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Ponathil A, Ozkan F, Welch B, Bertrand J, Chalil Madathil K. Family health history collected by virtual conversational agents: An empirical study to investigate the efficacy of this approach. J Genet Couns 2020; 29:1081-1092. [PMID: 32125052 DOI: 10.1002/jgc4.1239] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/26/2022]
Abstract
Family health history (FHx) is one of the simplest and most cost-effective and efficient ways to collect health information that could help diagnose and treat genetic diseases at an early stage. This study evaluated the efficacy of collecting such family health histories through a virtual conversational agent (VCA) interface, a new method for collecting this information. Standard and VCA interfaces for FHx collection were investigated with 50 participants, recruited via email and word of mouth, using a within-subject experimental design with the order of the interfaces randomized and counterbalanced. Interface workload, usability, preference, and satisfaction were assessed using the NASA Task Load Index workload instrument, the IBM Computer System Usability Questionnaire, and a brief questionnaire derived from the Technology Acceptance Model. The researchers also recorded the number of errors and the total task completion time. It was found that the completion times for 2 of the 5 tasks were shorter for the VCA interface than for the standard one, but the overall completion time was longer (17 min 44 s vs. 16 min 51 s, p = .019). We also found the overall workload to be significantly lower (34.32 vs. 42.64, p = .003) for the VCA interface, and usability metrics including overall satisfaction (5.62 vs. 4.72, p < .001), system usefulness (5.76 vs. 4.84, p = .001), information quality (5.43 vs. 4.62, p < .001), and interface quality (5.66 vs. 4.64, p < .001) to be significantly higher for this interface as well. Approximately 3 out of 4 participants preferred the VCA interface to the standard one. Although the overall time taken was slightly longer than with standard interface, the VCA interface was rated significantly better across all other measures and was preferred by the participants. These findings demonstrate the advantages of an innovative VCA interface for collecting FHx, validating the efficacy of using VCAs to collect complex patient-specific data in health care.
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Affiliation(s)
- Amal Ponathil
- Glenn Department of Civil Engineering, Clemson University, Clemson, SC, USA
| | - Firat Ozkan
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - Brandon Welch
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Jeffrey Bertrand
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - Kapil Chalil Madathil
- Glenn Department of Civil Engineering, Clemson University, Clemson, SC, USA.,Department of Industrial Engineering, Clemson University, Clemson, SC, USA.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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Incorporating Colorectal Cancer Genetic Risk Assessment into Gastroenterology Practice. ACTA ACUST UNITED AC 2019; 17:702-715. [DOI: 10.1007/s11938-019-00267-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Thomas S, Hovick S, Tan N, Sturm A, Sweet K. How Online Family History Tool Design and Message Content Impact User Perceptions: An Examination of Family Health Link. Public Health Genomics 2018; 21:53-66. [DOI: 10.1159/000493847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/18/2018] [Indexed: 11/19/2022] Open
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Welch BM, Wiley K, Pflieger L, Achiangia R, Baker K, Hughes-Halbert C, Morrison H, Schiffman J, Doerr M. Review and Comparison of Electronic Patient-Facing Family Health History Tools. J Genet Couns 2018; 27:381-391. [PMID: 29512060 PMCID: PMC5861014 DOI: 10.1007/s10897-018-0235-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/05/2018] [Indexed: 01/23/2023]
Abstract
Family health history (FHx) is one of the most important pieces of information available to help genetic counselors and other clinicians identify risk and prevent disease. Unfortunately, the collection of FHx from patients is often too time consuming to be done during a clinical visit. Fortunately, there are many electronic FHx tools designed to help patients gather and organize their own FHx information prior to a clinic visit. We conducted a review and analysis of electronic FHx tools to better understand what tools are available, to compare and contrast to each other, to highlight features of various tools, and to provide a foundation for future evaluation and comparisons across FHx tools. Through our analysis, we included and abstracted 17 patient-facing electronic FHx tools and explored these tools around four axes: organization information, family history collection and display, clinical data collected, and clinical workflow integration. We found a large number of differences among FHx tools, with no two the same. This paper provides a useful review for health care providers, researchers, and patient advocates interested in understanding the differences among the available patient-facing electronic FHx tools.
