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Studies validate use of family health history as gold standard in disease risk assessment
Date:11/5/2010

gnition of patients at risk for hereditary cancer, and increased referrals for genetic consultation and testing. This education program which was developed by Maren Scheuner, MD, MPH, Director of the Health Services Genomics Program and Clinical Genetic Services at VA GLA, and a group of her colleagues is comprised of informational (Web site, CME-approved lecture series), clinical (patient and provider information sheets, a family history reminder with template in the electronic health record (or EHR)), and behavioral components (practice-feedback reports regarding clinicians' use of the EHR tool).

To evaluate the impact of the education program, Scheuner and colleagues kept track of changes in the knowledge, attitudes and behaviors of seven clinicians (five physicians, one nurse practitioner, and one physician assistant) who practice in the Women's Clinics at VA GLA and have agreed to participate in the study. At baseline, the mean percent correct score for clinician knowledge was 55% (range: 26-77%) with the lowest scores in the areas of genetic testing and recognition of hereditary cancer syndromes. The topics rated as most relevant to primary care practitioners were management of hereditary cancer, knowing when to refer a patient, and ethical issues.

The clinical tools developed for the EHR appear to have had the greatest impact in changing clinician behavior. During the first five months of implementation of the education program, 568 cancer family histories were completed using the reminder and template in the EHR. The family history data captured with the template includes information that previously was not routinely documented by the clinicians, but is necessary to recognize high-risk patients, such as a family history of cancer in second-degree relatives, identifying the maternal or paternal lineage of affected relatives, and the age of cancer diagnosis in relatives. As a result, the genetics consultation service at the VA GLA receive
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Contact: Kristen Long
klong@ashg.org
301-634-7346
American Society of Human Genetics
Source:Eurekalert

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