The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Nadeem Qureshi - One of the best experts on this subject based on the ideXlab platform.
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Is Family History still underutilised? Exploring the views and experiences of primary care doctors in Malaysia
Journal of Community Genetics, 2020Co-Authors: Norita Hussein, Nadeem Qureshi, Tun Firzara Abdul Malik, Hani Salim, Azah Samad, Chirk Jenn NgAbstract:Family History has long been recognised as a non-invasive and inexpensive tool to identify individuals at risk of genetic conditions. Even in the era of evolving genetic and genomic technology, the role of Family History in predicting individual risk for genetic testing and guiding in preventive interventions is still relevant, especially in low-resource countries. The aim of this study was to explore primary care doctors’ views and experiences in Family History taking and how they utilised Family History in day-to-day clinical consultations in Malaysia. Four focus group discussions and six in-depth interviews involving 25 primary care doctors were conducted. Three themes emerged from the analysis: (1) primary care doctors considered Family History as an important part of clinical assessment, (2) proactive versus reactive approach in collecting Family History and (3) Family History collection was variable and challenging. Family History was documented in either free text or pedigree depending on the perception of its appropriateness during the consultation. This study highlighted the need to improve the approach, documentation and the implementation of Family History in the Malaysian primary care settings. Integrating Family filing concept with built-in clinical decision support into electronic medical records is a potential solution in ensuring effective Family History taking in primary care.
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availability and quality of coronary heart disease Family History in primary care medical records implications for cardiovascular risk assessment
PLOS ONE, 2014Co-Authors: Paula Dhiman, Joe Kai, Laura Horsfall, Kate Walters, Nadeem QureshiAbstract:Background: The potential to use data on Family History of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD). However the quality of Family health information in primary care records is unclear. Aim: To assess the availability and quality of Family History of CHD documented in electronic primary care records Design: Cross-sectional study Setting: 537 UK Family practices contributing to The Health Improvement Network database. Method: Data were obtained from patients aged 20 years or more, registered with their current practice between 1st January 1998 and 31st December 2008, for at least one year. The availability and quality of recorded CHD Family History was assessed using multilevel logistic and ordinal logistic regression respectively. Results: In a cross-section of 1,504,535 patients, 19% had a positive or negative Family History of CHD recorded. Multilevel logistic regression showed patients aged 50–59 had higher odds of having their Family History recorded compared to those aged 20–29 (OR:1.23 (1.21 to 1.25)), however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88)). Of the 140,058 patients with a positive Family History recorded (9% of total cohort), age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of Family History recording and age, gender, deprivation and year of registration. Conclusion: Family History of CHD is documented in a small proportion of primary care records; and where positive Family History is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.
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Family History in public health practice a genomic tool for disease prevention and health promotion
Annual Review of Public Health, 2010Co-Authors: Rodolfo Valdez, Paula W Yoon, Nadeem Qureshi, Ridgely Fisk Green, Muin J KhouryAbstract:Family History is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include Family History to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of Family History over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of Family History in public health has been poorly explored. To establish Family History as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized Family histories of many diseases. Their goal is to create Family History tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of Family History as a public health tool.
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Family History in public health practice a genomic tool for disease prevention and health promotion
Annual Review of Public Health, 2010Co-Authors: Rodolfo Valdez, Paula W Yoon, Nadeem Qureshi, Ridgely Fisk Green, Muin J KhouryAbstract:Family History is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include Family History to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of Family History over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of Family History in public health has been poorly explored. To establish Family History as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized Family histories of many diseases. Their goal is to create Family History tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of Family his...
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systematic review Family History in risk assessment for common diseases
Annals of Internal Medicine, 2009Co-Authors: Brenda Wilson, Nadeem Qureshi, Pasqualina Santaguida, Julian Little, June C Carroll, Judith E Allanson, Parminder RainaAbstract:Wilson and associates reviewed evidence about the potential beneficial and harmful effects of routinely collecting Family History information in primary care settings. They also reviewed studies th...
Muin J Khoury - One of the best experts on this subject based on the ideXlab platform.
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Family History wide association study to identify clinical and environmental risk factors for common chronic diseases
American Journal of Epidemiology, 2019Co-Authors: Danielle Rasooly, Muin J Khoury, John P A Ioannidis, Chirag J PatelAbstract:Family History is a strong risk factor for many common chronic diseases and summarizes shared environmental and genetic risk, but how this increased risk is mediated is unknown. We developed a "Family History-wide association study" (FamWAS) to systematically and comprehensively test clinical and environmental quantitative traits (CEQTs) for their association with Family History of disease. We implemented our method on 457 CEQTs for association with Family History of diabetes, asthma, and coronary heart disease (CHD) in 42,940 adults spanning 8 waves of the 1999-2014 US National Health and Nutrition Examination Survey. We conducted pooled analyses of the 8 survey waves and analyzed trait associations using survey-weighted logistic regression. We identified 172 (37.6% of total), 32 (7.0%), and 78 (17.1%) CEQTs associated with Family History of diabetes, asthma, and CHD, respectively, in subcohorts of individuals without the respective disease. Twenty associated CEQTs were shared across Family History of diabetes, asthma, and CHD, far more than expected by chance. FamWAS can examine traits not previously studied in association with Family History and uncover trait overlap, highlighting a putative shared mechanism by which Family History influences disease risk.
