Evidence map›Paper›PMID 40857647›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2025

Electronic health records-based algorithms to screen for U.S. Centers for Disease Control and Prevention tier 1 genetic diseases: a scoping review.

William R Harris, Marianna S Hernandez, Khanh N H Ngo, Anne Fladger, Charles A Brunette, Sulaiman R Hamarneh, Joshua W Knowles, Matthew S Lebo, Jason L Vassy

Abstract readScoping Review
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Harnessing data to advance health and health equity.Journal of the American Medical Informatics Association : JAMIA · 2025
    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.

William R HarrisHarvard Medical School, Boston, MA, 02115, United States.ORCID 0009-0007-0011-5181
Marianna S HernandezMassachusetts College of Pharmacy and Health Sciences, Boston, MA, 02115, United States.
Khanh N H NgoUniversity of California, Irvine, Irvine, CA, 92697, United States.
Anne FladgerCountway Library of Medicine, Harvard Medical School, Boston, MA, 02115, United States.
Charles A BrunetteVA Boston Healthcare System, Boston, MA, 02130, United States.ORCID 0000-0003-1620-3526
Sulaiman R HamarnehVA Boston Healthcare System, Boston, MA, 02130, United States.
Joshua W KnowlesDepartment of Medicine, Division of Cardiovascular Medicine, Cardiovascular Institute and Prevention Research Center, Stanford University School of Medicine, Stanford, CA, 94305, United States.
Matthew S LeboHarvard Medical School, Boston, MA, 02115, United States.ORCID 0000-0002-9733-5207
Jason L VassyVA Boston Healthcare System, Boston, MA, 02130, United States.ORCID 0000-0001-6113-5564

Funding

Stanford Islet Research CoreP30DK116074 · NIDDK · STANFORD UNIVERSITY · PI Seung K Kim · 2017 to 2026
$19.5M
Characterization of novel insulin resistance genes by gene editing, high-throughput phenotyping and in vivo studiesR01DK120565 · NIDDK · STANFORD UNIVERSITY · PI KNOWLES, JOSHUA WILEY · 2019 to 2023
$3.2M
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
Mechanisms of NAT2 Regulation of Insulin Resistance and Mitochondrial DysfunctionR01DK116750 · NIDDK · STANFORD UNIVERSITY · PI KNOWLES, JOSHUA WILEY · 2019 to 2023
$2.4M
Beyond GWAS of insulin resistance: An integrated approach to translate genetic association to functionR01DK106236 · NIDDK · STANFORD UNIVERSITY · PI KNOWLES, JOSHUA WILEY · 2016 to 2020
$2.4M
Molecular Mechanisms of Insulin Resistance Associated LociR01DK107437 · NIDDK · STANFORD UNIVERSITY · PI QUERTERMOUS, THOMAS · 2016 to 2019
$2.2M
Molecular Mechanisms of Insulin Resistance Associated LociR01DK137889 · NIDDK · STANFORD UNIVERSITY · PI Joshua Wiley Knowles · 2024 to 2026
$1.8M
The VA Genomics Learning Health System: Implementing genomic medicine across diverse veteran communitiesU01HG013781 · NHGRI · BOSTON VA RESEARCH INSTITUTE, INC. · PI Lori Ann Orlando, MAREN Theresa SCHEUNER · 2024 to 2026
$1.2M
CSRD VA I01 CX002635HSRD VA I01 HX003627NHGRI NIH HHS R35 HG010706NHGRI NIH HHS U01 HG013781NIDDK NIH HHS P30 DK116074NIDDK NIH HHS R01 DK106236NIDDK NIH HHS R01 DK107437NIDDK NIH HHS R01 DK116750NIDDK NIH HHS R01 DK120565NIDDK NIH HHS R01 DK137889NIH HHS P30DK116074NIH HHS R01 DK106236NIH HHS R01 DK107437NIH HHS R01 DK116750NIH HHS R01 DK120565NIH HHS R01 DK137889NIH HHS R35 HG010706NIH HHS U01 HG013781VA I01 CX002635VA I01 HX003627
6 · The paper itself

Abstract

objectiveMissed diagnosis of genetic conditions is a persistent challenge in clinical care, particularly for familial hypercholesterolemia (FH), hereditary breast and ovarian cancer (HBOC), and Lynch syndrome-conditions designated by the U.S. Centers for Disease Control and Prevention (CDC) as Tier 1 genomic applications. This scoping review summarizes evidence on the use of electronic health record (EHR)-based algorithms to identify individuals with these conditions. MATERIALS AND

methodsWe conducted a scoping review using the JBI Manual for Evidence Synthesis and reported results according to PRISMA-ScR guidelines. We searched Ovid MEDLINE, Embase, and Web of Science through October 2024 for studies evaluating EHR-based algorithms to identify individuals with FH, HBOC, or Lynch syndrome. Eligible studies addressed (1) performance of algorithms in detecting clinically or genetically confirmed cases or (2) outcomes from the implementation of algorithms in unselected populations with follow-up to identify new diagnoses.

resultsOf 598 articles screened, 22 met inclusion criteria. Most studies (20/22) focused on FH. Fourteen FH studies assessed algorithm performance, and 7 reported prospective implementation. FH algorithm performance varied widely (AUROC range 0.78-0.95), with machine learning models outperforming rule-based approaches. Implementation studies reported positive predictive values ranging from 11% to 67%. Only two studies addressed HBOC or Lynch syndrome, both using rules-based algorithms with limited sensitivity. DISCUSSION: Machine learning models consistently outperform rules-based algorithms relying on clinical criteria, but limited evidence exists for HBOC and Lynch syndrome.

conclusionsEarly identification of CDC Tier 1 genetic conditions through EHR-based screening algorithms holds promise but will require both technical and implementation advances to realize improved patient care and outcomes.

Indexed as

AlgorithmsColorectal Neoplasms, Hereditary NonpolyposisElectronic Health RecordsGenetic TestingHereditary Breast and Ovarian Cancer SyndromeHyperlipoproteinemia Type IICenters for Disease Control and Prevention, U.S.HumansUnited Stateselectronic health recordsfamilial hypercholesterolemiagenomic screeninghereditary breast and ovarian cancer syndromeLynch syndromemachine learning

Identifiers

PMID40857647
PMCPMC12451938

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Registered trials

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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.