Delivery models for predictive genetic testing: preliminary results of a systematic reviewBrigid Unim
European Journal of Public Health ,
Nov 2016
Unim, B , Lagerberg, T , Adamo, G , Pitini, E , D’Andrea, E , Vacchio, MR , De Vito, C , et al.
Delivery models for predictive genetic testing: preliminary results of a systematic reviewBrigid Unim
9th European Public Health Conference: Parallel Sessions
189
6.K. Pitch presentations: From genomics to
vaccination in promoting health
Delivery models for predictive genetic testing:
preliminary results of a systematic review
Brigid Unim
Background
Research on the integration of genomic knowledge into clinical
practice and public health is in an early phase, and many
concerns remain. The aim of this study is to identify, classify,
and evaluate delivery models for the provision of predictive
genetic testing in Europe vs. extra-European (Anglophone)
countries.
Methods
A systematic review of the literature was conducted to identify
existing genetic delivery models. Inclusion criteria were that
articles be: published 2000-2015; in English or Italian; and
from European or non-European countries (Canada, USA,
Australia or New Zealand). Additional policy documents were
retrieved from represented countries’ government-affiliated
websites (non-systematic search).
Results
A total of 117 records were included, reporting on 148 genetic
programmes. The programmes integrated into healthcare
systems were 99 (64.9%), 49 (33.1%) were pilot programmes
and 4 (2.7%) were direct-to-consumer genetic services. Most
programmes were delivered in the United Kingdom (58,
39.2%), USA (35, 23.6%) or Australia (16, 10.8%). Tests for
hereditary breast and ovarian cancer and Lynch syndrome
were most commonly offered (39.9% and 12.8% of programmes, respectively). Many of the genetic tests offered have
insufficient clinical validity or utility. The identified genetic
programmes can be classified into five basic genetic service
models based on which type of healthcare professional has the
most prominent role in test referral: I) the geneticists model;
II) the primary care model; III) the medical specialists model;
IV) the population screening programmes model; V) and the
direct-to-consumer model. Rudimentary evaluation of the
identified programmes will be made based on outcomes and
process measures of the models.
Conclusions
This review, as part of an European multicenter study, will
facilitate the identification of appropriate models, outcome
and process measures for the provision of predictive genetic
testing in Europe.
Key messages:
Current genetic services are delivered without standardized
set of process and outcome measures, which are essential for
the evaluation of healthcare services
Identification of appropriate genetic services delivery
models is important for the implementation of genetic
applications of proven efficacy, effectiveness and costeffectiveness
B Unim1, T Lagerberg2, G Adamo1, E Pitini1, E D’Andrea1,
MR Vacchio1, C De Vito1, P Villari1
1
Department of Public Health and Infectious Diseases, Sapienza University
of Rome, Rome, Italy
2
Better Value HealthCare Ltd, Oxford, UK
Contact:
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Article home page: https://academic.oup.com/eurpub/article/26/suppl_1/ckw169.043/2448732
Unim, B, Lagerberg, T, Adamo, G, Pitini, E, D’Andrea, E, Vacchio, MR, De Vito, C, Villari, P.
Delivery models for predictive genetic testing: preliminary results of a systematic reviewBrigid Unim ,
European Journal of Public Health,
2016, Volume 26, Issue suppl_1, DOI: 10.1093/eurpub/ckw169.043