[Predictive ability of the BRCAPro model compared to nursing professionals in the selection of candidates for the genetic study of hereditary breast or ovarian cancer].
OBJECTIVE
To compare the predictive skills of the BRCAPro predictive model and nurses with different training/experience levels in identifying families with a personal and family history of breast cancer as likely candidates to being studied genetically.


METHODS
Descriptive study in which 2 nurses with different levels of training in genetic counselling have estimated the probability of being carrier of a mutation in the BRCA1/BRCA2 genes of 157 families. The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of both nurses and the BRCAPro model were calculated.


RESULTS
The nurse with less experience demonstrated more specificity (N2:0.84) compared to the nurse with more experience (N1:0.23) and to BRCAPro model (0.47). The sensitivity of the nurses was 0.95 (N1) and 0.28 (N2), whereas that of BRCAPro was 0.74. The PPV was similar in the three cases. The NPV of the nurse with more experience (0.93) was higher than that of BRCAPro model (0.85) and the nurse with less experience (0.72).


CONCLUSIONS
Clinical experience contributes to obtaining a high sensitivity, but with a significant decrease of specificity. The BRCAPro predictive model obtains intermediate values between both nurses. The BRCAPro predictive model could be a useful tool to help improve those values with lower scores, that is, the specificity and PPV for nurses with more experience and the sensitivity and NPV for those with less experience.
Unidad de Consejo Genético, Servicio de Prevención del Cáncer, Hospital Duran y Reynals, Instituto Catalán de Oncología, Barcelona, España. lbenito@iconcologia.net
Llúcia
L
Benito-Aracil
Carmen
C
Yagüe-Muñoz
Sílvia
S
Iglesias-Casals
Mònica
M
Salinas-Masdeu
Alex
A
Teulé-Vega
Conxi
C
Lázaro-García
Ignacio
I
Blanco
D001943:Breast Neoplasms / Q000235:genetics*; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D056726:Genetic Association Studies; D006801:Humans; D008962:Models, Theoretical; D009733:Nursing Diagnosis; D010051:Ovarian Neoplasms / Q000235:genetics*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies