5. https://www.nih.gov/precision-medicine-initiative-cohort-program

6. Graphic generated with data obtained from https://www.genome.gov/https://www.genome.gov/ & https://www.nih.gov/precision-medicine-initiative-cohort-program

8. https://www.whitehouse.gov/

9. https://www.nih.gov/precision-medicine-initiative-cohort-program

14. www.uptodate.com

16. www.23andme.com

17. www.uptodate.com

19. Berger et al 2009

20. The epigenetic pathway. Shelley L. Berger et al. Genes Dev. 2009;23:781-783 Copyright © 2009 by Cold Spring Harbor Laboratory Press

23. Define precision medicine Recap the state of affairs of precision medicine initiatives Introduce the role of ‘Omics’ sciences in personalizing medicine To identify ways in which precision medicine may influence clinical practice through a case-based example, specifically focusing on: Pharmacogenomics Motivating behavioral changes To acknowledge the challenges and limitations of these initiatives

28. 1. Pharmacogenomics

29. The Case of Warfarin

31. Pirmohamed et al (2013)

34. Genotype-Guided vs Clinical Dosing of Warfarin and Its Analogues: Meta-analysis of Randomized Clinical Trials JAMA Intern Med. 2014;174(8):1330-1338. doi:10.1001/jamainternmed.2014.2368 % of time INR in therapeutic rangeMajor bleeding Thromboembolic events INR >4

35. Genotype-Guided vs Clinical Dosing of Warfarin and Its Analogues: Meta-analysis of Randomized Clinical Trials

36. The Case of Warfarin

39. 1. Pharmacogenomics:

40. Schork 2015

41. 1. Pharmacogenomics: Drug effectiveness

42. Chen et al. 2014

43. David SP 2014

45. 2. Motivating behavior change by incorporating genetic risk into counseling

47. Carpenter et al. 2007; Graves et al 2014

50. 2. Motivating behavior change by incorporating genetic risk into counseling Hollands et al 2016

57. Collins & Varmus 2015

62. 2. Improved decision making