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Hermanto I, Chandra CK, Utari A, Winarni TI, Cayami FK. Knowledge of genetics and attitudes toward genetic testing among university students in Indonesia. J Community Genet 2024:10.1007/s12687-024-00711-0. [PMID: 38851656 DOI: 10.1007/s12687-024-00711-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/02/2024] [Indexed: 06/10/2024] Open
Abstract
The development in human genetics must be tracked with the knowledge to provide support and positive attitudes towards genetic research and its healthcare applications, including genetic testing. Unfortunately, there has been a delay in enacting public policies related to the genetics professionals as well as the diagnosis, treatment, and prevention of genetic diseases in Indonesia. This research was conducted to build an overview of genetic knowledge and public attitudes toward genetic testing among Indonesian undergraduates. This cross-sectional study involved undergraduate students selected using the convenience sampling method. The questionnaire consisted of two parts: a true/false questionnaire (16 statements) regarding knowledge of genetics and a 5-points Likert scale questionnaire (27 statements) pertaining to attitudes towards genetic testing. A total of 1596 undergraduate students completed online questionnaire. The highest knowledge score and the most positive overall attitudes were observed in the healthcare-related majors compared to those who studied science and technology and social and humanity. A weak positive correlation was observed between knowledge and attitude toward genetic testing (Pearson's r = 0.206, p < 0.001). Undergraduate students from healthcare-related majors displayed better in both knowledge of genetics and had more positive attitudes toward genetic testing.
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Affiliation(s)
- Iskandar Hermanto
- Faculty of Medicine, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia
| | | | - Agustini Utari
- Center for Biomedical Research (CEBIOR), Faculty of Medicine, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia
- Department of Pediatric, Faculty of Medicine, Universitas Diponegoro/Dr, Kariadi Hospital Semarang, Semarang, 50275, Central Java, Indonesia
| | - Tri Indah Winarni
- Center for Biomedical Research (CEBIOR), Faculty of Medicine, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia
- Department of Anatomy, Faculty of Medicine, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia
| | - Ferdy Kurniawan Cayami
- Center for Biomedical Research (CEBIOR), Faculty of Medicine, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia.
- Department of Anatomy, Faculty of Medicine, Universitas Diponegoro, Semarang, 50275, Central Java, Indonesia.
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Baseline Targeted Moderation in a Trial of the Family Check-Up 4 Health: Potential Explanations for Finding Few Practical Effects. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:226-236. [PMID: 34159507 DOI: 10.1007/s11121-021-01266-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/25/2022]
Abstract
Not all participants will benefit equally from even well-established, evidence-based prevention programs. For this reason, the field of prevention science is beginning to embrace individual tailoring of interventions. The Family Check-Up was among the first prevention programs to tailor at the family level as opposed to the more prevalent focus on adapting programs for different cultures, genders, and other immutable participant characteristics. Despite tailoring, families with lower levels of stress and parental mental health issues, children with lower baseline conduct problems, and families living in an extremely deprived neighborhood benefitted less from the Family Check-Up. This study examined baseline targeted moderation (BTM) within a trial of the Family Check-Up 4 Health (FCU4Health) program, an adaptation of the Family Check-Up for primary care delivery and explicit targeting of obesogenic behaviors. Ethnically diverse, low-income families (N = 240) with children ages 5.5 to 12 years identified in pediatric primary care with elevated body mass index (BMI) were enrolled and randomized to FCU4Health or usual care. Few BTM effects were found using single-variable-as-moderator and latent-class-as-moderator analytic approaches across the primary (child BMI, body composition) and secondary outcomes (family health routines; child eating behaviors, food choices, emotional problems, problem behaviors, quality of life; caregiver BMI and body composition), as well as hypothesized mediators (child self-regulation, parenting skills). The high-risk nature of the sample and the FCU4Health being individually tailored might have mitigated finding BTM effects. This trial was prospectively registered (NCT03013309 ClinicalTrials.gov).
