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实施科学、基因组精准医学与健康改善:一条新的前进道路?

Implementation science, genomic precision medicine, and improved health: A new path forward?

作者信息

Williams Janet K, Feero W Gregory, Leonard Debra G B, Coleman Bernice

机构信息

College of Nursing, The University of Iowa, Iowa City, IA.

Maine Dartmouth Family Medicine Residency Program, Augusta, ME.

出版信息

Nurs Outlook. 2017 Jan-Feb;65(1):36-40. doi: 10.1016/j.outlook.2016.07.014. Epub 2016 Aug 20.

Abstract

Implementation of genomic discoveries into health care optimally includes evaluation of outcomes for recipients of care, providers, payers, and health care systems. However, the influence of specific aspects of the implementation process on observed outcomes may be missed if assessment of implementation success is not built into the implementation design. The intersection of implementation science with genomics may provide new insights on how to maximize the benefits of emerging genomic technologies in health care. In this summary, members of the Roundtable on Genomics and Precision Health, formerly the Roundtable on Translating Genomic-Based Research for Health, of the National Academies of Sciences, Engineering, and Medicine and the American Academy of Nursing explore challenges and opportunities for nurses to participate in implementing genomic discoveries into their practice informed by the principles of implementation science. Implementation requires collaboration across disciplines. Nurses can take leadership roles in engaging key stakeholders in health care organizations, assuring that communications regarding implementation are consistent with genomic literacy for each group of stakeholders, and planning for evaluation of data to assess how each component of the implementation process affected the overall outcome for health care.

摘要

将基因组学发现应用于医疗保健,最理想的情况是对接受治疗者、医疗服务提供者、付款方以及医疗保健系统的结果进行评估。然而,如果在实施设计中没有纳入对实施成功与否的评估,可能会忽略实施过程中特定方面对观察到的结果的影响。实施科学与基因组学的交叉领域可能会为如何在医疗保健中最大化新兴基因组技术的益处提供新的见解。在本综述中,美国国家科学院、工程院和医学院以及美国护理学会的基因组学与精准健康圆桌会议(前身为将基于基因组的研究转化为健康圆桌会议)的成员探讨了护士在依据实施科学原则将基因组学发现应用于实践中所面临的挑战与机遇。实施需要跨学科合作。护士可以在促使医疗保健组织中的关键利益相关者参与方面发挥领导作用,确保关于实施的沟通与每组利益相关者的基因组知识水平相一致,并规划数据评估,以评估实施过程的每个组成部分如何影响医疗保健的总体结果。

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