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Genetics in Health care
As direct-to-consumer genetic and genomic tests become more ubiquitous, the role of medical and health professionals in fully harnessing the powers of this powerful toolincreases. Many direct-to-consumer products and services are already available, suchas23andMeandNavigenics®, which provide quite a bit of information on disease risk and traits but relatively few details in terms of how this information should beinterpreted or its clinical relevance. Besides, genetic tests for many diseases aredeveloped on the basis of limited scientific information and may not yet provide validor useful results to individuals who are tested.Different types of genetic tests in the market include,1.
 
Newborn screening2.
 
Diagnostic testing3.
 
Carrier testing4.
 
Prenatal testing5.
 
Preimplantation testing6.
 
Predictive and presymptomatic testing7.
 
Forensic testingClinicians must understandand be able to explain to patients which test results areclinically relevant and which are merely unsubstantiated claims.Public health leaders and other healthcare providers too need to understand their role in this environment.It is a continuously evolving field and requires knowledgeable people to separate factsfrom fiction and guide proper interpretation of the test results.Reach a customized search engine for genetics,click here.
 
 
Genetics for better Treatment
-With the availability of a myriad of genetic tests, Clinicians should be aware of genomic tests that may affect the care of their patient population. Various Tests existto guide disease diagnosis, prognosis and susceptibility to drugs. Most of thetreatments for cancers (like Her2 testing in breast cancer) are now guided by resultsof genetic testing for susceptibility to specific anti-cancer drugs.Examples of CDC-funded evidence-based reports that guide genomic testing anddiagnostic strategies include-
 
Genomic Tests for Ovarian Cancer Detection and Management;
 
Testing for Cytochrome P450 (CYP450) Polymorphisms in Adults With Non-Psychotic Depression Prior to Treatment With Selective Serotonin ReuptakeInhibitors (SSRIs);
 
Hereditary Nonpolyposis Colorectal Cancer: Diagnostic Strategies and TheirImplications;
 
Impact of Gene Expression Profiling Tests on Breast Cancer Outcomes;
 
Can UGT1A1 Genotyping Reduce Morbidity and Mortality in Patients WithMetastatic Colorectal Cancer Treated With Irinotecan? 
 
DNA Testing Strategies Aimed at Reducing Morbidity and Mortality From LynchSyndrome. 
Family History Tools
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Most chronic diseases are a result of genetics and environment. Family members sharegenes, behaviors, lifestyles, and environments that together may influence theirhealth and chronic disease. The basest understanding of genetics is the use of familyhistory tools to predict disease patterns. These tools document medical risks and risksin relation to family members, including genetic risk, exposures, and behavioral,social, and cultural informationOPHGstarted the Family History Public Health Initiative in 2002 to increase awarenessabout family history as an important risk factor for common chronic diseases such ascancer and diabetes mellitus, and to promote the use of family history in programsaimed at reducing the burden of these diseases in the US population. Several familyhistory tools exist and may be quickly and easily utilized by public health and primarycare providers and patients:
 
American Medical Association: Family History Tools: Website with toolsincluding “Prenatal Genetic Screening Questionnaire,” “Pediatric ClinicalGenetics Questionnaire,” and “Adult Family History Form”;
 
Centers for Disease Control and Prevention: Website with family history toolsand resources;
 
 
Cyrillic: Computer program for drawing pedigrees and linking data to othergenetics programs;
 
Pedigree-Draw: Computer application for the creating, drawing, and editing of pedigrees;
 
Progeny: Lab management software for collection of genetic data;
 
US Surgeon General’s Family History Initiative: “My Family Health Portrait”:Web-based tool for patients to organize family history and to share withhealthcare providers and family members.
Public health genomics
-Good use of genetics includes a major role in planning public health initiatives. Thegoals of public health genomics are to improve public health interventions for diseasesof major public health importance, including chronic, infectious, environmental, andoccupational diseases. Population-based epidemiologic studies are the basis forestimating the absolute, relative, and attributable risks that gauge the effects of genomic factors on the health of individuals and populations.
Counseling-
The patient and family members involved may have different perceptions of risk andattitudes toward genetic testing. Information for one person often has medicalconsequences for other related individuals, and healthcare providers must successfullynavigate this delicate arena to improve outcomes for everyone involved. A firmunderstanding of genetics-based probability and risk assessment and the ability tocommunicate clearly and effectively are important for all healthcare providers.
Continuing Medical Education in Genetics
-It is critical for practicing clinicians and public health professionals to maintaingenomic literacy by staying up-to-date on recent literature and applications in medicalgenetics and genomics.
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