An Evidence Framework for Genetic Testing

An Evidence Framework for Genetic Testing PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309453321
Category : Medical
Languages : en
Pages : 149

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Book Description
Advances in genetics and genomics are transforming medical practice, resulting in a dramatic growth of genetic testing in the health care system. The rapid development of new technologies, however, has also brought challenges, including the need for rigorous evaluation of the validity and utility of genetic tests, questions regarding the best ways to incorporate them into medical practice, and how to weigh their cost against potential short- and long-term benefits. As the availability of genetic tests increases so do concerns about the achievement of meaningful improvements in clinical outcomes, costs of testing, and the potential for accentuating medical care inequality. Given the rapid pace in the development of genetic tests and new testing technologies, An Evidence Framework for Genetic Testing seeks to advance the development of an adequate evidence base for genetic tests to improve patient care and treatment. Additionally, this report recommends a framework for decision-making regarding the use of genetic tests in clinical care.

An Evidence Framework for Genetic Testing

An Evidence Framework for Genetic Testing PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309453321
Category : Medical
Languages : en
Pages : 149

Get Book

Book Description
Advances in genetics and genomics are transforming medical practice, resulting in a dramatic growth of genetic testing in the health care system. The rapid development of new technologies, however, has also brought challenges, including the need for rigorous evaluation of the validity and utility of genetic tests, questions regarding the best ways to incorporate them into medical practice, and how to weigh their cost against potential short- and long-term benefits. As the availability of genetic tests increases so do concerns about the achievement of meaningful improvements in clinical outcomes, costs of testing, and the potential for accentuating medical care inequality. Given the rapid pace in the development of genetic tests and new testing technologies, An Evidence Framework for Genetic Testing seeks to advance the development of an adequate evidence base for genetic tests to improve patient care and treatment. Additionally, this report recommends a framework for decision-making regarding the use of genetic tests in clinical care.

Assessing Genetic Risks

Assessing Genetic Risks PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309047986
Category : Medical
Languages : en
Pages : 353

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Book Description
Raising hopes for disease treatment and prevention, but also the specter of discrimination and "designer genes," genetic testing is potentially one of the most socially explosive developments of our time. This book presents a current assessment of this rapidly evolving field, offering principles for actions and research and recommendations on key issues in genetic testing and screening. Advantages of early genetic knowledge are balanced with issues associated with such knowledge: availability of treatment, privacy and discrimination, personal decision-making, public health objectives, cost, and more. Among the important issues covered: Quality control in genetic testing. Appropriate roles for public agencies, private health practitioners, and laboratories. Value-neutral education and counseling for persons considering testing. Use of test results in insurance, employment, and other settings.

The Evaluation of Forensic DNA Evidence

The Evaluation of Forensic DNA Evidence PDF Author: National Research Council
Publisher: National Academies Press
ISBN: 0309121949
Category : Science
Languages : en
Pages : 271

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Book Description
In 1992 the National Research Council issued DNA Technology in Forensic Science, a book that documented the state of the art in this emerging field. Recently, this volume was brought to worldwide attention in the murder trial of celebrity O. J. Simpson. The Evaluation of Forensic DNA Evidence reports on developments in population genetics and statistics since the original volume was published. The committee comments on statements in the original book that proved controversial or that have been misapplied in the courts. This volume offers recommendations for handling DNA samples, performing calculations, and other aspects of using DNA as a forensic toolâ€"modifying some recommendations presented in the 1992 volume. The update addresses two major areas: Determination of DNA profiles. The committee considers how laboratory errors (particularly false matches) can arise, how errors might be reduced, and how to take into account the fact that the error rate can never be reduced to zero. Interpretation of a finding that the DNA profile of a suspect or victim matches the evidence DNA. The committee addresses controversies in population genetics, exploring the problems that arise from the mixture of groups and subgroups in the American population and how this substructure can be accounted for in calculating frequencies. This volume examines statistical issues in interpreting frequencies as probabilities, including adjustments when a suspect is found through a database search. The committee includes a detailed discussion of what its recommendations would mean in the courtroom, with numerous case citations. By resolving several remaining issues in the evaluation of this increasingly important area of forensic evidence, this technical update will be important to forensic scientists and population geneticistsâ€"and helpful to attorneys, judges, and others who need to understand DNA and the law. Anyone working in laboratories and in the courts or anyone studying this issue should own this book.

