Browsing by Author "Kannry, Joseph"

Now showing 1 - 5 of 5
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    Establishing the value of genomics in medicine: the IGNITE Pragmatic Trials Network.
    (Springer, 2021-07) Ginsburg, Geoffrey S.; Cavallari, Larisa H.; Chakraborty, Hrishikesh; Cooper-DeHoff, Rhonda M.; Dexter, Paul R.; Eadon, Michael T.; Ferket, Bart S.; Horowitz, Carol R.; Johnson, Julie A.; Kannry, Joseph; Kucher, Natalie; Madden, Ebony B.; Orlando, Lori A.; Parker, Wanda; Peterson, Josh; Pratt, Victoria M.; Rakhra-Burris, Tejinder K.; Ramos, Michelle A.; Skaar, Todd C.; Sperber, Nina; Steen-Burrell, Kady-Ann; Van Driest, Sara L.; Voora, Deepak; Wiisanen, Kristin; Winterstein, Almut G.; Volpi, Simona
    PURPOSE: A critical gap in the adoption of genomic medicine into medical practice is the need for the rigorous evaluation of the utility of genomic medicine interventions. METHODS: The Implementing Genomics in Practice Pragmatic Trials Network (IGNITE PTN) was formed in 2018 to measure the clinical utility and cost-effectiveness of genomic medicine interventions, to assess approaches for real-world application of genomic medicine in diverse clinical settings, and to produce generalizable knowledge on clinical trials using genomic interventions. Five clinical sites and a coordinating center evaluated trial proposals and developed working groups to enable their implementation. RESULTS: Two pragmatic clinical trials (PCTs) have been initiated, one evaluating genetic risk APOL1 variants in African Americans in the management of their hypertension, and the other to evaluate the use of pharmacogenetic testing for medications to manage acute and chronic pain as well as depression. CONCLUSION: IGNITE PTN is a network that carries out PCTs in genomic medicine; it is focused on diversity and inclusion of underrepresented minority trial participants; it uses electronic health records and clinical decision support to deliver the interventions. IGNITE PTN will develop the evidence to support (or oppose) the adoption of genomic medicine interventions by patients, providers, and payers.
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    Implementing a pragmatic clinical trial to tailor opioids for acute pain on behalf of the IGNITE ADOPT PGx investigators.
    (Wiley, 2022-07-28) Cavallari, Larisa H.; Cicali, Emily; Wiisanen, Kristin; Fillingim, Roger B.; Chakraborty, Hrishikesh; Myers, Rachel A.; Blake, Kathryn V.; Asiyanbola, Bolanle; Baye, Jordan F.; Bronson, Wesley H.; Cook, Kelsey J.; Elwood, Erica N.; Gray, Chancellor F.; Gong, Yan; Hines, Lindsay; Kannry, Joseph; Kucher, Natalie; Lynch, Sheryl; Nguyen, Khoa A.; Obeng, Aniwaa Owusu; Pratt, Victoria M.; Prieto, Hernan A.; Ramos, Michelle; Sadeghpour, Azita; Singh, Rajbir; Rosenman, Marc; Starostik, Petr; Thomas, Cameron D.; Tillman, Emma; Dexter, Paul R.; Horowitz, Carol R.; Orlando, Lori A.; Peterson, Josh F.; Skaar, Todd C.; Van Driest, Sara L.; Volpi, Simona; Voora, Deepak; Parvataneni, Hari K.; Johnson, Julie A.
    Opioid prescribing for postoperative pain management is challenging because of inter-patient variability in opioid response and concern about opioid addiction. Tramadol, hydrocodone, and codeine depend on the cytochrome P450 2D6 (CYP2D6) enzyme for formation of highly potent metabolites. Individuals with reduced or absent CYP2D6 activity (i.e., intermediate metabolizers [IMs] or poor metabolizers [PMs], respectively) have lower concentrations of potent opioid metabolites and potentially inadequate pain control. The primary objective of this prospective, multicenter, randomized pragmatic trial is to determine the effect of postoperative CYP2D6-guided opioid prescribing on pain control and opioid usage. Up to 2020 participants, age ≥8 years, scheduled to undergo a surgical procedure will be enrolled and randomized to immediate pharmacogenetic testing with clinical decision support (CDS) for CYP2D6 phenotype-guided postoperative pain management (intervention arm) or delayed testing without CDS (control arm). CDS is provided through medical record alerts and/or a pharmacist consult note. For IMs and PM in the intervention arm, CDS includes recommendations to avoid hydrocodone, tramadol, and codeine. Patient-reported pain-related outcomes are collected 10 days and 1, 3, and 6 months after surgery. The primary outcome, a composite of pain intensity and opioid usage at 10 days postsurgery, will be compared in the subgroup of IMs and PMs in the intervention (n = 152) versus the control (n = 152) arm. Secondary end points include prescription pain medication misuse scores and opioid persistence at 6 months. This trial will provide data on the clinical utility of CYP2D6 phenotype-guided opioid selection for improving postoperative pain control and reducing opioid-related risks.
