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At the Intersection of Precision Medicine and Population Health: An Implementation-Effectiveness Study of Family Health History Based Systematic Risk Assessment in Primary Care (BMC Health Services Research)

Publication Topics

California Health Interview Survey; 2005 California Health Interview Survey (CHIS 2005); Access to Health Care; Screening for Early Disease Detection

Publication Type

CHIS Journal Article

Publication Date


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<a onclick="OpenPopUpPage('http:\u002f\\u002f_layouts\u002flistform.aspx?PageType=4\u0026ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}\u0026ID=1808\u0026RootFolder=*', RefreshPage); return false;" href=";ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&amp;ID=1808&amp;RootFolder=*">Lori A. Orlando</a>

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<a onclick="OpenPopUpPage('http:\u002f\\u002f_layouts\u002flistform.aspx?PageType=4\u0026ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}\u0026ID=151\u0026RootFolder=*', RefreshPage); return false;" href=";ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&amp;ID=151&amp;RootFolder=*">et al</a>

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Summary: Risk assessment is a precision medicine technique that can be used to enhance population health when applied to prevention. Several barriers limit the uptake of risk assessment in health care systems; and little is known about the potential impact that adoption of systematic risk assessment for screening and prevention in the primary care population might have. Authors present results of a first of its kind multi-institutional study of a precision medicine tool for systematic risk assessment.
Authors undertook an implementation-effectiveness trial of systematic risk assessment of primary care patients in 19 primary care clinics at four geographically and culturally diverse healthcare systems. All adult English- or Spanish-speaking patients were invited to enter personal and family health history data into MeTree, a patient-facing family health history driven risk assessment program, for 27 medical conditions. Risk assessment recommendations followed evidence-based guidelines for identifying and managing those at increased disease risk.

Findings: In this study, 1889 participants completed MeTree, entering information on N = 25,967 individuals; and N = 1443 (76.4%) participants received increased risk recommendations: 597 (31.6%) for monogenic hereditary conditions, 508 (26.9%) for familial-level risk, and 1056 (56.1%) for risk of a common chronic disease. There were 6617 recommendations given across the 1443 participants. In multivariate analysis, only the total number of relatives entered was significantly associated with receiving a recommendation.

A significant percentage of the general primary care population meet criteria for more intensive risk management. In particular 46% for monogenic hereditary and familial level disease risk. Adopting strategies to facilitate systematic risk assessment in primary care could have a significant impact on populations within the U.S. and even beyond.

This study cites data from the 2005 California Health Interview Survey.


Article 1

Journal Article: At the Intersection of Precision Medicine and Population Health: An Implementation-Effectiveness Study of Family Health History Based Systematic Risk Assessment in Primary Care

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Press Release

Related Link 1

California Health Interview Survey (CHIS)

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Version: 5.0
Created at 11/17/2020 3:49 AM by i:0#.f|uclachissqlmembershipprovider|celeste
Last modified at 11/17/2020 4:06 AM by i:0#.f|uclachissqlmembershipprovider|celeste