Retrospective Analysis of the Utility of Genetic Testing in Predicting Drug Response in Chronic Pain
Notice bibliographique
Résumé
Abstract Introduction Chronic pain is often unrecognized and/or undertreated, and as a result has significant impact on functional abilities, quality of life, societal participation and health care utilization. Medications remain a mainstay of treatment, but selection for any given patient remains a challenge when trying to predict efficacy and/or side effects. There is interest to see whether genetic analysis of how a given drug is processed for a patient can help with rational drug choices. This appears to have some early support in cardiac, psychiatric and acute pain studies. We studied whether genetic analysis of drug processing using the Pillcheck program could have helped in choosing the appropriate medications in a cohort of patients suffering from chronic pain. To our knowledge this type of study has not been completed in this environment and/or patient population. Methods We retrospectively studied a 31 patient cohort seen in the Canadian Forces Health Services Unit (Ottawa) Physiatry clinic. All patients suffered from a diagnosed chronic pain condition, completed the Pillcheck genetic drug processing analysis and filled-in questionnaires looking at efficacy and side effects of the drugs. We analyzed the correlation between the Pillcheck predictions and participants’ self-reported treatment efficacy and tolerability. The goal was to explore the clinical utility of Pillcheck results in guiding prescriptions for chronic pain patients. Results 31 patients returned completed questionnaires and had samples taken. Forty eight percent of the participants were actively treated with one of the study pain medications, and 84% had been taking at least one of these medications and discontinued. Pillcheck scores did not correlate with self-reported efficacy of any of the medications, nor did it correlate with self-reported side effects. Furthermore, active medications were more likely to receive a score indicating caution should be exerted, than were medications which had been discontinued. Discussion In a small cohort of pain patients with comorbid psychiatric disorders, genetic profiling using Pillcheck did not seem to correlate with reported benefit or side effect profile of commonly prescribed pain medications. Furthermore, discontinued medications were no more likely to be marked as warranting caution than did actively used medications. Conclusion Retrospectively using pharmacogenetics to guide medication selection in Canadian Forces members with chronic pain did not correlate with response or side effects. A larger prospective controlled study, measuring numerous clinical and non- clinical outcomes would be worthwhile in the future before widespread adoption for patients living with chronic pain.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».