Addressing Challenges in Genetic Test Evaluation

Addressing Challenges in Genetic Test Evaluation PDF Author: U. S. Department of Health and Human Services
Publisher: CreateSpace
ISBN: 9781484124420
Category : Medical
Languages : en
Pages : 110

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Book Description
Genetic testing is a rapidly expanding area with many clinical applications. While the introduction of new genetic tests creates tremendous potential for improving patient care, it is essential to evaluate these tests thoroughly to ensure that they are accurate and lead to improved patient outcomes when used in clinical practice settings. While the general principles for evaluating genetic tests are similar to those for evaluating other clinical tests, there are differences in how the principles are applied and the degree to which certain issues are relevant. The context for genetic testing is often more complex than that of other clinical tests. Evaluating the clinical impact of genetic tests under a broad range of clinical scenarios, particularly when the evaluation involves heritable conditions, requires use of appropriate frameworks. To date, systematic reviewers have not been consistent in their approaches to evaluating genetic tests. Clarifying a set of analytic frameworks customized for different testing scenarios but sharing the same principles could be beneficial to the practice of genetic testing evaluation. Another challenge in evaluating genetic tests is the assessment of analytic validity. Analytic validity refers to the ability of a laboratory test to accurately and reliably measure the properties or characteristics it is intended to measure (e.g., the presence of a gene mutation). Evaluation of a genetic test's analytic validity is often required as part of the effort to establish the aforementioned “chain of evidence.” The paucity of published data and a lack of an optimized search strategy for identifying data on analytic validity from gray literature remain a major barrier to evaluating analytic validity of genetic tests. Meanwhile, there is a lack of established quality assessment guidance for assessing analytic validity studies when they are identified. To address these important issues related to genetic test evaluation, the Agency for Healthcare Research and Quality commissioned this report. The report addressed the following four Key Questions: Key Question 1: Is it feasible to clarify a comprehensive framework or a limited set of frameworks for evaluating genetic tests by modifying existing frameworks? Key Question 2: What are the strengths and limitations of different approaches to literature searching to assess evidence on variability in genetic and laboratory testing? Is there an optimal approach to literature search? Key Question 3: Is it feasible to apply existing quality rating criteria to analytic validity studies on genetic tests? Is there an optimal quality rating instrument for these studies? Key Question 4: What are existing gaps in evidence on sources and contributors of variability common to all genetic tests, or to specific categories of genetic tests? What approaches will lead to generating data to fill these gaps? These four key questions fall into two categories that are intrinsically connected but different in scope: evaluation frameworks and analytic validity

Systems for Research and Evaluation for Translating Genome-Based Discoveries for Health

Systems for Research and Evaluation for Translating Genome-Based Discoveries for Health PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309147417
Category : Medical
Languages : en
Pages : 103

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Book Description
With the advent of genome-wide association studies, numerous associations between specific gene loci and complex diseases have been identified-for breast cancer, coronary artery disease, and asthma, for example. This rapidly advancing field of genomics has stirred great interest in "personalized" health care from both the public and private sectors. The hope is that using genomic information in clinical care will lead to reduced health care costs and improved health outcomes as therapies are tailored to the genetic susceptibilities of patients. A variety of genetically based health care innovations have already reached the marketplace, but information about the clinical use of these treatments and diagnostics is limited. Currently data do not provide information about how a genomic test impacts clinical care and patient health outcomes-other approaches are needed to garner such information. This volume summarizes a workshop to address central questions related to the development of systems to evaluate clinical use of health care innovations that stem from genome-based research: What are the practical realities of creating such systems? What different models could be used? What are the strengths and weaknesses of each model? How effectively can such systems address questions about health outcomes?

