Timely Ordering of Pharmacogenetic Testing
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: ML-based intervention.
- Who it may be relevant to
- Registry conditions: Machine Learning, Prediction Models, Pediatrics, Precision Medicine. Basic parameters: 6 months — 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Canada
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Timely Ordering of Pharmacogenetic Testing in Pediatric Oncology
Overview
The goal of this trial is to learn if a machine learning (ML) model can help optimize drug therapy in the pediatric population. The main question\[s\] it aims to answer are whether a machine learning model predicting receipt of a targeted medication within the next three months: * Increases the offering of pharmacogenetic testing prior to receipt of a targeted medication * Increases the number of patients with pharmacogenetic results prior to receipt of a targeted medication * Increases the number of patients who have alteration in medication choice or dose based on pharmacogenetic results This trial only focuses on the prediction and provision of participants with a high-risk of receiving a medication with a pharmacogenetic indication in the next three months.
Detailed description
This study aims to evaluate the effectiveness of a ML model in predicting patients at high risk of requiring a "targeted medication" within the next three months. A machine learning model will predict, the morning following admission to any inpatient service, whether there will be receipt of a targeted medication within the next three months. The research team will be notified regarding eligible patients each morning, and the research team or pharmacogenomics team will approach the patient's primary care team as applicable. By leveraging ML, this study seeks to enhance the identification of patients who would benefit from such medications in a timely and resource-efficient manner.
The study team identified specific medications as indications for pharmacogenetic testing based on prevalence and level of evidence for modifying prescribing practices. These pre-selected medications are referred to as "targeted medications" and are as follows: azathioprine, brivaracetam, clobazam, clopidogrel, flecainide, phenytoin, tacrolimus, voriconazole and warfarin. Only systemically administered (oral, subcutaneous, intramuscular or intravenous) medications or prescriptions (e.g. not topical, intrathecal or intravitreal) are included. Phenytoin was only considered if given orally (to exclude emergency administration without a plan for ongoing treatment).
Pharmacogenetic testing will be offered to participants and conducted as addressed in an associated pharmacogenetic testing protocol (REB# 1000053445 PI: Iris Cohn).
Interventions
- Other ML-based intervention
A ML-based model will predict and identify participants that are at high-risk of receiving a targeted medication within three months after their hospital admission date.
Primary outcome measures
- Proportion of Patients with Pharmacogenetic Testing [Time frame: Day 1 to 3 months]
Secondary outcome measures (2)
- Number of patients with pharmacogenetic results available prior to receipt of targeted medication [Time frame: Day 1]
- Number of patients who have alteration in medication choice or dose based on pharmacogenetic results [Time frame: Day 1]
Eligibility criteria
Inclusion criteria
- Inpatient at The Hospital for Sick Children
- Between 6 months to 18 years old
Exclusion criteria
- Prior pharmacogenetic testing and/or prior receipt of a targeted medication
- Current Intensive Care Unit (ICU) admission
- Expected hospital discharge is prior to midnight on the day of admission
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
Canada · 1 center
- The Hospital for Sick Children — Toronto
Identifiers
NCT: NCT06902688 · 3423