Medical Utility of Patient Family History Questioned

Reviewers acknowledge usefulness of the primary care practice, but find little real data to support it

TUESDAY, Nov. 3 (HealthDay News) -- While taking a patient's family history is standard primary care practice, its ability to predict patient risk or affect outcomes is not well supported by data, according to a literature review published online Nov. 3 in the Annals of Internal Medicine.

Brenda J. Wilson, of the University of Ottawa, and colleagues reviewed the medical literature for studies on the benefits and detriments of collecting a family history. Study questions included the accuracy of the information collected and whether family history can predict individual risk and improve outcomes.

The reviewers found insufficient data to answer any of the study questions. Two uncontrolled studies which were reviewed did not produce sufficient evidence to decide whether a family history improves outcomes, while there was weak evidence from 41 heterogeneous studies that a family history can help detect disease risk and prevalence. Twenty-three studies suggested that patients report the absence of disease in relatives more accurately than its presence.

"Occasionally, family history questions reveal unusual familial disease patterns and prompt specialist investigation. Primary care practitioners can also gain insight into patients' experiences of disease within the family, which are relevant to framing preventive advice. However, many questions remain regarding whether information gained from family history assessment improves risk prediction and chronic disease risk management, the best way to collect such information, and the positive and negative impacts on patient outcomes from this activity," the authors write.

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