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    Policy Statement on Clinical Informatics Fellowships and the Future of Informatics- Driven Medicine
    (Thieme, 2020-10) Kannry, Joseph; Smith, Jeff; Mohan, Vishnu; Levy, Bruce; Finnell, John; Lehmann, Christoph U.; Emergency Medicine, School of Medicine
    Board certified clinical informaticians provide expertise in leveraging health IT (HIT) and health data for patient care and quality improvement. Clinical Informatics experts possess the requisite skills and competencies to make systems-level improvements in care delivery using HIT, workflow and data analytics, knowledge acquisition, clinical decision support, data visualization, and related informatics tools. However, these physicians lack structured and sustained funding because they have no billing codes. The sustainability and growth of this new and promising medical subspecialty is threatened by outdated and inconsistent funding models that fail to support the education and professional growth of clinical informaticians. The Clinical Informatics Program Directors' Community is calling upon the Centers for Medicare and Medicaid Services to consider novel funding structures and programs through its Innovation Center for Clinical Informatics Fellowship training. Only through structural and sustained funding for Clinical Informatics fellows will be able to fully develop the potential of electronic health records to improve the quality, safety, and cost of clinical care.
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    Reimagining the research-practice relationship: policy recommendations for informatics-enabled evidence-generation across the US health system
    (Oxford Academic, 2019-01-16) Embi, Peter J.; Richesson, Rachel; Tenenbaum, Jessica; Kannry, Joseph; Friedman, Charles; Sarkar, Indra Neil; Smith, Jeff; Medicine, School of Medicine
    Abstract. The widespread adoption and use of electronic health records and their use to enable learning health systems (LHS) holds great promise to accelerate both evidence-generating medicine (EGM) and evidence-based medicine (EBM), thereby enabling a LHS. In 2016, AMIA convened its 10th annual Policy Invitational to discuss issues key to facilitating the EGM-EBM paradigm at points-of-care (nodes), across organizations (networks), and to ensure viability of this model at scale (sustainability). In this article, we synthesize discussions from the conference and supplements those deliberations with relevant context to inform ongoing policy development. Specifically, we explore and suggest public policies needed to facilitate EGM-EBM activities on a national scale, particularly those policies that can enable and improve clinical and health services research at the point-of-care, accelerate biomedical discovery, and facilitate translation of findings to improve the health of individuals and populations.
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    Reimagining the research-practice relationship: policy recommendations for informatics-enabled evidence-generation across the US health system
    (Oxford Academic, 2019-01-16) Embi, Peter J.; Richesson, Rachel; Tenenbaum, Jessica; Kannry, Joseph; Friedman, Charles; Sarkar, Indra Neil; Smith, Jeff; Medicine, School of Medicine
    Abstract. The widespread adoption and use of electronic health records and their use to enable learning health systems (LHS) holds great promise to accelerate both evidence-generating medicine (EGM) and evidence-based medicine (EBM), thereby enabling a LHS. In 2016, AMIA convened its 10th annual Policy Invitational to discuss issues key to facilitating the EGM-EBM paradigm at points-of-care (nodes), across organizations (networks), and to ensure viability of this model at scale (sustainability). In this article, we synthesize discussions from the conference and supplements those deliberations with relevant context to inform ongoing policy development. Specifically, we explore and suggest public policies needed to facilitate EGM-EBM activities on a national scale, particularly those policies that can enable and improve clinical and health services research at the point-of-care, accelerate biomedical discovery, and facilitate translation of findings to improve the health of individuals and populations