A Rapid-ACCE review of CYP2C9 and VKORC1 allele testing to inform warfarin dosing in adults at elevated risk for thrombotic events to avoid serious bleeding
This chapter describes the results from a Rapid-ACCE review (Analytic validity, Clinical validity, Clinical utility, and Ethical, legal, and social implications), designed to facilitate the transition of genetic tests from investigational settings to clinical and public health practice. The ACCE model is composed of a standard set of 44 questions, and builds on the methodologies and terminology introduced by the Secretary's Advisory Committee on Genetic Testing. In this review, the genetic test is CYP2C9 and VKORC1 genotyping, the disorder is serious bleeding, and the clinical scenario is adults at elevated risk for thrombotic events who are candidates for warfarin. These two genes are responsible for much of the observed differences in drug metabolism between individuals.
Keywords: Rapid-ACCE review, genetic tests, public health practice, CYP2C9, VKORC1, warfarin, serious bleeding, thrombotic events
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