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Family History in public health practice a genomic tool for disease prevention and health promotion
Annual Review of Public Health, 2010Co-Authors: Rodolfo Valdez, Paula W Yoon, Nadeem Qureshi, Ridgely Fisk Green, Muin J KhouryAbstract:Family History is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include Family History to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of Family History over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of Family History in public health has been poorly explored. To establish Family History as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized Family histories of many diseases. Their goal is to create Family History tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of Family History as a public health tool.
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Family History in public health practice a genomic tool for disease prevention and health promotion
Annual Review of Public Health, 2010Co-Authors: Rodolfo Valdez, Paula W Yoon, Nadeem Qureshi, Ridgely Fisk Green, Muin J KhouryAbstract:Family History is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include Family History to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of Family History over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of Family History in public health has been poorly explored. To establish Family History as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized Family histories of many diseases. Their goal is to create Family History tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of Family his...
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Family History assessment to detect increased risk for colorectal cancer conceptual considerations and a preliminary economic analysis
Cancer Epidemiology Biomarkers & Prevention, 2005Co-Authors: Scott D Ramsey, Linda E Pinsky, Wylie Burke, Lauren Clarke, Polly A Newcomb, Muin J KhouryAbstract:Background: Although the rationale for earlier screening of persons with a Family History of colorectal cancer is plausible, there is no direct evidence that earlier assessment is either effective or cost-effective. Objective: To estimate the clinical and economic effect of using Family History assessment to identify persons for colorectal cancer screening before age 50. Methods: We developed a decision model to compare costs and outcomes for two scenarios: ( a ) standard population screening starting at age 50; ( b ) Family History assessment at age 40, followed by screening colonoscopy at age 40 for those with a suggestive Family History of colorectal cancer. The analysis was conducted using the health insurer perspective. Results: Using U.S. population estimates, 22 million would be eligible for Family History assessment, and one million would be eligible for early colonoscopy; 2,834 invasive cancers would be detected, and 29,331 life years would be gained. The initial program cost would be $900 million. The discounted cost per life year gained of Family History assessment versus no assessment equals $58,228. The results were most sensitive to the life expectancy benefit from earlier screening, the cost of colonoscopy, and the relative risk of colon cancer in those with a Family History. Conclusions: The cost-effectiveness of Family History assessment for colorectal cancer approaches that of other widely accepted technologies; yet, the results are sensitive to several assumptions where better data are needed. Because of the relatively high prevalence of Family History in the population, careful analysis and empirical data are needed.
Preben Bo Mortensen - One of the best experts on this subject based on the ideXlab platform.
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psychiatric Family History and schizophrenia risk in denmark which mental disorders are relevant
Psychological Medicine, 2010Co-Authors: Preben Bo Mortensen, M G Pedersen, Carsten Bocker PedersenAbstract:Background A Family History of schizophrenia is the strongest single indicator of individual schizophrenia risk. Bipolar affective disorder and schizo-affective disorders have been documented to occur more frequently in parents and siblings of schizophrenia patients, but the familial occurrence of the broader range of mental illnesses and their role as confounders have not been studied in large population-based samples. Method All people born in Denmark between 1955 and 1991 (1.74 million) were followed for the development of schizophrenia (9324 cases) during 28 million person-years at risk. Information of schizophrenia in cohort members and psychiatric History in parents and siblings was established through linkage with the Danish Psychiatric Central Register. Data were analysed using log-linear Poisson regression. Results Schizophrenia was, as expected, strongly associated with schizophrenia and related disorders among first-degree relatives. However, almost any other psychiatric disorder among first-degree relatives increased the individual's risk of schizophrenia. The population attributable risk associated with psychiatric Family History in general was 27.1% whereas Family histories including schizophrenia only accounted for 6.0%. The general psychiatric Family History was a confounder of the association between schizophrenia and urbanization of place of birth. Conclusions Clinically diagnosed schizophrenia is associated with a much broader range of mental disorders in first-degree relatives than previously reported. This may suggest risk haplotypes shared across many disorders and/or shared environmental factors clustering in families. Failure to take the broad range of psychiatric Family History into account may bias results of all risk-factor studies of schizophrenia.
