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Comment & Response
October 30, 2019

Logistical Challenges Associated With Implementing Precision Medicine—Reply

Author Affiliations
  • 1Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
  • 2PERFUSE Study Group, Beth Israel Deaconess Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Cardiol. 2019;4(12):1301. doi:10.1001/jamacardio.2019.4175

In Reply We read with interest the letter of Stouffer and Lee, which highlights some of the hurdles to be overcome before a personalized medicine strategy can or will be incorporated into routine clinical practice. We appreciate that genotyping results in the Randomized Trial to Compare the Safety of Rivaroxaban vs Aspirin in Addition to Either Clopidogrel or Ticagrelor in Acute Coronary Syndrome (GEMINI-ACS-1) study1 were not provided to investigators as a point-of-care assessment owing to the need for validated central assessments. While this may have affected the use of this data, this does not affect the observation that approximately half of our investigators prestipulated that they would not act on this information in patients treated with clopidogrel.1

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