Learn how advances in biomedicine hold the potential to revolutionize drug development, drug treatments, and disease prevention: where are we now, and what does the future hold? This course will present short primers in genetics and mechanisms underlying variability in drug responses. A series of case studies will be used to illustrate principles of how genetics are being brought to bear on refining diagnoses and on personalizing treatment in rare and common diseases. The ethical and operational issues around how to implement large scale genomic sequencing in clinical practice will be addressed.
After completing this course, learners will understand
1. The ways in which genetic variants can contribute to human disease susceptibility
2. How to choose among drug therapies based on genetic factors
3. That the functional consequences of the vast majority of genetic variants discovered by modern sequencing are unknown.
This course is targeted primarily at physicians 5+ years out of training. Other healthcare providers, medical/health sciences students, and members of the public may also be interested.
Course launches January 15, 2016.
* The information presented in “Case Studies in Personalized Medicine” is offered for educational and informational purposes only, and should not be construed as personal medical advice. If you have questions or concerns about a medical matter, please consult your doctor or other professional healthcare provider.
The first module of this course will focus on introducing the concept of personalized medicine. We will very briefly review fundamentals of genetics as these apply to personalized medicine (DNA structure; RNA; protein structures; function of DNA; coding; DNA variations; types of genetic variants), as well as review statistical concepts and skills important to clinical data analysis (odds ratios, relative risk, P values, multiple testing, sensitivity, specificity, ROCs). In Module 2 we will explore drug actions and reactions as we look closely at the general mechanisms underlying variability in drug responses, drug metabolism and transport, and genetic variability in drug-handling molecules.
Genetics Definitions, Part II & Types of Genetic Variants•15 minutes
Data Analysis, Part I: What is a Good Study?•13 minutes
Data Analysis, Part II: What is a Good Test?•7 minutes
Introduction to Drug Therapy and General Mechanisms Underlying Variability in Drug Responses•13 minutes
Variability in Drug Therapy•16 minutes
Drug Metabolism & Transport•14 minutes
Genetic Variability in Drug-Handling Molecules•11 minutes
**Inside VUMC: The Promise of Personalized Medicine•1 minute
1 reading•Total 10 minutes
About this course•10 minutes
1 assignment•Total 30 minutes
Introduction to Personalized Medicine•30 minutes
5 discussion prompts•Total 50 minutes
What kinds of data are helpful?•10 minutes
What is a good study?•10 minutes
What is a good test?•10 minutes
Why might an individual who has a non-sense variant not have a phenotype?•10 minutes
What are causes of variability in drug action?•10 minutes
UNIT 2: STUDYING GENETIC VARIATION
Module 2•3 hours to complete
Module details
Module 3 focuses on how we study genetic variation. We'll start by looking at families and populations. Topics that will be introduced include family history and inheritance patterns, ancestry, and linkage. Then in Module 4 we shift our focus to studying the contemporary techniques and technologies used to study genetic variation, including genome-wide association and sequencing.
What's included
7 videos1 assignment4 discussion prompts
Show info about module content
7 videos•Total 104 minutes
Family History and Inheritance Patterns•18 minutes
Ancestry: Genetic Variation Across Generations and Geography•17 minutes
**Inside VUMC: From Phenotype to Genotype and Back: Studying Heart Disease in Families•2 minutes
Genome-Wide Association•26 minutes
Sequencing•29 minutes
**Inside VUMC: History of Sequencing Technologies•2 minutes
1 assignment•Total 30 minutes
Studying Genetic Variation•30 minutes
4 discussion prompts•Total 40 minutes
What are causes of incomplete penetrance?•10 minutes
How big should your GWAS sample size be?•10 minutes
How big would the odds ratio need to be?•10 minutes
Can sequencing inform understanding of common diseases?•10 minutes
UNIT 3: CASE STUDIES IN PERSONALIZED MEDICINE, PART 1
Module 3•4 hours to complete
Module details
In Module 5 we will begin to discuss specific cases as these apply to personalized medicine. We will first look very closely at a case of familial hypercholesterolemia as we investigate how we use genomic medicine to move from a rare disease to a common medication, using genomics to find new drug targets, and a discussion of the side effects of statin therapy. In Module 6 we will look at a collection of "high risk pharmacogenetics"cases that illustrate adverse reactions due to drug metabolism and variable drug responses.