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Meyn S, Blaschke S, Mess F. Food Literacy and Dietary Intake in German Office Workers: A Longitudinal Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16534. [PMID: 36554414 PMCID: PMC9779084 DOI: 10.3390/ijerph192416534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Widespread patterns of poor dietary behavior are a key factor causing the increasing prevalence of chronic diseases around the world. Research has provided initial insights into the potential of food literacy (FL) to empower individuals to improve their dietary behavior. However, studies on FL interventions in working adults are scarce. The intervention delivered in this study was a comprehensive 3-week full time education-based workplace health promotion program (WHPP) that provided the participants with in-depth knowledge and skills regarding nutrition and health. We aimed to investigate the short- and long-term effects of the WHPP on FL and dietary intake (DI) and to examine the association between FL and DI in a sample of 144 German office workers (30.0% female). Using two random intercept mixed linear regression models, we found significant strong improvements for both FL (β = 0.52, p < 0.0001) and DI (β = 0.63, p < 0.0001) after the WHPP when compared to baseline. Significant long-term improvements at 18 months were strong for FL (β = 0.55, p < 0.0001) and weak for DI (β = 0.10, p < 0.0001). FL showed a significant moderate effect on DI across all measurement time points (β = 0.24, p < 0.0001). We conclude that well-designed WHPPs can induce long-term improvements in FL and DI, and that FL can be viewed as an asset to further expand food-related knowledge and skills and to enhance dietary behavior. Our study fills a gap of long-term findings regarding the role of FL in WHPPs and supports the idea of implementing FL in the development of comprehensive WHPPs to improve DI.
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Cadario F. Vitamin D and ω-3 Polyunsaturated Fatty Acids towards a Personalized Nutrition of Youth Diabetes: A Narrative Lecture. Nutrients 2022; 14:nu14224887. [PMID: 36432570 PMCID: PMC9699239 DOI: 10.3390/nu14224887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 11/22/2022] Open
Abstract
After the discovery of insulin, nutrition has become central in the management of diabetes in order to limit glycemic rise after meals, optimize metabolic control, and prevent complications. Over the past one hundred years, international scientific societies have consecutively refined nutritional needs and optimized food intake for the treatment of diabetes. In particular, over the past century, nutrition applied with pumps for the administration of insulin and continuous glucose monitoring have allowed substantial advancement in the treatment of type 1 diabetes mellitus. The role of some substances, such as vitamin D and n-3 polyunsaturated fatty acids, have been proposed without univocal conclusions, individually or in combination, or in the diet, to improve the nutrition of type 1 and type 2 diabetes. This second condition, which is highly associated with overweight, should be prevented from childhood onwards. Personalized nutrition could bypass the problem, reaching a scientific conclusion on the individual subject. This article focuses on childhood and adolescent diabetes, aims to provide a narrative summary of nutrition over the past century, and promotes the concept of personalized nutrition to pediatricians and pediatric diabetologists as a possible tool for the treatment of type 1 diabetes and the prevention of type 2 diabetes.
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Affiliation(s)
- Francesco Cadario
- Division of Pediatrics, University of Piemonte Orientale, 28100 Novara, Italy;
- Diabetes Research Institute Federation, Miami, FL 33163, USA
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Le Franc S, Herrera Altamira G, Guillen M, Butet S, Fleck S, Lécuyer A, Bougrain L, Bonan I. Toward an Adapted Neurofeedback for Post-stroke Motor Rehabilitation: State of the Art and Perspectives. Front Hum Neurosci 2022; 16:917909. [PMID: 35911589 PMCID: PMC9332194 DOI: 10.3389/fnhum.2022.917909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Stroke is a severe health issue, and motor recovery after stroke remains an important challenge in the rehabilitation field. Neurofeedback (NFB), as part of a brain–computer interface, is a technique for modulating brain activity using on-line feedback that has proved to be useful in motor rehabilitation for the chronic stroke population in addition to traditional therapies. Nevertheless, its use and applications in the field still leave unresolved questions. The brain pathophysiological mechanisms after stroke remain partly unknown, and the possibilities for intervention on these mechanisms to promote cerebral plasticity are limited in clinical practice. In NFB motor rehabilitation, the aim is to adapt the therapy to the patient’s clinical context using brain imaging, considering the time after stroke, the localization of brain lesions, and their clinical impact, while taking into account currently used biomarkers and technical limitations. These modern techniques also allow a better understanding of the physiopathology and neuroplasticity of the brain after stroke. We conducted a narrative literature review of studies using NFB for post-stroke motor rehabilitation. The main goal was to decompose all the elements that can be modified in NFB therapies, which can lead to their adaptation according to the patient’s context and according to the current technological limits. Adaptation and individualization of care could derive from this analysis to better meet the patients’ needs. We focused on and highlighted the various clinical and technological components considering the most recent experiments. The second goal was to propose general recommendations and enhance the limits and perspectives to improve our general knowledge in the field and allow clinical applications. We highlighted the multidisciplinary approach of this work by combining engineering abilities and medical experience. Engineering development is essential for the available technological tools and aims to increase neuroscience knowledge in the NFB topic. This technological development was born out of the real clinical need to provide complementary therapeutic solutions to a public health problem, considering the actual clinical context of the post-stroke patient and the practical limits resulting from it.
