FIGURE 2.

Steps for the design of clinical pharmacogenomics (PGx) in the hospital setting. The first step is to evaluate the available PGx evidence, review the most relevant drugs, and narrow down to the most actionable drug-gene pairs, then is to choose variant alleles based on population specific minor allele frequencies and data curated and evaluated by experts and drug regulatory authorities. Next is to decide with the molecular laboratory on the genotyping strategies and methods. Then is to work out with the information technology team the best way to interpret and report PGx test results, ideally into patients’ electronic health records if available, and with clinical decision support systems if feasible.