ArticleGenetics in medicine : official journal of the American College of Medical Genetics2016
Clinical utility of a Web-enabled risk-assessment and clinical decision support program.
Article in Genetics in medicine : official journal of the American College of Medical Genetics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect of genetics clinical decision support tools on health-care providers' decision making: a mixed-methods systematic review.Genetics in medicine : official journal of the American College of Medical Genetics · 2021Pooled it
- Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Pooled it
- A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer.Journal of general internal medicine · 2023Trial
- An Innovative Strategy for Collecting Family Health History: An Effectiveness-Implementation Trial in Primary Care Clinics.Annals of family medicine · 2025Article
- Making Informed Choices On Incorporating Chemoprevention into carE (MiCHOICE, SWOG 1904): Design and methods of a cluster randomized controlled trial.Contemporary clinical trials · 2024Article
- Implementation-effectiveness trial of systematic family health history based risk assessment and impact on clinical disease prevention and surveillance activities.BMC health services research · 2022Article
- Experience and Perceptions of a Family Health History Risk Assessment Tool among Multi-Ethnic Asian Breast Cancer Patients.Journal of personalized medicine · 2021Article
- Clinical implementation of an oncology-specific family health history risk assessment tool.Hereditary cancer in clinical practice · 2021Article
- Primary care physician experiences utilizing a family health history tool with electronic health record-integrated clinical decision support: an implementation process assessment.Journal of community genetics · 2020Article
- Evaluation of family health history collection methods impact on data and risk assessment outcomes.Preventive medicine reports · 2020Article
- Applying theory to characterize impediments to dissemination of community-facing family health history tools: a review of the literature.Journal of community genetics · 2020Review
- Effectiveness of interventions to identify and manage patients with familial cancer risk in primary care: a systematic review.Journal of community genetics · 2020Article
- Article
- Family health history: underused for actionable risk assessment.Lancet (London, England) · 2019Review
- Opportunities, resources, and techniques for implementing genomics in clinical care.Lancet (London, England) · 2019Review
- Effect of Sociodemographic Factors on Uptake of a Patient-Facing Information Technology Family Health History Risk Assessment Platform.Applied clinical informatics · 2019Article
- Operationalizing the Reciprocal Engagement Model of Genetic Counseling Practice: a Framework for the Scalable Delivery of Genomic Counseling and Testing.Journal of genetic counseling · 2018Article
- Review and Comparison of Electronic Patient-Facing Family Health History Tools.Journal of genetic counseling · 2018Review
- How do we increase uptake of tamoxifen and other anti-estrogens for breast cancer prevention?NPJ breast cancer · 2017Article
- Exploring precision medicine by utilizing individual genetic information for the management of Alzheimer's disease.PharmacogenomicsReview
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRisk-stratified guidelines can improve quality of care and cost-effectiveness, but their uptake in primary care has been limited. MeTree, a Web-based, patient-facing risk-assessment and clinical decision support tool, is designed to facilitate uptake of risk-stratified guidelines.
methodsA hybrid implementation-effectiveness trial of three clinics (two intervention, one control).
participantsconsentable nonadopted adults with upcoming appointments. PRIMARY OUTCOME: agreement between patient risk level and risk management for those meeting evidence-based criteria for increased-risk risk-management strategies (increased risk) and those who do not (average risk) before MeTree and after. MEASURES: chart abstraction was used to identify risk management related to colon, breast, and ovarian cancer, hereditary cancer, and thrombosis.
resultsParticipants = 488, female = 284 (58.2%), white = 411 (85.7%), mean age = 58.7 (SD = 12.3). Agreement between risk management and risk level for all conditions for each participant, except for colon cancer, which was limited to those <50 years of age, was (i) 1.1% (N = 2/174) for the increased-risk group before MeTree and 16.1% (N = 28/174) after and (ii) 99.2% (N = 2,125/2,142) for the average-risk group before MeTree and 99.5% (N = 2,131/2,142) after. Of those receiving increased-risk risk-management strategies at baseline, 10.5% (N = 2/19) met criteria for increased risk. After MeTree, 80.7% (N = 46/57) met criteria.
conclusionMeTree integration into primary care can improve uptake of risk-stratified guidelines and potentially reduce "overuse" and "underuse" of increased-risk services.Genet Med 18 10, 1020-1028.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.