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Okay, now for a little hands-on action. The steps are short and straightforward, but the results are both useful and interesting. I encourage you to try out these steps. Even if you ve been sitting there with your jaw hanging open throughout the entire chapter, even if you haven t the slightest idea what you re doing, you ll be able to create a fully functioning filter. The steps show you how to create the Rotator filter included on the CD-ROM. For a sneak peek at the havoc you can wreak with this filter, look at Figure A-45. Talk about your incentives!

If the only subjects enrolled in phase I and II clinical trials had genotypes (discovered by pharmacogenetic testing) that indicated that a new drug was likely to be safe and/or ef cacious in them, the size of the clinical trial could be reduced, lowering costs and making it more likely that fewer subjects would respond adversely or not at all (Roses, 2000a; Shi et al, 2001) The question is, how would researchers know which genotypes are more likely to make a new drug safe and ef cacious Predictions based on the importance of a drug-metabolizing enzyme may not be realized A minor enzyme in the metabolism of a drug (eg, CYP1A2) may play a major role in ADRs and another that is estimated to be in the major metabolic pathway of several drugs (eg.

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2453 Signi cance of Pre-Op Data Organization 24531 Organization of the Pre-Op Data Traditionally surgeons have relied on their memory for locating the body region where the procedure is to be performed They review the MRI and X-ray images the day before surgery and study the approach to be taken during the procedure These images are also brought to the OR for reference But they are displayed in hardcopy in an unorganized fashion scattered throughout the OR The next few paragraphs focus on the organization of the pre-op patient information that requires the preparation process described earlier This process is not done on the day of surgery; the information is saved days in advance with the display streamlined and organized for ef ciency purposes 2453.

, CYP2D6) may not be involved in as many ADRs because of the lower frequency of the harmful polymorphisms (Phillips et al, 2001) or the presence of compensatory pathways (Kalow and Grant, 1995) If tests used to screen subjects for clinical trials do not have high positive predictive values, some people in whom the drug would prove to be ef cacious and safe will be eliminated from the trial Rather than screen before phase I and II trials, the pharmacogenetic pro les can be obtained afterwards Those who tolerated and responded to a drug can be compared with those with ADRs or therapeutic failure The ensuing phase III trials, which enroll many more patients than phase I and II trials, could recruit only those patients with a favorable pharmacogenetic pro le [T]rials could be smaller and faster, and less expensive (Roses, 2000b) This approach poses two problems.

2 Surgical Whiteboard Data In addition to the input data described earlier, one type of pre-op data that is critical during surgery is the handwritten whiteboard information located at the entrance of the OR that contains a very short summary of the patient such as name, gender, age, weight, height, any allergies, comorbidity, and pain The pre-op authoring module described has been designed to integrate the whiteboard information onto the same pre-op screen for display in the OR during the surgery The following survey measures are included: 1 Visual analog scale (VAS): This a psychometric response scale to describe the amount of pain a patient is feeling from a speci c part of her/his body 2.

Oswestry disability index: This is based on the patient s responses to the pain survey used to identify how the pain in the back or legs is affecting the patient in his/her daily activities (Fig 2419B) 2454 Graphical User Interface The ePR system is designed to be user-friendly but effective at the same time So a criterion of the user interface is to minimize the number of mouse clicks needed to.

First, a favorable pro le is unlikely to be found only in drug responders and never in nonresponders; subject-patients who lack the pro le could still bene t from the drug Second, by reducing the number of subjects in phase III trials there will be.

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