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Maldonado BL, Piqué DG, Kaplan RC, Claw KG, Gignoux CR. Genetic risk prediction in Hispanics/Latinos: milestones, challenges, and social-ethical considerations. J Community Genet 2023; 14:543-553. [PMID: 37962783 PMCID: PMC10725387 DOI: 10.1007/s12687-023-00686-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
Genome-wide association studies (GWAS) have allowed the identification of disease-associated variants, which can be leveraged to build polygenic scores (PGSs). Even though PGSs can be a valuable tool in personalized medicine, their predictive power is limited in populations of non-European ancestry, particularly in admixed populations. Recent efforts have focused on increasing racial and ethnic diversity in GWAS, thus, addressing some of the limitations of genetic risk prediction in these populations. Even with these efforts, few studies focus exclusively on Hispanics/Latinos. Additionally, Hispanic/Latino populations are often considered a single population despite varying admixture proportions between and within ethnic groups, diverse genetic heterogeneity, and demographic history. Combined with highly heterogeneous environmental and socioeconomic exposures, this diversity can reduce the transferability of genetic risk prediction models. Given the recent increase of genomic studies that include Hispanics/Latinos, we review the milestones and efforts that focus on genetic risk prediction, summarize the potential for improving PGS transferability, and highlight the challenges yet to be addressed. Additionally, we summarize social-ethical considerations and provide ideas to promote genetic risk prediction models that can be implemented equitably.
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Affiliation(s)
- Betzaida L Maldonado
- Human Medical Genetics & Genomics Graduate Program, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
- Colorado Center for Personalized Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
- Department of Biomedical Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
| | - Daniel G Piqué
- Colorado Center for Personalized Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Section of Genetics and Metabolism, Department of Pediatrics, Children's Hospital Colorado, Aurora, CO, USA
| | - Robert C Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Katrina G Claw
- Human Medical Genetics & Genomics Graduate Program, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Colorado Center for Personalized Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Biomedical Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Christopher R Gignoux
- Human Medical Genetics & Genomics Graduate Program, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Colorado Center for Personalized Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Biomedical Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Carlozzi NE, Kallen MA, Troost JP, Bragg A, Martin-Howard J, De La Cruz B, Miner JA, Moldovan I, Jack BW, Mitchell S. Development and calibration data for the Healthcare Access Item Bank: a new computer adaptive test for persons with type 2 diabetes mellitus. Qual Life Res 2023; 32:781-796. [PMID: 36315318 PMCID: PMC10472318 DOI: 10.1007/s11136-022-03278-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2022] [Indexed: 03/08/2023]
Abstract
PURPOSE The purpose of this study was to develop a new measure to evaluate the ability to receive medical services when needed among persons with type 2 diabetes mellitus. METHODS The Healthcare Access measure was developed using data from 225 persons with type 2 diabetes mellitus who completed an item pool comprised of 54 questions pertaining to their experience accessing healthcare services. RESULTS Exploratory and confirmatory factor analyses supported the retention of 45 items. In addition, a constrained graded response model (GRM), as well as analyses that examined item misfit and differential item functioning (investigated for age, sex, education, race, and socioeconomic status), supported the retention of 44 items in the final item bank. Expert review and GRM item calibration products were used to inform the selection of a 6-item static short form and to program the Healthcare Access computer adaptive test (CAT). Preliminary data supported the reliability (i.e., internal consistency and test-retest reliability) and validity (i.e., convergent, discriminant, and known-groups) of the new measure. CONCLUSIONS The new Healthcare Access item bank can be used to examine the experiences that persons with type 2 diabetes mellitus have with healthcare access, to better target treatment improvements and mitigate disparities; it will be available as a part of the Neuro-Qol measurement system through healthmeasures.net and the PROMIS Application Programmable Interface (API) in early 2023.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
- Department of Physical Medicine & Rehabilitation, Center for Clinical Outcomes Development and Application (CODA), University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Building NCRC B14, Room G216, Ann Arbor, MI, 48109-2800, USA.
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jonathan P Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Alexa Bragg
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Jessica Martin-Howard
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | - Jennifer A Miner
- Department of Physical Medicine & Rehabilitation, Center for Clinical Outcomes Development and Application (CODA), University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Building NCRC B14, Room G216, Ann Arbor, MI, 48109-2800, USA
| | - Ioana Moldovan
- Department of Family Medicine, Boston Medical Center, Boston, MA, USA
| | - Brian W Jack
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Family Medicine, Boston Medical Center, Boston, MA, USA
| | - Suzanne Mitchell
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Family Medicine, Boston Medical Center, Boston, MA, USA
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Carrasco-Aguilar A, Galán JJ, Carrasco RA. Obamacare: A bibliometric perspective. Front Public Health 2022; 10:979064. [PMID: 36033824 PMCID: PMC9416003 DOI: 10.3389/fpubh.2022.979064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 01/25/2023] Open
Abstract
Obamacare is the colloquial name given to the Affordable Care Act (ACA) signed into law by President Obama in the USA, which ultimately aims to provide universal access to health care services for US citizens. The aim of this paper is to provide an overview of the political-legal, economic, social, management (or administrative), and medical (or health) repercussions of this law, using a bibliometric methodology as a basis. In addition, the main contributors to research on ACA issues have been identified in terms of authors, organizations, journals, and countries. The downward trend in scientific production on this law has been noted, and it has been concluded that a balance has not yet been reached between the coexistence of private and public health care that guarantees broad social coverage without economic or other types of barriers. The law requires political consensus to be implemented in a definitive and global manner for the whole of the United States.
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Emmons RP, Harris IM, Abdalla M, Afolabi TM, Barner AE, Baxter MV, Bisada M, Chase AM, Christenberry EJ, Cobb BT, Dang Y, Hickman CM, Mills AR, Wease H. Impact of remote delivery of clinical pharmacy services on health disparities and access to care. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Ila M. Harris
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Maha Abdalla
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Miriam Bisada
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Yen Dang
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | - Alex R. Mills
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Heather Wease
- American College of Clinical Pharmacy Lenexa Kansas USA
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