RAGs: A Novel Approach to Computerized Genetic Risk Assessment and Decision Support from Pedigrees

A. S. Coulson; D. W. Glasspool; J. Fox; J. Emery

doi:10.1055/s-0038-1634427

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2001; 40(04): 315-322
DOI: 10.1055/s-0038-1634427

Original Article

Schattauer GmbH

RAGs: A Novel Approach to Computerized Genetic Risk Assessment and Decision Support from Pedigrees

A. S. Coulson

¹Advanced Computation Laboratory, Imperial Cancer Research Fund, London, United Kingdom

,

D. W. Glasspool

¹Advanced Computation Laboratory, Imperial Cancer Research Fund, London, United Kingdom

,

J. Fox

¹Advanced Computation Laboratory, Imperial Cancer Research Fund, London, United Kingdom

,

J. Emery

²General Practice & Primary Care Research Unit, Department of Public Health & Primary Care, University of Cambridge, Institute of Public Health, Cambridge, United Kingdom

› Author Affiliations

Abstract

Summary

Objectives: To assist general practitioners in evaluating patients’ genetic risk of cancer on the basis of family history data.

Methods: A new computer application, RAGs (Risk Assessment in Genetics), has been developed to help doctors create graphical family trees and assess the genetic risk of breast and colorectal cancer. RAGs possesses two features that distinguish it from similar software: (i) a user-centred design, which takes into account the requirements of the doctor-patient encounter; (ii) effective and accessible risk reporting by employing qualitative evidence for or against increased risk, which is more easily understood than numerical probabilities. The system allows any rule-based genetic risk guideline to be implemented, and may be readily modified to cater for the varying degrees of information required by different specialists.

Results: RAGs permits fast, accurate data entry, and results in more appropriate management decisions than those made via other techniques. In addition, RAGs enables both the clinician and the patient to understand how it arrives at its conclusions, since the use of qualitative evidence allows the program to provide explanations for its reasoning.

Conclusions: The RAGs system promises to help practitioners be more effective gatekeepers to genetic services. It may empower doctors both to make an informed choice when deciding to refer patients who are at increased genetic risk of breast or colorectal cancer, and to reassure those who are at low risk.

Keywords

Genetic Predisposition - Family Tree - Computer-assisted Decision Making - Primary Care

Full Text

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