What's included
13 videos1 assignment4 discussion prompts
Show info about module content
13 videos•Total 174 minutes
From rare to common disease: familial hypercholesterolemia•12 minutes
Using Genomics to Find New Drug Targets: Familial Hypercholesterolemia•17 minutes
Muscle Pains During Statin Therapy (Myopathy)•14 minutes
**Inside VUMC: Studying Cardiac Arrhythmias in Cells•4 minutes
A Second Heart Attack a Month After a First•15 minutes
Headache During Venlafaxine (Antidepressant)•17 minutes
Respiratory Arrest After Tonsillectomy•10 minutes
A Bleeding Complication 5 Days After Starting Warfarin•22 minutes
**Inside VUMC: Genotyping•2 minutes
Drug Metabolism and Variable Drug Responses – Four More Examples•17 minutes
1 assignment•Total 30 minutes
Case Studies, Part I•30 minutes
4 discussion prompts•Total 40 minutes
PCSK9 mutations and familial hypercholesterolemia•10 minutes
Simvastatin-related myopathy•10 minutes
Which drug-gene interactions warrant testing?•10 minutes
Should RCTs be done on every pharmacogenomic association before clinical implementation?•10 minutes
UNIT 4: CASE STUDIES IN PERSONALIZED MEDICINE, PART 2
Module 4•3 hours to complete
Module details
Module 7 continues our focus on case studies with a look at some cases that illustrate how personalized medicine informs treatment decisions related to specific diseases/conditions. These include cystic fibrosis, Marfan syndrome, heart failure, neuropsychiatric diseases, and diabetes. Three cases/lessons focus specifically on how genomic medicine informs testing for and treatment of cancer.
What's included
9 videos1 assignment4 discussion prompts
Show info about module content
9 videos•Total 119 minutes
Cystic Fibrosis•12 minutes
Marfan Syndrome•12 minutes
A Case of Idiopathic Heart Failure•16 minutes
Personalizing Care in Neuropsychiatric Disease•19 minutes
Personalizing Care in Diabetes•22 minutes
Genomics to Subtype Cancer•12 minutes
A Family Member With Breast Cancer•15 minutes
A Family Member With Colon Cancer•12 minutes
**Inside VUMC: Organizing Infrastructure to Support Genetic Testing Decisions•1 minute
1 assignment•Total 30 minutes
Case Studies, Part II•30 minutes
4 discussion prompts•Total 40 minutes
How much should a drug cost?•10 minutes
What data are needed in decisions about starting lithium therapy?•10 minutes
Would you order a CYP2D6 genotype before starting venlafaxine?•10 minutes
When to test for BRCA1 mutations?•10 minutes
UNIT 5: PERSONALIZED MEDICINE IN A SYSTEM OF CARE
Module 5•3 hours to complete
Module details
Module 8 serves as a review and a continuing discussion of the cases presented in Modules 5-7, as we take a look at where we are now and what's on the horizon in personalized medicine. In Module 9 we will explore some critical considerations for implementing and operationalizing personalized medicine in a system of care, particularly in the area of informatics. We will discuss the role of the electronic medical record in a learning healthcare system, how electronic records support discovery, and using electronic records in the delivery of personalized medicine.
What's included
9 videos1 assignment3 discussion prompts
Show info about module content
9 videos•Total 96 minutes
Where We Are Now•19 minutes
Where We Are Going•24 minutes
**Inside VUMC: Using iPSCs: Drug Discovery and Drug Efficacy•3 minutes
**Inside VUMC: Generating iPSCs•2 minutes
Electronic Medical Records & The Learning Healthcare System (Discovery)•22 minutes
Using Electronic Records to Personalize Care (Delivery)•19 minutes
**Inside VUMC: Using the EMR to Ascertain Patients for Genetic Studies•2 minutes
**Inside VUMC: Biobanking & DNA Extraction at BioVU•2 minutes
**Inside VUMC: Personalized Medicine is a Team Sport•1 minute
1 assignment•Total 30 minutes
Personalized Medicine in a System of Care•30 minutes
3 discussion prompts•Total 30 minutes
What limits our use of genomic sequencing data in practice?•10 minutes
What are possible drawbacks to widespread use of EMRs?•10 minutes
What are the barriers to widespread implementation of genomic medicine?•10 minutes
FINAL REFLECTION ACTIVITY
Module 6•3 hours to complete
Module details
We are on the verge of having patients come to their physicians with their entire genome sequenced. How can we best use this information to improve care? This course looks closely at many specific genetic variants that have been identified as playing a role in a person’s susceptibility to disease and/or potential for adverse reaction to certain substances/drugs.
In the peer review activity below, please reflect on how your learning in this course has impacted your understanding of personalized medicine. There are two versions of this activity – one for healthcare professionals (doctors, nurses, pharmacists, medical students, etc.), and one for non-healthcare professionals (patients, consumers, general interest, etc.)
Please be sure to choose the appropriate version of the activity.
What's included
2 peer reviews
Show info about module content
2 peer reviews•Total 180 minutes
For Healthcare Professionals•120 minutes
For a General Audience (not Healthcare Professionals)•60 minutes
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Vanderbilt University, located in Nashville, Tenn., is a private research university and medical center offering a full-range of undergraduate, graduate and professional degrees.
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Reviewed on Nov 21, 2016
It was a great course and so much information. I would surely like to get more knowledge and insight of the topic discussed.
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Reviewed on Nov 12, 2019
One of the best courses that I ever completed on coursera. Dr. Dan Roden speaks flawlessly and the way he speaks followed my flow of thoughts and logic. Great course indeed.
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AJ
5·
Reviewed on Feb 14, 2016
very informative course at advanced level and also taps the basics required to understand the advanced concepts wherever necessary.
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