Barriers to clinical adoption of next generation sequencing: Perspectives of a policy Delphi panel

AbstractThis research aims to inform policymakers by engaging expert stakeholders to identify, prioritize, and deliberate the most important and tractable policy barriers to the clinical adoption of next generation sequencing (NGS). A 4-round Delphi policy study was done with a multi-stakeholder panel of 48 experts. The first 2 rounds of online questionnaires (reported here) assessed the importance and tractability of 28 potential barriers to clinical adoption of NGS across 3 major policy domains: intellectual property, coverage and reimbursement, and FDA regulation. We found that: 1) proprietary variant databases are seen as a key challenge, and a potentially intractable one; 2) payer policies were seen as a frequent barrier, especially a perceived inconsistency in standards for coverage; 3) relative to other challenges considered, FDA regulation was not strongly perceived as a barrier to clinical use of NGS. Overall the results indicate a perceived need for policies to promote data-sharing, and a desire for consistent payer coverage policies that maintain reasonably high standards of evidence for clinical utility, limit testing to that needed for clinical care decisions, and yet also flexibly allow for clinician discretion to use genomic testing in uncertain circumstances of high medical need

Structure and Composition of Wild Black Howler Troops (Alouatta caraya) in Gallery Forests of the Argentinean Chaco

The genus Alouatta occurs from the south of Mexico to northern Argentina and from the South American Pacific Coast to the Brazilian Atlantic Forest. A. caraya is the southernmost species, inhabiting central and southern Brazil, eastern Bolivia, Paraguay, and northern Argentina. Although there are adequate demographic data from populations in the forests of the Río Paraná in Argentina, the data are comparatively limited for populations in the Argentinean Chaco. In this preliminary study we describe the composition and structure of wild troops of A. caraya that inhabit the gallery forests along the Riacho Pilagá in Formosa Province and compare them with data obtained from this area two decades ago.Fil: Juárez, Cecilia Paola. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; ArgentinaFil: Dvoskin, Rachel. Department Of Anthropology.; Estados UnidosFil: Fernandez Duque, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; Argentin