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Affiliation(s)
- Brandon M Welch
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
- ItRunsInMyFamily.com, Inc., Charleston, SC, USA.
| | - Kevin Wiley
- Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Lance Pflieger
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA
| | - Rosaline Achiangia
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Karen Baker
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Chanita Hughes-Halbert
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Joshua Schiffman
- ItRunsInMyFamily.com, Inc., Charleston, SC, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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Stoll K, Kubendran S, Cohen SA. The past, present and future of service delivery in genetic counseling: Keeping up in the era of precision medicine. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2018. [DOI: 10.1002/ajmg.c.31602] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Katie Stoll
- Genetic Support FoundationOlympia Washington
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Lowery JT, Ahnen DJ, Schroy PC, Hampel H, Baxter N, Boland CR, Burt RW, Butterly L, Doerr M, Doroshenk M, Feero WG, Henrikson N, Ladabaum U, Lieberman D, McFarland EG, Peterson SK, Raymond M, Samadder NJ, Syngal S, Weber TK, Zauber AG, Smith R. Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review. Cancer 2016; 122:2633-45. [PMID: 27258162 PMCID: PMC5575812 DOI: 10.1002/cncr.30080] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/08/2016] [Accepted: 01/15/2016] [Indexed: 12/14/2022]
Abstract
Persons with a family history (FH) of colorectal cancer (CRC) or adenomas that are not due to known hereditary syndromes have an increased risk for CRC. An understanding of these risks, screening recommendations, and screening behaviors can inform strategies for reducing the CRC burden in these families. A comprehensive review of the literature published within the past 10 years has been performed to assess what is known about cancer risk, screening guidelines, adherence and barriers to screening, and effective interventions in persons with an FH of CRC and to identify FH tools used to identify these individuals and inform care. Existing data show that having 1 affected first-degree relative (FDR) increases the CRC risk 2-fold, and the risk increases with multiple affected FDRs and a younger age at diagnosis. There is variability in screening recommendations across consensus guidelines. Screening adherence is <50% and is lower in persons under the age of 50 years. A provider's recommendation, multiple affected relatives, and family encouragement facilitate screening; insufficient collection of FH, low knowledge of guidelines, and poor family communication are important barriers. Effective interventions incorporate strategies for overcoming barriers, but these have not been broadly tested in clinical settings. Four strategies for reducing CRC in persons with familial risk are suggested: 1) improving the collection and utilization of the FH of cancer, 2) establishing a consensus for screening guidelines by FH, 3) enhancing provider-patient knowledge of guidelines and communication about CRC risk, and 4) encouraging survivors to promote screening within their families and partnering with existing screening programs to expand their reach to high-risk groups. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2633-2645. © 2016 American Cancer Society.
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Affiliation(s)
- Jan T Lowery
- Colorado School of Public Health, Aurora, Colorado
| | - Dennis J Ahnen
- School of Medicine and Gastroenterology of the Rockies, University of Colorado, Boulder, Colorado
| | - Paul C Schroy
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Heather Hampel
- Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
| | | | | | - Randall W Burt
- Huntsman Cancer Institute, University of Utah Health Care, Salt Lake City, Utah
| | - Lynn Butterly
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | | | - W Gregory Feero
- Maine Dartmouth Family Medicine Residency Program, Augusta, Maine
| | | | - Uri Ladabaum
- Stanford University School of Medicine, Stanford, California
| | | | | | - Susan K Peterson
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - N Jewel Samadder
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | - Ann G Zauber
- Memorial Sloan Kettering Cancer Center, New York, New York
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Murray MF. Parental DNA sequence is critical family history in clinical genomics. Genet Med 2016; 18:675-677. [PMID: 26765341 DOI: 10.1038/gim.2015.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 10/27/2015] [Indexed: 06/05/2023] Open
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Baumgart LA, Postula KJV, Knaus WA. Initial clinical validation of Health Heritage, a patient-facing tool for personal and family history collection and cancer risk assessment. Fam Cancer 2015; 15:331-9. [DOI: 10.1007/s10689-015-9863-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Wang C, Sen A, Plegue M, Ruffin MT, O'Neill SM, Rubinstein WS, Acheson LS. Impact of family history assessment on communication with family members and health care providers: A report from the Family Healthware™ Impact Trial (FHITr). Prev Med 2015; 77:28-34. [PMID: 25901453 PMCID: PMC4508012 DOI: 10.1016/j.ypmed.2015.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 04/06/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. METHODS A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. RESULTS A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p's<.01), indicating that intervention had effects of different magnitude between those already communicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. CONCLUSION Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers.
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Affiliation(s)
- Catharine Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, USA.
| | - Ananda Sen
- Department of Biostatistics, University of Michigan, Ann Arbor, USA; Department of Family Medicine, University of Michigan, Ann Arbor, USA
| | - Melissa Plegue
- Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, USA; Department of Family Medicine, University of Michigan, Ann Arbor, USA
| | - Mack T Ruffin
- Department of Family Medicine, University of Michigan, Ann Arbor, USA
| | - Suzanne M O'Neill
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Evanston, USA
| | - Wendy S Rubinstein
- National Center for Biotechnology Information, National Institutes of Health, Bethesda, USA
| | - Louise S Acheson
- Departments of Family Medicine & Community Health and Reproductive Biology, Case Western Reserve University and Case Comprehensive Cancer Center, University Hospitals Case Medical Center, Cleveland, USA
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