Protection of Human Genetic Information

Protection of Human Genetic Information PDF Author: Australia. Law Reform Commission
Publisher: Sydney : Australian Law Reform Commission
ISBN: 9780642732118
Category : Data protection
Languages : en
Pages : 441

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Book Description
13. Law enforcement issues

Educating Health Professionals in Genomic Medicine: Evidence-Based Strategies and Approaches

Educating Health Professionals in Genomic Medicine: Evidence-Based Strategies and Approaches PDF Author: Sylvia Ann Metcalfe
Publisher: Frontiers Media SA
ISBN: 2889660591
Category : Medical
Languages : en
Pages : 129

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Book Description
This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact.

Building Genetic Medicine

Building Genetic Medicine PDF Author: Shobita Parthasarathy
Publisher: MIT Press
ISBN: 0262250098
Category : Science
Languages : en
Pages : 285

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Book Description
A comparative study of genetic testing for breast and ovarian cancer in the United States and Britain that shows the importance of national context in the development and use of science and technology even in an era of globalization. In Building Genetic Medicine, Shobita Parthasarathy shows how, even in an era of globalization, national context is playing an important role in the development and use of genetic technologies. Focusing on the development and deployment of genetic testing for breast and ovarian cancer (known as BRCA testing) in the United States and Britain, Parthasarathy develops a comparative analysis framework in order to investigate how national “toolkits” shape both regulations and the architectures of technologies and uses this framework to assess the implications of new genetic technologies. Parthasarathy argues that differences in the American and British approaches to health care and commercialization of research led to the establishment of different BRCA services in the two countries. In Britain, the technology was available through the National Health Service as an integrated program of counseling and laboratory analysis, and was viewed as a potentially cost-effective form of preventive care. In the United States, although BRCA testing was initially offered by a number of providers, one company eventually became the sole provider of a test available to consumers on demand. Parthasarathy draws lessons for the future of genetic medicine from these cross-national differences, and discusses the ways in which comparative case studies can inform policy-making efforts in science and technology.

Clinical Applications for Next-Generation Sequencing

Clinical Applications for Next-Generation Sequencing PDF Author: Urszula Demkow
Publisher: Academic Press
ISBN: 0128018410
Category : Science
Languages : en
Pages : 334

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Book Description
Clinical Applications for Next Generation Sequencing provides readers with an outstanding postgraduate resource to learn about the translational use of NGS in clinical environments. Rooted in both medical genetics and clinical medicine, the book fills the gap between state-of-the-art technology and evidence-based practice, providing an educational opportunity for users to advance patient care by transferring NGS to the needs of real-world patients. The book builds an interface between genetic laboratory staff and clinical health workers to not only improve communication, but also strengthen cooperation. Users will find valuable tactics they can use to build a systematic framework for understanding the role of NGS testing in both common and rare diseases and conditions, from prenatal care, like chromosomal abnormalities, up to advanced age problems like dementia. Fills the gap between state-of-the-art technology and evidence-based practice Provides an educational opportunity which advances patient care through the transfer of NGS to real-world patient assessment Promotes a practical tool that clinicians can apply directly to patient care Includes a systematic framework for understanding the role of NGS testing in many common and rare diseases Presents evidence regarding the important role of NGS in current diagnostic strategies

DNA Technology in Forensic Science

DNA Technology in Forensic Science PDF Author: National Research Council
Publisher: National Academies Press
ISBN: 0309045878
Category : Science
Languages : en
Pages : 199

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Book Description
Matching DNA samples from crime scenes and suspects is rapidly becoming a key source of evidence for use in our justice system. DNA Technology in Forensic Science offers recommendations for resolving crucial questions that are emerging as DNA typing becomes more widespread. The volume addresses key issues: Quality and reliability in DNA typing, including the introduction of new technologies, problems of standardization, and approaches to certification. DNA typing in the courtroom, including issues of population genetics, levels of understanding among judges and juries, and admissibility. Societal issues, such as privacy of DNA data, storage of samples and data, and the rights of defendants to quality testing technology. Combining this original volume with the new update-The Evaluation of Forensic DNA Evidence-provides the complete, up-to-date picture of this highly important and visible topic. This volume offers important guidance to anyone working with this emerging law enforcement tool: policymakers, specialists in criminal law, forensic scientists, geneticists, researchers, faculty, and students.