title: Health-related direct-to-consumer genetic tests: a public health assessment and analysis of practices related to Internet-based tests for risk of thrombosis.
abstract: BACKGROUND
  Recent years have seen increased concern about direct-to-consumer (DTC) genetic testing (i.e., the sale and use of genetic tests without involving a health care provider). Numerous professional organizations have developed policies in this area. However, little systematic evidence exists to inform public policy about these tests.
  
  
  METHODS
  We conducted a systematic search to identify genetic tests that are sold DTC without involving a health care provider. We evaluated the practices of companies offering DTC genetic tests for risk of thrombosis using criteria from multiple sources and a minimal set of key practices.
  
  
  RESULTS
  We identified 84 instances of currently available health-related DTC genetic tests sold on 27 Web sites; the most common were for pharmacogenomics (12), risk of thrombosis (10), and nutrigenomics (10). For the DTC genetic tests for risk of thrombosis, we found low adherence to recommendations. Online information was frequently incomplete and had low agreement with professional recommendations.
  
  
  CONCLUSIONS
  Our findings document the rapid growth in the availability of health-related DTC genetic tests and highlight the need to improve the delivery of DTC genetic tests. A major implication of this study is the need for the scientific and medical community to develop consistent recommendations to increase their impact.
authors.affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA. katrina.ab.goddard@kpchr.org
authors.forename: K A B
authors.initials: KA
authors.lastname: Goddard
authors.forename: J
authors.initials: J
authors.lastname: Robitaille
authors.forename: N F
authors.initials: NF
authors.lastname: Dowling
authors.forename: A R
authors.initials: AR
authors.lastname: Parrado
authors.forename: J
authors.initials: J
authors.lastname: Fishman
authors.forename: L A
authors.initials: LA
authors.lastname: Bradley
authors.forename: C A
authors.initials: CA
authors.lastname: Moore
authors.forename: M J
authors.initials: MJ
authors.lastname: Khoury
mesh_terms: D005165:Factor V / Q000235:genetics; D005817:Genetic Counseling; D033142:Genetic Services; D005821:Genetic Techniques; D006801:Humans; D007255:Information Services; D020407:Internet; D008389:Marketing of Health Services; D010353:Patient Education as Topic; D010597:Pharmacogenetics; D011634:Public Health; D011640:Public Policy; D012107:Research Design; D012306:Risk; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology*
chemical_list: C095381:factor V Leiden; D005165:Factor V