The online version of this article (doi:10.1186/1471-2296-15-31) contains supplementary material, which is available to authorized users.
All authors declare that they have no competing interest to report.
RW participated in interpretation of data, drafted and critically revised the manuscript, and gave final approval of the current version. TH analyzed and assisted in interpretation of the data, assisted in drafting the manuscript, and gave final approval of the current version. AB contributed to concept and design of the study, critically revised the manuscript, and gave final approval of the current version. KP assisted in data acquisition and interpretation, critically revised the manuscript, and gave final approval of the current version. EH contributed to analysis and interpretation of the data, critically revised the manuscript, and gave final approval of the current version. GG contributed to conception and design of the study, critically revised the manuscript, and gave final approval of the current version. VH contributed to conception and design of the study, critically revised the manuscript, and gave final approval of the current version. LO contributed to study design, interpretation of data, critically revised the manuscript, and gave final approval of the current version. RW and LO had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the analysis. All authors have no conflicts of interest to report.
Studies have shown that the quality of family health history (FHH) collection in primary care is inadequate to assess disease risk. To use FHH for risk assessment, collected data must have adequate detail. To address this issue, we developed a patient facing FHH assessment tool, MeTree. In this paper we report the content and quality of the FHH collected using MeTree.
Design: A hybrid implementation-effectiveness study. Patients were recruited from 2009 to 2012. Setting: Two community primary care clinics in Greensboro, NC. Participants: All non-adopted adult English speaking patients with upcoming appointments were invited to participate. Intervention: Education about and collection of FHH with entry into MeTree. Measures: We report the proportion of pedigrees that were high-quality. High-quality pedigrees are defined as having all the following criteria: (1) three generations of relatives, (2) relatives’ lineage, (3) relatives’ gender, (4) an up-to-date FHH, (5) pertinent negatives noted, (6) age of disease onset in affected relatives, and for deceased relatives, (7) the age and (8) cause of death (Prim Care 31:479–495, 2004.).
Enrollment: 1,184. Participant demographics: age range 18-92 (mean 58.8, SD 11.79), 56% male, and 75% white. The median pedigree size was 21 (range 8-71) and the FHH entered into MeTree resulted in a database of 27,406 individuals. FHHs collected by MeTree were found to be high quality in 99.8% (N = 1,182/1,184) as compared to <4% at baseline. An average of 1.9 relatives per pedigree (range 0-50, SD 4.14) had no data reported. For pedigrees where at least one relative has no data (N = 497/1,184), 4.97 relatives per pedigree (range 1-50, SD 5.44) had no data. Talking with family members before using MeTree significantly decreased the proportion of relatives with no data reported (4.98% if you talked to your relative vs. 10.85% if you did not, p-value < 0.001.).
Using MeTree improves the quantity and quality of the FHH data that is collected and talking with relatives prior to the collection of FHH significantly improves the quantity and quality of the data provided. This allows more patients to be accurately risk stratified and offered appropriate preventive care guided by their risk level.
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- Quality of family history collection with use of a patient facing family history assessment tool
R Ryanne Wu
Tiffany L Himmel
Adam H Buchanan
Karen P Powell
Elizabeth R Hauser
Geoffrey S Ginsburg
Vincent C Henrich
Lori A Orlando
- BioMed Central
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