Panel Assesses Evidence For The Collection And Use Of Family Health History Information
Gumbo
Information
Main Category: Diabetes
Also Included In: Stroke; Cancer / Oncology; Heart Disease
Article Date: 28 Aug 2009 - 4:00 PDT
Though most Americans are familiar with completing a questionnaire about
their family health history when visiting health care providers, an
independent panel was convened by the National Institutes of Health this
week to critically assess exactly what we know and what we need to learn
about how this process relates to improving health. The conference focused
on the use of family history in the primary care setting for common diseases
such as diabetes, stroke, cancer, and heart disease. The panel has released
their findings in a statement that is available at http://consensus.nih.gov.
Reporting a positive history of a family disease or condition to a health
care provider could prompt a range of next steps, from lifestyle changes
including diet and exercise to referral to genetic services or other
specialists. The panel perceived a need to approach their assessment from a
balanced perspective, appreciating the potential for both benefits and harms
of obtaining and acting upon family history information. Their statement
recognized the longstanding use and intuitive appeal of this relatively
simple and noninvasive tool to try to improve health outcomes for at-risk
individuals. The collection of a family history may also foster productive
relationships between individuals and their clinicians. At the same time,
theoretical harms, such as overtreatment and patient anxiety, should be
taken into account. The panel's findings and recommendations were aimed
primarily at the research and health professional communities, rather than
the public at large, and intended to inform the research agenda rather than
influence current clinical practice.
"Given the unprecedented proliferation of genomic information, it is
imperative to clarify the role of family history in improving health," said
Panel Chair Dr. Alfred O. Berg, a Professor in the Department of Family
Medicine at the University of Washington, Seattle. "Additionally, increased
emphasis on personalized medicine and electronic health records creates a
fascinating opportunity to maximize the value of this information
responsibly."
The panel recognized that family history has an important role in the
practice of medicine and may motivate positive lifestyle changes, enhance
individual empowerment, and influence clinical interventions. The panel
found that it is unclear how this information can be effectively gathered
and used in the primary care setting for common diseases. Additional
research is needed to understand how the routine collection of family
history will lead to improved health outcomes. To help address these gaps,
the panel outlined several research recommendations in three categories: the
family health information to be collected, the optimal way to collect and
use it, and the outcomes of this tool for diagnosis and engagement with
individuals and family members.
Individuals interested in recording their family's health history can visit
http://www.hhs.gov/familyhistory, a tool provided by the Office of the
Surgeon General.
The panel's complete updated draft state-of-the-science statement is
available at http://consensus.nih.gov. The conference was sponsored by the
NIH Office of Medical Applications of Research and the National Human Genome
Research Institute along with other NIH and Department of Health and Human
Services components. This conference was conducted under the NIH Consensus
Development Program, which convenes conferences to assess the available
scientific evidence and develop objective statements on controversial
medical issues.
The 16-member conference panel included experts in the fields of family
medicine, population health, pediatrics, obstetrics and gynecology, health
economics, epidemiology, biostatistics, genetic counseling, medical
genetics, nursing, health informatics, endocrinology, behavioral science,
ethics, health services and outcomes research, and a public representative.
A complete listing of the panel members and their institutional affiliations
is included in the draft conference statement.
In addition to the material presented at the conference by speakers and the
comments of conference participants presented during discussion periods, the
panel considered pertinent research from the published literature and the
results of a systematic review of the literature. The systematic review was
prepared through the Agency for Healthcare Research and Quality
Evidence-based Practice Centers (EPC) program, by the McMaster University
Evidence-based Practice Center. The EPCs develop evidence reports and
technology assessments based on rigorous, comprehensive syntheses and
analyses of the scientific literature, emphasizing explicit and detailed
documentation of methods, rationale, and assumptions. The evidence report on
family history and improving health is available at
http://www.ahrq.gov/clinic/tp/famhimptp.htm.
The panel's statement is an independent report and is not a policy statement
of the NIH or the federal government. The NIH Consensus Development Program
was established in 1977 as a mechanism to judge controversial topics in
medicine and public health in an unbiased, impartial manner. NIH has
conducted 119 consensus development conferences, and 30 state-of-the-science
(formerly "technology assessment") conferences, addressing a wide range of
issues. A backgrounder on the NIH Consensus Development Program process is
available at http://consensus.nih.gov/backgrounder.htm.
The Office of the Director, the central office at NIH, is responsible for
setting policy for NIH, which includes 27 Institutes and Centers. This
involves planning, managing, and coordinating the programs and activities of
all NIH components. The Office of the Director also includes program offices
which are responsible for stimulating specific areas of research throughout
NIH.
The National Institutes of Health (NIH) - The Nation's Medical Research
Agency - includes 27 Institutes and Centers and is a component of the U.S.
Department of Health and Human Services. It is the primary federal agency
for conducting and supporting basic, clinical and translational medical
research, and it investigates the causes, treatments, and cures for both
common and rare diseases.
Source:
Kelli Marciel
NIH/National Institutes of Health, Office of Disease Prevention
http://www.medicalnewstoday.com/articles/162240.php
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