학술논문

Project Baby Bear: Rapid precision care incorporating rWGS in 5 California children’s hospitals demonstrates improved clinical outcomes and reduced costs of care
Document Type
article
Source
American Journal of Human Genetics. 108(7)
Subject
Comparative Effectiveness Research
Pediatric
Clinical Research
Health Services
Clinical Trials and Supportive Activities
Good Health and Well Being
California
Cohort Studies
Cost of Illness
Critical Care
Critical Illness
Female
Hospitals
Pediatric
Humans
Infant
Infant
Newborn
Male
Medicaid
Precision Medicine
Prospective Studies
Treatment Outcome
United States
Whole Genome Sequencing
MediCal
QUALY
comparative effectiveness research
critical care
genetic disease
health outcomes research
neonatal intensive care
pediatrics
quality improvement
quality-adjusted life years
rare disease
real-world care
Biological Sciences
Medical and Health Sciences
Genetics & Heredity
Language
Abstract
Genetic disorders are a leading contributor to mortality in neonatal and pediatric intensive care units (ICUs). Rapid whole-genome sequencing (rWGS)-based rapid precision medicine (RPM) is an intervention that has demonstrated improved clinical outcomes and reduced costs of care. However, the feasibility of broad clinical deployment has not been established. The objective of this study was to implement RPM based on rWGS and evaluate the clinical and economic impact of this implementation as a first line diagnostic test in the California Medicaid (Medi-Cal) program. Project Baby Bear was a payor funded, prospective, real-world quality improvement project in the regional ICUs of five tertiary care children's hospitals. Participation was limited to acutely ill Medi-Cal beneficiaries who were admitted November 2018 to May 2020, were