Evidence map›Paper›PMID 39669592›Full record

ArticleGenetics in medicine open2024

Processes and outcomes from a clinical genetics e-consultation service managed by a primary care physician champion.

Benjamin J Kerman, Carrie B L Zawatsky, Elizabeth Fieg, Natasha Y Frank, Roseann S Donnelly, Robert C Green, John C Kennedy, Neal Lakdawala, Adam M Licurse, Emma F Perez and 5 more

Abstract read
In one paragraph

Article in Genetics in medicine open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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. Article
  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

15 authors.

Benjamin J KermanDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Carrie B L ZawatskyDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Elizabeth FiegDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Natasha Y FrankDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Roseann S DonnellyDepartment of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston, MA.
Robert C GreenDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
John C KennedyHarvard Medical School, Boston, MA.
Neal LakdawalaHarvard Medical School, Boston, MA.
Adam M LicurseHarvard Medical School, Boston, MA.
Emma F PerezDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Charlene L PreysVA Boston Healthcare System, Boston, MA.
Joel B KrierHarvard Medical School, Boston, MA.
Huma Q RanaHarvard Medical School, Boston, MA.
Bethany ZettlerDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Jason L VassyDivision of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.

Funding

Pragmatic randomized trial of polygenic risk scoring for common diseases in primary careR35HG010706 · NHGRI · HARVARD MEDICAL SCHOOL · PI VASSY, JASON L · 2019 to 2024
$2.6M
NHGRI NIH HHS R35 HG010706
6 · The paper itself

Abstract

Purpose: Timely access to clinical genetics consultations remains a barrier to timely genomic medicine services, which new service delivery models might help address. Methods: We implemented a genetics electronic consultation (eConsult) service staffed by a primary care physician (PCP) champion, supervised by genetics specialists. Chart reviews from July 2018 to January 2022 examined categories of questions received, e-consultant's recommendations, and outcomes of any conventional genetics referrals. Providers were surveyed on likelihood of ordering a conventional genetics consultation before eConsult and satisfaction with eConsult responses. Results: Conventional genetics consultation was recommended for 338 out of 462 (73%) eConsults received, among whom 254 out of 338 (75%) had an order placed for a conventional consult by the provider requesting the eConsult. Among all 462 eConsults, including in cases which conventional consult was not recommended, 279 (60%) were referred for conventional genetics consultation, of which 171 out of 279 (61%) completed a consult. Of these, 122 out of 171 (71%) were recommended for genetic testing, and 84 out of 122 (69%) completed testing. The genetic testing of 23 out of 84 (27%) patients identified informative actionable findings. Supervising genetics specialists made substantive revisions to PCP draft responses for only 8% (36/462) of eConsults. Conclusion: This case series demonstrates that a PCP champion eConsult model can feasibly triage and respond to genetics questions with PCP-relevant content and yield high provider satisfaction. Such a model warrants further evaluation as an addition to the genetic services of health care systems.

Indexed as

Clinical geneticse-consultationOutcomesPrimary care

Identifiers

PMID39669592
PMCPMC11613873

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.