Genome Sequencing in Personalised Medicine: The Development of Clinical Pathways over the Next Five Years

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dc.contributor.advisor Sawyer, A en
dc.contributor.advisor Shepherd, P en
dc.contributor.author Green, Sasha en
dc.date.accessioned 2015-05-20T01:47:07Z en
dc.date.issued 2014 en
dc.identifier.citation 2014 en
dc.identifier.uri http://hdl.handle.net/2292/25586 en
dc.description Full text is available to authenticated members of The University of Auckland only. en
dc.description.abstract The exponentially decreasing cost, time and increasing accessibility of genomic sequencing technologies has meant that personal genome sequencing is becoming an affordable reality. Genomic sequence information is a unique dataset that has the potential to guide personalised medicine, particularly in the area of cancer management. Cancer is becoming an increasing burden worldwide, requiring innovation in healthcare to help combat it. There is already evidence of personalised medicine in cancer management through the use of targeted drug therapies and companion genetic tests, and this is expected to grow due to increasing genomic research and innovation. All tumours have unique combinations of mutations, therefore traditional cancer clinical pathways have been ineffective due to their one-size-fits-all approach. As a small flexible nation that has already embraced technology in healthcare with the digitalisation of electronic medical records, New Zealand may provide a model for using genomic sequence information in the clinical setting. It is proposed that the unique genomic sequence dataset will be stored in the electronic health record and leveraged to guide more personalised decisions in clinical pathways. To investigate this, qualitative semi-structured interviews with sixteen individuals involved in either cancer management or genomic research were undertaken, complemented by secondary data. Interviews aimed to understand the barriers and benefits that genomic sequence information may have in the clinical setting when applied to breast cancer management and its use in clinical pathways. It is evident that a number of ethical, storage, practical, technical, and economic barriers remain to be overcome before a clinical pathway software platform integrated with genomic sequence data can be implemented in routine clinical use. Therapeutic intervention and tumour monitoring were identified as the stages in the breast cancer clinical pathway that genomic information might be applied over the next five years, in combination with the multiplex assay panel sequencing platform. Genomic sequence information is one of many possible datasets contributing to a holistic view of a patient’s health needs in order to provide a personalised approach to cancer management and care coordination. However the linchpin of this technology rests upon the uptake of clinical pathways in routine medical practice. en
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof Masters Thesis - University of Auckland en
dc.relation.isreferencedby UoA99264781086602091 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights Restricted Item. Available to authenticated members of The University of Auckland. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri http://creativecommons.org/licenses/by-nc-sa/3.0/nz/ en
dc.title Genome Sequencing in Personalised Medicine: The Development of Clinical Pathways over the Next Five Years en
dc.type Thesis en
thesis.degree.discipline Bioscience Enterprise en
thesis.degree.grantor The University of Auckland en
thesis.degree.level Masters en
dc.rights.holder Copyright: The Author en
pubs.elements-id 487382 en
pubs.record-created-at-source-date 2015-05-20 en


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