Assessing patient readiness for the clinical adoption of personalized medicine.

BACKGROUND/AIMS: Although pharmacogenomics-based diagnostics and therapeutics are increasingly being translated into personalized medicine applications, relatively little evidence exists about how novel pharmacogenomics-based technologies will be accepted and adopted by patients. It is important to understand the characteristics of genomic diagnostics and targeted therapeutics that might impact utilization or serve as barriers to adoption of these novel technologies in order to formulate appropriate policies and procedures. The objective of this study was to investigate patients' understanding and knowledge of personalized medicine and the process of decision-making regarding pharmacogenomics testing and targeted therapeutics and to better understand how patients value receiving pharmacogenomics-based care. METHODS: We conducted 4 focus groups with 8-10 individuals in each group with patients recruited from out-patient clinics at The Methodist Hospital in Houston, Tex., USA. RESULTS: The use of genomic diagnostics and targeted therapeutics to facilitate personalized medicine has considerable support from patients. However, our data revealed that participants were concerned with issues surrounding privacy and confidentiality of genetic test results, particularly with respect to access of information by insurers, with potential costs of testing and issues related to accuracy of test results. Questions regarding willingness to pay revealed that patients would be more willing to pay out-of-pocket if the disease associated with pharmacogenomic testing for treatment was perceived to be high risk (e.g., colorectal cancer) versus a chronic condition that was perceived as lower risk (e.g., high cholesterol). CONCLUSION: As the personalized medicine approach is increasingly incorporated into health care, understanding patients' needs and their readiness to adopt these novel technologies will become progressively more important for the development of appropriate health policies.

Stereotactic excision of deeply seated intracranial mass lesions.

Fourteen cases of stereotactic excision of deeply seated intracranial masses is reported. A simple and comparatively inexpensive technique facilitates the excision of well demarcated deep and small tumours. The procedure is suitable for the excision of solitary metastasis, some small gliomas and intraventricular tumours.