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Affiliation(s)
- Salomé Le Franc
- Rehabilitation Medicine Unit, University Hospital of Rennes, Rennes, France
- Hybrid Team, Inria, University of Rennes, Irisa, UMR CNRS 6074, Rennes, France
- *Correspondence: Salomé Le Franc,
| | | | - Maud Guillen
- Hybrid Team, Inria, University of Rennes, Irisa, UMR CNRS 6074, Rennes, France
- Neurology Unit, University Hospital of Rennes, Rennes, France
| | - Simon Butet
- Rehabilitation Medicine Unit, University Hospital of Rennes, Rennes, France
- Empenn Unit U1228, Inserm, Inria, University of Rennes, Irisa, UMR CNRS 6074, Rennes, France
| | - Stéphanie Fleck
- Université de Lorraine, CNRS, LORIA, Nancy, France
- EA7312 Laboratoire de Psychologie Ergonomique et Sociale pour l’Expérience Utilisateurs (PERSEUS), Metz, France
| | - Anatole Lécuyer
- Hybrid Team, Inria, University of Rennes, Irisa, UMR CNRS 6074, Rennes, France
| | | | - Isabelle Bonan
- Rehabilitation Medicine Unit, University Hospital of Rennes, Rennes, France
- Empenn Unit U1228, Inserm, Inria, University of Rennes, Irisa, UMR CNRS 6074, Rennes, France
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Baratta J, Brown-Johnson C, Safaeinili N, Goldman Rosas L, Palaniappan L, Winget M, Mahoney M. Patient and Health Professional Perceptions of Telemonitoring for Hypertension Management: Qualitative Study. JMIR Form Res 2022; 6:e32874. [PMID: 35687380 PMCID: PMC9233257 DOI: 10.2196/32874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/07/2022] [Accepted: 04/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background Hypertension is the most prevalent and important risk factor for cardiovascular disease, affecting nearly 50% of the US adult population; however, only 30% of these patients achieve controlled blood pressure (BP). Incorporating strategies into primary care that take into consideration individual patient needs, such as remote BP monitoring, may improve hypertension management. Objective From March 2018 to December 2018, Stanford implemented a precision health pilot called Humanwide, which aimed to leverage high-technology and high-touch medicine to tailor individualized care for conditions such as hypertension. We examined multi-stakeholder perceptions of hypertension management in Humanwide to evaluate the program’s acceptability, appropriateness, feasibility, and sustainability. Methods We conducted semistructured interviews with 16 patients and 15 health professionals to assess their experiences with hypertension management in Humanwide. We transcribed and analyzed the interviews using a hybrid approach of inductive and deductive analysis to identify common themes around hypertension management and consensus methods to ensure reliability and validity. Results A total of 63% (10/16) of the patients and 40% (6/15) of the health professionals mentioned hypertension in the context of Humanwide. These participants reported that remote BP monitoring improved motivation, BP control, and overall clinic efficiency. The health professionals discussed feasibility challenges, including the time needed to analyze BP data and provide individualized feedback, integration of BP data, technological difficulties with the BP cuff, and decreased patient use of remote BP monitoring over time. Conclusions Remote BP monitoring for hypertension management in Humanwide was acceptable to patients and health professionals and appropriate for care. Important challenges need to be addressed to improve the feasibility and sustainability of this approach by leveraging team-based care, engaging patients to sustain remote BP monitoring, standardizing electronic medical record integration of BP measurements, and finding more user-friendly BP cuffs.
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Affiliation(s)
- Juliana Baratta
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Cati Brown-Johnson
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Nadia Safaeinili
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Lisa Goldman Rosas
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Latha Palaniappan
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Marcy Winget
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Megan Mahoney
- Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
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7
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Dixon SB, Chow EJ, Hjorth L, Hudson MM, Kremer LCM, Morton LM, Nathan PC, Ness KK, Oeffinger KC, Armstrong GT. The Future of Childhood Cancer Survivorship: Challenges and Opportunities for Continued Progress. Pediatr Clin North Am 2020; 67:1237-1251. [PMID: 33131544 PMCID: PMC7773506 DOI: 10.1016/j.pcl.2020.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
As treatment evolves and the population who survive childhood cancer ages and increases in number, researchers must use novel approaches to prevent, identify and mitigate adverse effects of treatment. Future priorities include collaborative efforts to pool large cohort data to improve detection of late effects, identify late effects of novel therapies, and determine the contribution of genetic factors along with physiologic and accelerated aging among survivors. This knowledge should translate to individual risk prediction and prevention strategies. Finally, we must utilize health services research and implementation science to improve adoption of survivorship care recommendations outside of specialized pediatric oncology centers.
