Evidence map›Paper›PMID 29441441›Full record

GuidelineJournal of genetic counseling2018

Comparison of Practice Guidelines, BRCAPRO, and Genetic Counselor Estimates to Identify Germline BRCA1 and BRCA2 Mutations in Pancreatic Cancer.

Robert C Grant, Spring Holter, Ayelet Borgida, Neesha C Dhani, David W Hedley, Jennifer J Knox, Mohammad R Akbari, George Zogopoulos, Steven Gallinger

Abstract readPractice Guideline
PubMed Publisher
In one paragraph

Guideline in Journal of genetic counseling, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Systematic evidence review and meta-analysis of outcomes associated with cancer genetic counseling.Genetics in medicine : official journal of the American College of Medical Genetics · 2024
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Robert C GrantDivision of Medical Oncology, University of Toronto, Toronto, Canada. robert.grant@utoronto.ca.
Spring HolterOntario Pancreas Cancer Study, Toronto, Canada.
Ayelet BorgidaOntario Pancreas Cancer Study, Toronto, Canada.
Neesha C DhaniDivision of Medical Oncology, University of Toronto, Toronto, Canada.
David W HedleyDivision of Medical Oncology, University of Toronto, Toronto, Canada.
Jennifer J KnoxDivision of Medical Oncology, University of Toronto, Toronto, Canada.
Mohammad R AkbariDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
George ZogopoulosResearch Institute of the McGill University Health Centre, Montreal, Canada.
Steven GallingerOntario Institute for Cancer Research, Toronto, Canada.
University of Toronto · CAPrincess Margaret Cancer Centre · CAMcGill University · CAPancreas Centre (Canada) · CAPancreatic Cancer Canada Foundation · CA

Funding

NIH HHS 5R01CA0970975-08
6 · The paper itself

Abstract

Germline BRCA1 and BRCA2 (BRCA) mutation carriers with pancreatic ductal adenocarcinoma (PDAC) may benefit from precision therapies and their relatives should undergo tailored cancer prevention. In this study, we compared strategies to identify BRCA carriers with PDAC. Incident cases of PDAC were prospectively recruited for BRCA sequencing. Probands were evaluated using the National Comprehensive Cancer Network (NCCN) and the Ontario Ministry of Health and Long-Term Care (MOHLTC) guidelines. The probability of each proband carrying a mutation was estimated by surveying genetic counselors and using BRCAPRO. BRCA mutations were detected in 22/484 (4.5%) probands. 152/484 (31.2%) and 16/484 (3.3%) probands met the NCCN and MOHLTC guidelines, respectively. The NCCN guidelines had higher sensitivity than the MOHLTC guidelines (0.864 versus 0.227, P < 0.001) but lower specificity (0.712 versus 0.976, P < 0.001). One hundred and nineteen genetic counselors completed the survey. Discrimination was similar between genetic counselors and BRCAPRO (area-under-the-curve: 0.755 and 0.775, respectively, P = 0.702). Genetic counselors generally overestimated (P = 0.008), whereas BRCAPRO severely underestimated (P < 0.001), the probability that each proband carried a mutation. Our results indicate that the NCCN guidelines and genetic counselors accurately identify BRCA mutations in PDAC, while the MOHLTC guidelines and BRCAPRO should be updated to account for the association between BRCA and PDAC.

Indexed as

Genes, BRCA1Genes, BRCA2Genetic CounselingMutationAdultFemaleHumansMaleMiddle AgedPancreatic NeoplasmsBRCA1BRCA2BRCAPROGenetic counselingGuidelinesPancreatic cancer

Identifiers

PMID29441441
OpenAlexW2789333681

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.