precise_cip

HIPER is pleased to announce that we have been awarded the PRECISE Clinical Implementation Pilot (CIP) Grant for three precision medicine research projects and supplementary funding for related pilot studies. Each project will receive up to $1.5 million over a 2-year period. The CIP grant will support our research efforts to improve patient outcomes, whilst working towards cost sustainability and the optimisation of healthcare experiences for both providers and patients.

We’d like to give due credits to the team who have worked tirelessly to secure the grants for the following projects:  

1. BREAst Cancer Screening Tailored for Her (BREATHE): A breath of fresh air to breast cancer screening in Singapore
2. Clinical Implementation of Pre-emptive Pharmacogenomic Testing as a Precision Medicine Tool in Routine Clinical Practice in Singapore. 
3. Addressing the challenges in Case identification, Cascade Screening, Genetic testing and Treatment in Familial Hypercholesterolemia (FH) – a cross-cluster clinical implementation program by FHCARE

HIPER has also been awarded supplementary grant for the project ELectronic PHenotyping to Enhance Patient Access to Precision Medicine (ELPHA)

1) BREAst Cancer Screening Tailored for HEr: A breath of fresh air to breast cancer screening in Singapore 

Grant quantum: $1,500,000

The BREAst screening Tailored for HEr (BREATHE) study, a prospective cohort study, endeavors to change the current age-based screening paradigm in a prospective study for women aged 35-59 years. The initiative uses validated breast cancer risk calculators incorporating genetic (breast cancer polygenic risk score and BOADICEA breast cancer predisposition genes) and non-genetic risk factors (Gail model, mammography density, recall status) to generate individual breast cancer risk profiles.

BREATHE aims to 1) assess the feasibility of a risk-based breast cancer screening paradigm, 2) increase participation of routine screening by empowering women with knowledge about their breast cancer risk, and ultimately 3) change screening frequencies to suit personal risk level to maximize efficiency and cost.

Under the aegis of the Jurong Health Fund, BREATHE is currently being piloted at the Ng Teng Fong General Hospital, National University Hospital, Bukit Batok Polyclinic and Choa Chu Kang Polyclinic. With support from the PRECISE CIP grant call, the study will be expanded to include Alexandra Hospital and Jurong Medical Centre, benefiting more women in the process.

Dr Wang Yi of HIPER is working on this research as the Health Economics PI, together with Assoc Prof Mikael Martman, Clinical PI and Senior Consultant at NUH, and Dr Jingmei Li, Scientific PI and Group Leader and NRF Fellow Women’s Health and Genetics, Genome Institute of Singapore at A*STAR.

2)  Clinical Implementation of Pre-emptive Pharmacogenomic Testing as a Precision Medicine Tool in Routine Clinical Practice in Singapore.  

Grant quantum: $1,499,998

This is a prospective, longitudinal, interventional, and pragmatic multi-cluster study involving the clinical utility of pre-emptive PGx testing to guide drug and dosage selection. The study aims to a) allow clinicians to readily access the patient’s PGx test results to guide clinical decisions; b) avert adverse drug reactions (ADR) with genotype-guided treatment; c) avert use of drugs that do not work for certain patients with the mutation; and d) incorporate Best Practice Alert (BPA) into the new electronic health record system – EPIC to pave the path for precision medicine for new drug-gene pairs to be added on the pre-emptive panel testing in the future. 

Associate Professor Wee Hwee-Lin, Director of HIPER and the Health Economist PI of this research, works closely with the Clinical PI Dr. Boon Cher Goh, Department of Haematology-Oncology, National University Cancer Institute, Singapore.

3)  Addressing the challenges in Case identification, Cascade Screening, Genetic testing and Treatment in Familial Hypercholesterolemia (FH) – a cross-cluster clinical implementation program by FHCARE

Grant quantum: $1,500,000

This is a longitudinal observational cohort study that aims to a) improve case detection and reduce under-diagnosis of Familial Hypercholesterolemia (FH) by enhancing cascade screening, and b) increase the number of people with FH who achieve low density lipoproteins cholesterol (LDL-C) goal.

The study proposes that  a  co-ordinated  team,  dedicated  to  screening  of  patients,  determining  their genetic variants and maximizing the efficiency of cascade screening of their family members will allow early identification, diagnosis and optimized therapies for FH for primary and secondary prevention of Cardiovascular Disease.

With this project, three supplementary projects were approved; (1) Bot Terms Up – personalised tools to support genetic risk services; (2) Whole genome genotyping and next generation sequencing technologies for precision medicine in the clinic (NGS); and (3) Establishing a structured genetic education model amongst healthcare professionals.

The total quantum for these 3 supplementary projects are $735,000.

Associate Professor Wee Hwee-Lin, Director of HIPER, is the Health Economist PI of this research project, working closely with Dr. Tavintharan Subramaniam, the Clinical PI from Department of Medicine, Clinical Research Unit, Khoo Teck Puat Hospital.

4) ELectronic PHenotyping to Enhance Patient Access to Precision Medicine (ELPHA)

Supplementary grant quantum: $1,007,300

Cost-effective use of genomic tests requires identification of patients who are most likely to benefit from testing, and yet the selection process is currently not well informed and is largely passive. Electronic phenotyping using rich clinical, laboratory and imaging data available in electronic medical records coupled with genomic data and the application of artificial intelligence and machine learning will enable us to more efficiently identify patients who are likely to benefit from precision medicine. In this shared service project, we will bring together investigators from three regional health systems (RHS) across the CIP projects. 

Stay tuned for more updates in the coming months!

Please contact hiper@nus.edu.sg for any questions regarding the above projects.