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Affiliation(s)
- Stephanie B. Dixon
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Eric J. Chow
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Lars Hjorth
- Department of Paediatrics, Skåne University Hospital, Lund, Sweden
| | - Melissa M. Hudson
- Division of Cancer Survivorship, Department of Oncology, St. Jude. Children’s Research Hospital, Memphis, TN
| | | | - Lindsay M. Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Paul C. Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude. Children’s Research Hospital, Memphis, TN
| | | | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St. Jude. Children’s Research Hospital, Memphis, TN
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Bíró K, Dombrádi V, Fekete Z, Bányai G, Boruzs K, Nagy A, Ádány R. Investigating the knowledge of and public attitudes towards genetic testing within the Visegrad countries: a cross-sectional study. BMC Public Health 2020; 20:1380. [PMID: 32912246 PMCID: PMC7488256 DOI: 10.1186/s12889-020-09473-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Previous studies have investigated various factors that can determine the attitudes of the citizens considering genetic testing. However, none of them investigated how these attitudes may differ between the Visegrad countries. METHODS In this cross-sectional study a questionnaire developed by Dutch researchers was translated and used in Hungary, Slovakia, Czechia and Poland. In each country 1000 adult citizens were asked on the topics of personal benefits regarding genetic tests, genetic determinism, and finally, the availability and usage of genetic testing. Multivariate robust regression model was created including several possible influencing factors (such as age, sex, education, marital status, religiousness, and having a genetic test within the nuclear family) to identify the possible differences between the four countries. RESULTS The Hungarian citizens had the most positive opinion on the personal benefits of genetic testing followed by the Czech, Slovak and Polish. All differences were significant in this regard. Considering genetic determinism, the Slovak citizens had a significantly firmer belief in this issue compared to the Hungarians. No other significant differences were observed in this domain. On the topic of the availability and use of genetic testing the Hungarian citizens had the most accepting opinion among the four countries, followed by the Czech citizens. In this domain the Polish and Slovak answers did not differ significantly from each other. CONCLUSIONS Significant differences were observed even when considering various confounding effects. As the underlying reasons for these discrepancies are unknown, future studies should investigate this enigma among the four countries.
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Affiliation(s)
- Klára Bíró
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Viktor Dombrádi
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Zita Fekete
- Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Bányai
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Klára Boruzs
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Attila Nagy
- Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Róza Ádány
- MTA-DE Public Health Research Group, University of Debrecen, Debrecen, Hungary
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Abstract
Precision medicine is a new health care concept intended to hasten progress toward individualized treatment and, in so doing, to improve everyone's opportunity to enjoy good health. Yet, this concept pays scant attention to opportunities for change in the social determinants that are the major drivers of health. Precision medicine research is likely to generate improvements in medical care but may have the unintended consequence of worsening existing disparities in health care access. For prevention, precision medicine emphasizes comprehensive risk prediction and individual efforts to accomplish risk reduction. The application of the precision medicine vision to type 2 diabetes, a growing threat to population health, fails to acknowledge collective responsibility for a health-promoting society.
