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GREAT program assesses cancer risks
BY: SUSAN H. KAHN Assistant Editor
A new online tool to help physicians and patients understand a person’s risk for cancer has been developed by University Hospitals Case Medical Center (UHCMC) researchers.
The Genetic Risk Easy Assessment Tool (GREAT) is a web-based pilot program offered through University Hospitals MacDonald Women’s Hospital Breast Center. Its aim is to save time and provide more accurate information to physicians and patients.
Women undergoing mammograms or consultations at the hospital’s main campus are given the option of logging into the system and answering a series of questions about their family history, demographics and common diseases. From this information, GREAT creates a pedigree, or family tree, that highlights cancers and generates a report assessing the woman’s risk for breast cancer.
The report can have further benefit, as some of the cancer susceptibility genes it assesses can lead to more than one form of cancer.
GREAT is an outgrowth of a study of physician behavior conducted by Dr. Louise Acheson and Dr. Kurt Stange, Case professors of family medicine and oncology. They found that that on average, a primary care doctor spends 10 minutes with a patient during an office visit, 12 minutes if he or she takes a family history.
“Risk analysis and preventive care cannot be done within this time frame,” says Dr. Georgia Wiesner, director of the Center for Human Genetics and one of the key architects of GREAT. “We took the important task of gathering information, automated it, and put it in a format that both doctor and patient can understand. The program identifies those who need to be followed more closely by their physicians.”
This reporter took the assessment and found it very user-friendly. After logging in with my patient ID number, I answered a series of questions relating to my personal history including ethnicity, tobacco use, and history of colon polyps, breast biopsies and breast cancer. Next I was asked about four generations of biological relatives, both living and deceased. For each, the information sought was current age or age at death; history of cancer or other inheritable diseases, blood clots, heart attacks and diabetes; and the age at which their medical conditions were diagnosed.
After completing the questionnaire, which took about 15 minutes, a report was generated that I could print and share with my family and physicians. It consisted of my family tree and a summary of the information gathered. It also included personalized information about my risk for breast, ovarian and colon cancer plus suggestions for screening and prevention.
“The system connects a family history with risk computer models, which are very technical,” says Wiesner. “The patient receives a risk assessment comprehensible to a lay person; her physician can access the more complicated information.”
Although GREAT was designed specifically to examine cancer risk, other information I supplied is summarized on a page titled “Other diseases in the family,” with the suggestion I discuss these with my doctor. This report will be stored on a secure site; with my log-in ID, I can change or update it at any time. Eventually, the program will allow patients to automatically forward their reports to their physicians via e-mail.
The GREAT yearlong pilot program began in December and is funded by a research grant form the National Cancer Institute. Patient reception has been good so far, says Wiesner. The pilot study will gauge the program’s ease of use, any glitches in the process, and data accuracy. The overall goal is to make GREAT available to every patient who uses any Ireland Cancer Center service.
skahn@cjn.org
The Genetic Risk Easy Assessment Tool (GREAT) is a web-based pilot program offered through University Hospitals MacDonald Women’s Hospital Breast Center. Its aim is to save time and provide more accurate information to physicians and patients.
Women undergoing mammograms or consultations at the hospital’s main campus are given the option of logging into the system and answering a series of questions about their family history, demographics and common diseases. From this information, GREAT creates a pedigree, or family tree, that highlights cancers and generates a report assessing the woman’s risk for breast cancer.
The report can have further benefit, as some of the cancer susceptibility genes it assesses can lead to more than one form of cancer.
GREAT is an outgrowth of a study of physician behavior conducted by Dr. Louise Acheson and Dr. Kurt Stange, Case professors of family medicine and oncology. They found that that on average, a primary care doctor spends 10 minutes with a patient during an office visit, 12 minutes if he or she takes a family history.
“Risk analysis and preventive care cannot be done within this time frame,” says Dr. Georgia Wiesner, director of the Center for Human Genetics and one of the key architects of GREAT. “We took the important task of gathering information, automated it, and put it in a format that both doctor and patient can understand. The program identifies those who need to be followed more closely by their physicians.”
This reporter took the assessment and found it very user-friendly. After logging in with my patient ID number, I answered a series of questions relating to my personal history including ethnicity, tobacco use, and history of colon polyps, breast biopsies and breast cancer. Next I was asked about four generations of biological relatives, both living and deceased. For each, the information sought was current age or age at death; history of cancer or other inheritable diseases, blood clots, heart attacks and diabetes; and the age at which their medical conditions were diagnosed.
After completing the questionnaire, which took about 15 minutes, a report was generated that I could print and share with my family and physicians. It consisted of my family tree and a summary of the information gathered. It also included personalized information about my risk for breast, ovarian and colon cancer plus suggestions for screening and prevention.
“The system connects a family history with risk computer models, which are very technical,” says Wiesner. “The patient receives a risk assessment comprehensible to a lay person; her physician can access the more complicated information.”
Although GREAT was designed specifically to examine cancer risk, other information I supplied is summarized on a page titled “Other diseases in the family,” with the suggestion I discuss these with my doctor. This report will be stored on a secure site; with my log-in ID, I can change or update it at any time. Eventually, the program will allow patients to automatically forward their reports to their physicians via e-mail.
The GREAT yearlong pilot program began in December and is funded by a research grant form the National Cancer Institute. Patient reception has been good so far, says Wiesner. The pilot study will gauge the program’s ease of use, any glitches in the process, and data accuracy. The overall goal is to make GREAT available to every patient who uses any Ireland Cancer Center service.
skahn@cjn.org
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