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Family History of psychiatric disorders and age at first contact in schizophrenia an epidemiological study
British Journal of Psychiatry, 2002Co-Authors: Majella Byrne, Esben Agerbo, Preben Bo MortensenAbstract:Background The risk for schizophrenia has been associated with a Family History of this and other psychiatric disorders. The relationship between age at first contact and Family History of psychiatric illness is not certain. Aims To estimate the risks for schizophrenia associated with a range of psychiatric diagnoses in Family members and to investigate the relationship between these risks and age at first contact for schizophrenia. Method A nested case—control study design was employed. Psychiatric admission data and socio-economic data were available for 7704 cases admitted between 1981 and 1998 in Denmark, 192 590 gender- and age-matched controls, and for the parents and siblings of all subjects. Results Controlling for socio-economic factors, risk for schizophrenia was associated with a Family History of all psychiatric disorders except substance misuse and independently with a Family History of suicide. The risk for schizophrenia associated with a Family History of psychiatric disorders decreased as age at first contact increased. Conclusions Risk for schizophrenia is associated with a range of psychiatric disorders in Family members and these risks are not constant across the risk period.
Ridgely Fisk Green - One of the best experts on this subject based on the ideXlab platform.
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Family History in public health practice a genomic tool for disease prevention and health promotion
Annual Review of Public Health, 2010Co-Authors: Rodolfo Valdez, Paula W Yoon, Nadeem Qureshi, Ridgely Fisk Green, Muin J KhouryAbstract:Family History is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include Family History to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of Family History over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of Family History in public health has been poorly explored. To establish Family History as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized Family histories of many diseases. Their goal is to create Family History tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of Family History as a public health tool.
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Family History in public health practice a genomic tool for disease prevention and health promotion
Annual Review of Public Health, 2010Co-Authors: Rodolfo Valdez, Paula W Yoon, Nadeem Qureshi, Ridgely Fisk Green, Muin J KhouryAbstract:Family History is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include Family History to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of Family History over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of Family History in public health has been poorly explored. To establish Family History as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized Family histories of many diseases. Their goal is to create Family History tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of Family his...
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summary of workgroup meeting on use of Family History information in pediatric primary care and public health
Pediatrics, 2007Co-Authors: Ridgely Fisk GreenAbstract:A workgroup meeting on the use of Family History information in pediatric primary care and public health sponsored by the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention was held February 24 to 25, 2006. The workgroup participants met to discuss how to improve the use of Family History information in pediatric settings. Topics addressed at the meeting included current practices, needs, and barriers for use of Family History information in pediatric primary care and public health. Other considerations included how available Family History tools might be applicable to pediatric settings and which areas require additional research. Specific model conditions were presented that illustrated issues involved in the use of Family History information in pediatric settings, including cystic fibrosis, fragile X syndrome, polycystic kidney disease, hyperlipidemia and coronary artery disease, and birth defects. Ethical, economic, and technologic concerns involved in integration of Family History information into pediatric settings were discussed also.
Sapna Syngal - One of the best experts on this subject based on the ideXlab platform.
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cancer risk assessment quality and impact of the Family History interview
American Journal of Preventive Medicine, 2004Co-Authors: Harvey J Murff, Daniel W Byrne, Sapna SyngalAbstract:Background: Identification of individuals at high risk for colon and breast cancer requires an adequate Family History assessment and can influence cancer screening and genetic testing decisions. Little data exist that evaluate the completeness of the Family History interview in primary care. Methods: Retrospective chart review of 995 new patient visits to 28 primary care physicians evaluating the completeness of the Family cancer History for colon or breast cancer. Family History information was evaluated for inclusion of age at diagnosis, degree of kinship, and specification of disease of interest. Results: Family History information on cancer diagnoses was collected on 679 (68%) of the patients. Specific information regarding the individual affected and the cancer diagnosis was present in 414 (61%) of the records. Affected first-degree relatives were more likely to have their age of cancer diagnosis recorded than second-degree relatives (39%, 95% confidence interval [CI]=34%–44% vs 16%, 95% CI=12%–20%). Age at diagnosis of cancer in first-degree relatives was documented in 51% of colon cancers, 38% of breast cancers, and 27% of ovarian cancers. Only 17% of individuals who meet criteria for early-onset breast cancer genetic testing were referred for genetic services. Conclusions: Adequate cancer risk assessment using Family History information requires age at cancer diagnosis and specification of a cancer diagnosis. Age at diagnosis was frequently missing from Family History assessments, which could have a potential impact on identification of high-risk individuals. When Family History information does identify high-risk individuals, only the minority are referred for genetic services.
