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Development and validation of a primary care-based family health history and decision support program (MeTree).

Publication ,  Journal Article
Orlando, LA; Buchanan, AH; Hahn, SE; Christianson, CA; Powell, KP; Skinner, CS; Chesnut, B; Blach, C; Due, B; Ginsburg, GS; Henrich, VC
Published in: N C Med J
2013

INTRODUCTION: Family health history is a strong predictor of disease risk. To reduce the morbidity and mortality of many chronic diseases, risk-stratified evidence-based guidelines strongly encourage the collection and synthesis of family health history to guide selection of primary prevention strategies. However, the collection and synthesis of such information is not well integrated into clinical practice. To address barriers to collection and use of family health histories, the Genomedical Connection developed and validated MeTree, a Web-based, patient-facing family health history collection and clinical decision support tool. MeTree is designed for integration into primary care practices as part of the genomic medicine model for primary care. METHODS: We describe the guiding principles, operational characteristics, algorithm development, and coding used to develop MeTree. Validation was performed through stakeholder cognitive interviewing, a genetic counseling pilot program, and clinical practice pilot programs in 2 community-based primary care clinics. RESULTS: Stakeholder feedback resulted in changes to MeTree's interface and changes to the phrasing of clinical decision support documents. The pilot studies resulted in the identification and correction of coding errors and the reformatting of clinical decision support documents. MeTree's strengths in comparison with other tools are its seamless integration into clinical practice and its provision of action-oriented recommendations guided by providers' needs. LIMITATIONS: The tool was validated in a small cohort. CONCLUSION: MeTree can be integrated into primary care practices to help providers collect and synthesize family health history information from patients with the goal of improving adherence to risk-stratified evidence-based guidelines.

Duke Scholars

Published In

N C Med J

ISSN

0029-2559

Publication Date

2013

Volume

74

Issue

4

Start / End Page

287 / 296

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Assessment
  • Primary Health Care
  • Middle Aged
  • Medical History Taking
  • Male
  • Internet
  • Humans
  • Female
  • Family
 

Citation

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ICMJE
MLA
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Orlando, L. A., Buchanan, A. H., Hahn, S. E., Christianson, C. A., Powell, K. P., Skinner, C. S., … Henrich, V. C. (2013). Development and validation of a primary care-based family health history and decision support program (MeTree). N C Med J, 74(4), 287–296.
Orlando, Lori A., Adam H. Buchanan, Susan E. Hahn, Carol A. Christianson, Karen P. Powell, Celette Sugg Skinner, Blair Chesnut, et al. “Development and validation of a primary care-based family health history and decision support program (MeTree).N C Med J 74, no. 4 (2013): 287–96.
Orlando LA, Buchanan AH, Hahn SE, Christianson CA, Powell KP, Skinner CS, et al. Development and validation of a primary care-based family health history and decision support program (MeTree). N C Med J. 2013;74(4):287–96.
Orlando, Lori A., et al. “Development and validation of a primary care-based family health history and decision support program (MeTree).N C Med J, vol. 74, no. 4, 2013, pp. 287–96.
Orlando LA, Buchanan AH, Hahn SE, Christianson CA, Powell KP, Skinner CS, Chesnut B, Blach C, Due B, Ginsburg GS, Henrich VC. Development and validation of a primary care-based family health history and decision support program (MeTree). N C Med J. 2013;74(4):287–296.

Published In

N C Med J

ISSN

0029-2559

Publication Date

2013

Volume

74

Issue

4

Start / End Page

287 / 296

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Assessment
  • Primary Health Care
  • Middle Aged
  • Medical History Taking
  • Male
  • Internet
  • Humans
  • Female
  • Family