title: The SAGE-PAGE trial: do family genograms make a difference?
abstract: BACKGROUND
  Despite enthusiastic promotion of family genograms, the impact of routine use of this tool on clinical practice has not been systematically examined. The present study investigated whether doing a genogram, or having one available, makes physicians more sensitive to psychosocial issues or in other ways affects the physician-patient relationship or the process of clinical care.
  
  
  METHODS
  In a randomized clinical trial, patients visiting 5 physicians at an academic family practice center (n = 189) received a physician-administered genogram (PAGE); a self-administered genogram (SAGE), which the patient completed before seeing the physician; or no genogram. A fourth (baseline) group was tested without genograms prior to the randomized trial.
  
  
  RESULTS
  Analyses of patients' and physicians' postencounter questionnaires showed no impact of genograms on how physicians think about and deal with clinical problems or how patients view the encounter with their physicians. Compared with control groups, neither patient- nor physician-administered genograms increased the physician's (self-defined) understanding of the patient or the importance the physician attached to psychosocial issues in the case. A positive finding was that physicians considered genograms more relevant when they did them themselves. On the other hand, physician-administered genograms also increased the length of the encounter and were substantially less complete (conveying less information) than genograms completed by patients.
  
  
  CONCLUSIONS
  THe results leave open the possibility that genograms do make a difference when used routinely by residents or experts or in difficult cases when family assessment is indicated. While enthusiasm about genogram applications in family medicine is understandable, the clinical utility of this tool remains to be demonstrated scientifically.
authors.affiliation: Department of Family Medicine, Baylor College of Medicine, Houston 77005.
authors.forename: J C
authors.initials: JC
authors.lastname: Rogers
authors.forename: M
authors.initials: M
authors.lastname: Rohrbaugh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005190:Family / Q000523:psychology; D005826:Genetics, Medical; D006801:Humans; D008487:Medical History Taking / Q000379:methods*; D008875:Middle Aged; D010817:Physician-Patient Relations; D011787:Quality of Health Care