The Revolution Will Be Sequenced: Anticipating the Knowledge Gap within the Genomic Pillar of Precision Medicine

Autor/in	McGrath, Scott
Titel	The Revolution Will Be Sequenced: Anticipating the Knowledge Gap within the Genomic Pillar of Precision Medicine
Quelle	(2019), (178 Seiten) PDF als Volltext Verfügbarkeit Ph.D. Dissertation, University of Nebraska at Omaha
Sprache	englisch
Dokumenttyp	gedruckt; online; Monographie
ISBN	978-1-3920-9835-6
Schlagwörter	Hochschulschrift; Dissertation; Medicine; Genetics; Primary Health Care; Physicians; Expertise; Knowledge Level; Data Interpretation; Self Efficacy; Data Use; Age Differences; Experience; Trust (Psychology); Patients; Educational Practices; Active Learning; Web Based Instruction; Research Needs; Randomized Controlled Trials; Computer Oriented Programs; Artificial Intelligence; Decision Support Systems + Suchen Sie Ihr Suchwort? Thesis; Dissertations; Academic thesis; Medizin; Humangenetik; Gesundheitsvorsorge; Physician; Doctor; Arzt; Expert appraisal; Wissensbasis; Data evaluation; Datenauswertung; Self-efficacy; Selbstwirksamkeit; Age; Difference; Age difference; Altersunterschied; Erfahrung; Patient; Bildungspraxis; Aktives Lernen; Web Based Training; Forschungsbedarf; Computerprogramm; Künstliche Intelligenz; Entscheidungshilfe
Abstract	The concept of precision medicine aims to provide additional context to patient data for healthcare providers. Precision medicine overlays three additional layers of patient data on top of standard patient information: environmental exposure, personal lifestyle and behavior patterns, and information gleaned from their genome. While precision medicine promises to provide physicians and their patients with increased levels of customization for preventative and primary care, there is evidence that preparation relating to the genomic pillar of precision medicine is not yet adequate to ensure successful deployment. Aim 1 in this dissertation explored the knowledge gap between primary care physicians and genetic experts via a validated survey instrument and compared these two group's ability to interpret genetic tests and their self-efficacy when working with genomic data. Results found the correct interpretation rates for the two groups were relatively high (74.4% for providers, 83.4% for specialists). Additionally, higher correct interpretation rates were associated with age, prior genetic test consultation experience, and level of trust assigned to the reports. Aim 2 mapped out the ideal educational techniques to help increase patient comprehension of genetic testing results by conducting a scoping review; 26 manuscripts were selected in this review. The papers were categorized into three themes that emerged: education interventions, curriculum development, and review papers. Finding from this review established that there is a need to develop web-based educational tools designed with active learning methodologies, additional randomized controlled trials are needed to develop more robust evidence, and clinical outcomes need to be linked with educational interventions. Aim 3 captured the development of a mhealth telehealth app; a proxy software solution to assist healthcare providers with a artificial intelligence driven clinical decision support as a method to assist with genetic data education and interpretation. AI driven CDSS was found to have some significant hurdles still yet to overcome. Precision medicine has moved from theoretical and planning stages into real world initiatives and there are now large amounts of resources being invested. It is critical to investigate solutions and continue identifying future roadblocks while they remain manageable. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.] (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2020/1/01