The Foundation of Precision Medicine: Integration of Electronic Health Records with Genomics Through Basic, Clinical, and Translational Research

2016 ◽  
2019 ◽  
Author(s):  
Charlotte A. Nelson ◽  
Atul J. Butte ◽  
Sergio E. Baranzini

ABSTRACTIn order to advance precision medicine, detailed clinical features ought to be described in a way that leverages current knowledge. Although data collected from biomedical research is expanding at an almost exponential rate, our ability to transform that information into patient care has not kept at pace. A major barrier preventing this transformation is that multi-dimensional data collection and analysis is usually carried out without much understanding of the underlying knowledge structure. In an effort to bridge this gap, Electronic Health Records (EHRs) of individual patients were connected to a heterogeneous knowledge network called Scalable Precision Medicine Oriented Knowledge Engine (SPOKE). Then an unsupervised machine-learning algorithm was used to create Propagated SPOKE Entry Vectors (PSEVs) that encode the importance of each SPOKE node for any code in the EHRs. We argue that these results, alongside the natural integration of PSEVs into any EHR machine-learning platform, provide a key step toward precision medicine.


PLoS Genetics ◽  
2021 ◽  
Vol 17 (6) ◽  
pp. e1009593
Author(s):  
Neil S. Zheng ◽  
Cosby A. Stone ◽  
Lan Jiang ◽  
Christian M. Shaffer ◽  
V. Eric Kerchberger ◽  
...  

Understanding the contribution of genetic variation to drug response can improve the delivery of precision medicine. However, genome-wide association studies (GWAS) for drug response are uncommon and are often hindered by small sample sizes. We present a high-throughput framework to efficiently identify eligible patients for genetic studies of adverse drug reactions (ADRs) using “drug allergy” labels from electronic health records (EHRs). As a proof-of-concept, we conducted GWAS for ADRs to 14 common drug/drug groups with 81,739 individuals from Vanderbilt University Medical Center’s BioVU DNA Biobank. We identified 7 genetic loci associated with ADRs at P < 5 × 10−8, including known genetic associations such as CYP2D6 and OPRM1 for CYP2D6-metabolized opioid ADR. Additional expression quantitative trait loci and phenome-wide association analyses added evidence to the observed associations. Our high-throughput framework is both scalable and portable, enabling impactful pharmacogenomic research to improve precision medicine.


2012 ◽  
Vol 21 (01) ◽  
pp. 135-138 ◽  
Author(s):  
Y. L. Yip ◽  

SummaryTo review current excellent research and trend in the field of bioinformatics and translational informatics with direct application in the medical domain.Synopsis of the articles selected for the IMIA Yearbook 2012.Six excellent articles were selected in this Yearbook’s section on Bioinformatics and Translational Informatics. They exemplify current key advances in the use of patient information for translational research and health surveillance. First, two proof-of-concept studies demonstrated the cross-institutional and -geographic use of Electronic Health Records (EHR) for clinical trial subjects identification and drug safety signals detection. These reports pave ways to global large-scale population monitoring. Second, there is further evidence on the importance of coupling phenotypic information in EHR with genotypic information (either in biobank or in gene association studies) for new biomedical knowledge discovery. Third, patient data gathered via social media and self-reporting was found to be comparable to existent data and less labor intensive. This alternative means could potentially overcome data collection challenge in cohort and prospective studies. Finally, it can be noted that metagenomic studies are gaining momentum in bioinformatics and system-level analysis of human microbiome sheds important light on certain human diseases.The current literature showed that the traditional bench to bedside translational research is increasing being complemented by the reverse approach, in which bedside information can be used to provide novel biomedical insights.


2017 ◽  
Vol 9 (3) ◽  
pp. e1378 ◽  
Author(s):  
Amy Sitapati ◽  
Hyeoneui Kim ◽  
Barbara Berkovich ◽  
Rebecca Marmor ◽  
Siddharth Singh ◽  
...  

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