Publication: How to use an article about genetic association - C: What are the results and will they help me in caring for my patients?
1
Issued Date
2009-01-21
Resource Type
ISSN
15383598
00987484
00987484
Other identifier(s)
2-s2.0-58749099119
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Mahidol University
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SCOPUS
Bibliographic Citation
JAMA - Journal of the American Medical Association. Vol.301, No.3 (2009), 304-308
Suggested Citation
John Attia, John P.A. Ioannidis, Ammarin Thakkinstian, Mark McEvoy, Rodney J. Scott, Cosetta Minelli, John Thompson, Claire Infante-Rivard, Gordon Guyatt How to use an article about genetic association - C: What are the results and will they help me in caring for my patients?. JAMA - Journal of the American Medical Association. Vol.301, No.3 (2009), 304-308. doi:10.1001/jama.2008.993 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/28213
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Title
How to use an article about genetic association - C: What are the results and will they help me in caring for my patients?
Other Contributor(s)
Royal Newcastle Hospital
Hunter Medical Research Institute, Australia
John Hunter Hospital
University of Ioannina, School of Medicine
Tufts University School of Medicine
Mahidol University
University of Newcastle, Australia
Hunter Area Pathology Service
University of Newcastle Faculty of Medicine and Health Sciences
National Heart and Lung Institute
University of Leicester
McGill University
McMaster University, Faculty of Health Sciences
Hunter Medical Research Institute, Australia
John Hunter Hospital
University of Ioannina, School of Medicine
Tufts University School of Medicine
Mahidol University
University of Newcastle, Australia
Hunter Area Pathology Service
University of Newcastle Faculty of Medicine and Health Sciences
National Heart and Lung Institute
University of Leicester
McGill University
McMaster University, Faculty of Health Sciences
Abstract
In the first 2 articles of this series, we reviewed the basic genetics concepts necessary to understand genetic association studies, and we enumerated the major issues in judging the validity of these studies. In this third article, we review the issues relating to the applicability of the results in the clinical situation. How large and precise are the associations? Many genetic effects are expected to be smaller in magnitude than traditional risk factors. Does the genetic association improve predictive power beyond easily measured clinical variables? In some cases, the additional genetic information adds only a small increment in the predictive ability of a diagnostic or prognostic test. What are the absolute vs relative effects? Even if the genetic risk is high in relative terms, the baseline risk may be very low in absolute terms. Is the risk-associated allele likely to be present in my patient? A risk allele may have a strong effect but be rare in a particular ethnic group. Is the patient likely better off knowing the genetic information? Given that genes cannot be modified, one must weigh whether the genetic information is likely to be helpful in planning other health interventions or initiating behavior change. ©2009 American Medical Association. All rights reserved.