Panel Assesses Evidence for the Collection and Use of Family Health History Information
Though most Americans are familiar with completing a questionnaire about their family health history when visiting health care providers, an independent panel was convened by the National Institutes of Health recently to critically assess exactly what we know and what we need to learn about how this process relates to improving health. The conference focused on the use of family history in the primary care setting for common diseases such as diabetes, stroke, cancer, and heart disease.
Hamidi: A person's family history plays an important role in the practice of medicine and has the potential to motivate positive lifestyle changes, enhance individual empowerment, and influence clinical interventions.Dr. Berg: When you look closely at family history, though, you'll find that there's a lot that we don't know about it.
Hamidi: Dr. Alfred O. Berg is professor in the Department of Family Medicine at the University of Washington in Seattle, and served as Panel Chair for the NIH State-of-the-Science Conference: Family History and Improving Health. Dr. Berg says it is imperative to clarify what is meant by the term "family history."
Dr. Berg: The term is in common use but it really doesn't have a common definition. Clinicians and patients understand it in different ways.
Hamidi: He adds that an increased emphasis on personalized medicine and electronic health records creates a fascinating opportunity to responsibly maximize the value of this information.
Dr. Berg: It's an interesting place to be in medicine right now with a huge increase in the availability of certain kinds of genomic information also with healthcare reform on the horizon a lot interest in electronic health records and in personalizing medical care, so the role that the family history might play in all of this is of obvious interest.
Hamidi: While the correlation between family history and an individual's own health is evident, the various methods by which this information is collected, recorded and analyzed aren't necessarily the most effective.
Dr. Berg: Family history questionnaires are not standardized; they cover a wide variety of factors. The questions may be imbedded in complex risk assessment tools along with other demographic and health factors and even the definition of family varies when you look at it from the perspective of geneticists, generalists, specialists and clinicians, family therapists and members of some ethnic and cultural groups.
Hamidi: The panelists drafted a proposal with twenty-five research recommendations falling under three categories: the structure or characteristics of family history, the process of acquiring a family history and lastly, examining the outcomes of family history acquisition, interpretation, and application.
Dr. Berg: It's been an interesting process. The topic was family history and improving health and of course, many common diseases have genetic, environmental, and lifestyle causes that family members share and healthcare professionals in the U.S. have always asked patients about family history information.
Hamidi: Dr. Berg explains that the interest in examining the role of family health history and its relationship to improving health outcomes is likely reflective of the fundamental changes that modern medicine and science are facing today.
Dr. Berg: But for the most part, the panel found that it is unclear how this information can be effectively gathered and used in the primary care setting for common diseases so our research recommendations outline our suggested approach for addressing the gaps in research.
Hamidi: The panel's complete and updated draft state-of-the-science statement is available at consensus.nih.gov. This is Anahita Hamidi, National Institutes of Health, Bethesda, Maryland.
About This Audio Report
Reporter: Anahita Hamidi
Sound Bite: Dr. Alfred O. Berg
Topic: Family History and Health