Clinical decision support (CDS) is often cited as an essential part of pharmacogenomics (PGx) implementations. A multitude of strategies are available; however, it is unclear which strategies are effective and which metrics are used to quantify clinical utility. The objective of this scoping review was to aggregate previous studies into a cohesive depiction of the current state of PGx CDS implementations and identify areas for future research on PGx CDS. Articles were included if they (i) described electronic CDS tools for PGx and (ii) reported metrics related to PGx CDS. Twenty of 3,449 articles were included and provided data on PGx CDS metrics from 15 institutions, with 93% of programs located at academic medical centers. The most common tools in CDS implementations were interruptive post-test alerts. Metrics for clinical response and alert response ranged from 12–73% and 21–98%, respectively. Few data were found on changes in metrics over time and measures that drove the evolution of CDS systems. Relatively few data were available regarding support of optimal approaches for PGx CDS. Post-test alerts were the most widely studied approach, and their effectiveness varied greatly. Further research on the usability, effectiveness, and optimization of CDS tools is needed.

中文翻译：

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药物基因组学临床决策支持：范围界定审查

临床决策支持 (CDS) 通常被认为是药物基因组学 (PGx) 实施的重要组成部分。有多种策略可用；然而，尚不清楚哪些策略是有效的，哪些指标用于量化临床效用。本范围审查的目的是将以前的研究汇总成对 PGx CDS 实施现状的连贯描述，并确定 PGx CDS 未来研究的领域。如果文章 (i) 描述了 PGx 的电子 CDS 工具并且 (ii) 报告了与 PGx CDS 相关的指标，则它们被包括在内。包括 3,449 篇文章中的 20 篇，并提供了来自 15 个机构的 PGx CDS 指标数据，其中 93% 的项目位于学术医疗中心。CDS 实施中最常用的工具是中断性测试后警报。临床反应和警报反应的指标分别为 12-73% 和 21-98%。关于指标随时间变化和推动 CDS 系统发展的措施的数据很少。关于支持 PGx CDS 最佳方法的可用数据相对较少。测试后警报是研究最广泛的方法，它们的有效性差异很大。需要进一步研究 CDS 工具的可用性、有效性和优化。