practice, and (iv) perceived barriers to integrating personalized medicine into clinical practice. Approximately 36% (n = 9) of physicians self-reported that they were not familiar with the concept of personalized medicine. After introducing the concept, the majority of physicians (68%, n = 19 of 28) were interested in incorporating personalized medicine in their practice, provided they have access to the necessary knowledge and tools. Participants mostly believed that genetic developments will directly affect their practice in the future. The key concerns highlighted were physician's access to clinical guidelines and training opportunities for the use of genetic testing and data interpretation. Despite the challenges that personalized medicine can create, in general, physicians in the focus groups expressed strong interest in using genetic information in their practice if they have access to the necessary knowledge and tools.

摘要

个体化医学——根据个体的遗传信息定制干预措施——很可能会改变未来的常规临床实践。然而,医生如何计划将遗传信息应用于医疗决策仍不清楚。我们旨在调查医生对未来个体化医学角色的看法,并确定影响他们在实践中使用基因检测决策的因素。我们在加拿大不列颠哥伦比亚省的三个卫生区(弗雷泽、温哥华沿海和内陆)进行了三次半结构化焦点小组讨论。在焦点小组中,参与者讨论了个体化医学的四个主题:(i)医生的一般理解,(ii)优缺点,(iii)潜在影响和未来临床实践中的作用,以及(iv)将个体化医学纳入临床实践的感知障碍。大约 36%(n=9)的医生自我报告说他们不熟悉个体化医学的概念。在介绍了这一概念后,大多数医生(68%,n=19/28)有兴趣将个体化医学纳入他们的实践,前提是他们能够获得必要的知识和工具。参与者大多认为遗传发展将直接影响他们未来的实践。突出强调的主要关注点是医生获得临床指南以及基因检测和数据解释使用培训机会的途径。尽管个体化医学可能带来挑战,但在一般情况下,如果医生能够获得必要的知识和工具,他们对在实践中使用遗传信息表达了浓厚的兴趣。

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