title: How can the evaluation of genetic tests be enhanced? Lessons learned from the ACCE framework and evaluating genetic tests in the United Kingdom.
abstract: Advances in genetic technology are increasing the availability of genetic tests, not only for rare single gene disorders, but also for common diseases such as breast and colo-rectal cancer. Before there can be widespread uptake of these tests, they must be evaluated to confirm the benefits of their use. But how should genetic tests be evaluated, given the speed at which new tests are emerging? One highly influential approach is the analytic validity, clinical validity, clinical utility and ethical, legal and social issues (ACCE) framework, which has provided a benchmark for the evaluation of genetic tests. The approach has been adopted and adapted by the United Kingdom Genetic Testing Network, with the help of the Public Health Genetics Unit in Cambridge, to evaluate new genetic tests for use in the National Health Service. We discuss a number of conceptual, methodological, and practical issues concerning the evaluation of genetic tests, based on lessons learned from applying the ACCE framework and from the UK experience, and make a number of recommendations to further strengthen the evaluation of genetic tests.
authors.affiliation: University of Cambridge and Cambridge Genetics Knowledge Park, Cambridge, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Sanderson
authors.forename: Ron
authors.initials: R
authors.lastname: Zimmern
authors.forename: Mark
authors.initials: M
authors.lastname: Kroese
authors.forename: Julian
authors.initials: J
authors.lastname: Higgins
authors.forename: Christine
authors.initials: C
authors.lastname: Patch
authors.forename: Jon
authors.initials: J
authors.lastname: Emery
mesh_terms: D006580:Genetic Carrier Screening; D030342:Genetic Diseases, Inborn / Q000175:diagnosis*; D005820:Genetic Testing / Q000941:ethics; D006579:Heterozygote; D006801:Humans; D006113:United Kingdom