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Affiliation(s)
- Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle, WA
| | | | - David Schenck
- Ethics Program, Medical University of South Carolina, Charleston, SC
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Boccia S, Pastorino R, Ricciardi W, Ádány R, Barnhoorn F, Boffetta P, Cornel MC, De Vito C, Gray M, Jani A, Lang M, Roldan J, Rosso A, Sánchez JM, Van Dujin CM, Van El CG, Villari P, Zawati MH. How to Integrate Personalized Medicine into Prevention? Recommendations from the Personalized Prevention of Chronic Diseases (PRECeDI) Consortium. Public Health Genomics 2019; 22:208-214. [PMID: 31805565 DOI: 10.1159/000504652] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/02/2019] [Indexed: 11/19/2022] Open
Abstract
Medical practitioners are increasingly adopting a personalized medicine (PM) approach involving individually tailored patient care. The Personalized Prevention of Chronic Diseases (PRECeDI) consortium project, funded within the Marie Skłodowska Curie Action (MSCA) Research and Innovation Staff Exchange (RISE) scheme, had fostered collaboration on PM research and training with special emphasis on the prevention of chronic diseases. From 2014 to 2018, the PRECeDI consortium trained 50 staff members on personalized prevention of chronic diseases through training and research. The acquisition of skills from researchers came from dedicated secondments from academic and nonacademic institutions aimed at training on several research topics related to personalized prevention of cancer and cardiovascular and neurodegenerative diseases. In detail, 5 research domains were addressed: (1) identification and validation of biomarkers for the primary prevention of cardiovascular diseases, secondary prevention of Alzheimer disease, and tertiary prevention of head and neck cancer; (2) economic evaluation of genomic applications; (3) ethical-legal and policy issues surrounding PM; (4) sociotechnical analysis of the pros and cons of informing healthy individuals on their genome; and (5) identification of organizational models for the provision of predictive genetic testing. Based on the results of the research carried out by the PRECeDI consortium, in November 2018, a set of recommendations for policy makers, scientists, and industry has been issued, with the main goal to foster the integration of PM approaches in the field of chronic disease prevention.
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Affiliation(s)
- Stefania Boccia
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy, .,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,
| | - Roberta Pastorino
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Róza Ádány
- Department of Preventive Medicine, Debrecen University, Debrecen, Hungary
| | | | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Martina C Cornel
- Department of Clinical Genetics and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Muir Gray
- Better Value Health Care, Oxford, United Kingdom
| | - Anant Jani
- Value Based Healthcare Programme, Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Michael Lang
- Centre of Genomics and Policy, McGill University Faculty of Medicine, Montreal, Québec, Canada
| | - Jim Roldan
- Linkcare Health Services S.L., Barcelona, Spain
| | - Annalisa Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | - Cornelia M Van Dujin
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Carla G Van El
- Department of Clinical Genetics and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Ma'n H Zawati
- Centre of Genomics and Policy, McGill University Faculty of Medicine, Montreal, Québec, Canada
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Dombrádi V, Pitini E, van El CG, Jani A, Cornel M, Villari P, Gray M, Bíró K. Value-based genomic screening: exploring genomic screening for chronic diseases using triple value principles. BMC Health Serv Res 2019; 19:823. [PMID: 31711483 PMCID: PMC6849239 DOI: 10.1186/s12913-019-4703-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/31/2019] [Indexed: 12/23/2022] Open
Abstract
Background Genomic screening has unique challenges which makes it difficult to easily implement on a wide scale. If the costs, benefits and tradeoffs of investing in genomic screening are not evaluated properly, there is a risk of wasting finite healthcare resources and also causing avoidable harm. Main text If healthcare professionals – including policy makers, payers and providers – wish to incorporate genomic screening into healthcare while minimizing waste, maximizing benefits, and considering results that matter to patients, using the principles of triple value (allocative, technical, and personal value) could help them to evaluate tough decisions and tradeoffs. Allocative value focuses on the optimal distribution of limited healthcare resources to maximize the health benefits to the entire population while also accounting for all the costs of care delivery. Technical value ensures that for any given condition, the right intervention is chosen and delivered in the right way. Various methods (e.g. ACCE, HTA, and Wilson and Jungner screening criteria) exist that can help identify appropriate genomic applications. Personal value incorporates preference based informed decision making to ensure that patients are informed about the benefits and harms of the choices available to them and to ensure they make choices based on their values and preferences. Conclusions Using triple value principles can help healthcare professionals make reasoned and tough judgements about benefits and tradeoffs when they are exploring the role genomic screening for chronic diseases could play in improving the health of their patients and populations.
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Affiliation(s)
- Viktor Dombrádi
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Erica Pitini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Carla G van El
- Department of Clinical Genetics/Amsterdam Public Health research Institute, Section Community Genetics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anant Jani
- Value Based Healthcare Programme, Department of Primary Care, University of Oxford, Oxford, UK
| | - Martina Cornel
- Department of Clinical Genetics/Amsterdam Public Health research Institute, Section Community Genetics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Muir Gray
- Value Based Healthcare Programme, Department of Primary Care, University of Oxford, Oxford, UK.,Oxford Centre for Triple Value Healthcare, Oxford, UK
| | - Klára Bíró
- Department of Health Systems Management and Quality Management for Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
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Affiliation(s)
- Muin J Khoury
- Office of Public Health Genomics, Centers for Disease Control and Prevention, Atlanta, Georgia
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