title: Clinically relevant lessons from Family HealthLink: a cancer and coronary heart disease familial risk assessment tool.
abstract: OBJECTIVE
  A descriptive retrospective study was performed using two separate user cohorts to determine the effectiveness of Family HealthLink as a clinical triage tool.
  
  
  METHODS
  Cohort 1 consisted of 2,502 users who accessed the public website. Cohort 2 consisted of 194 new patients in a Comprehensive Breast Center setting. For patient users, we assessed documentation of family history and genetics referral. For all users seen in a genetics clinic, the Family HealthLink assessment was compared with that performed by genetic counselors and genetic testing outcomes.
  
  
  RESULTS
  For general public users, the percentage meeting high-risk criteria were: for cancer only, 22.2%; for coronary heart disease only, 24.3%; and for both diseases, 10.4%. These risk stratification percentages were similar for the patient users. For the patient users, there often was documentation of family history of certain cancer types by oncology professionals, but age of onset and coronary heart disease family history were less complete. Of 142 with high-risk assignments seen in a genetics clinic, 130 (91.5%) of these assignments were corroborated. Forty-two underwent genetic testing and 17 (40.5%) had new molecular diagnoses established.
  
  
  CONCLUSIONS
  A significant percentage of individuals are at high familial risk and may require more intensive screening and referral. Interactive family history triage tools can aid this process.Genet Med 17 6, 493-500.
authors.affiliation: Division of Human Genetics, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Kevin
authors.identifier: 000000029131347X
authors.initials: K
authors.lastname: Sweet
authors.affiliation: 1] Division of Human Genetics, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA [2] Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Sturm
authors.affiliation: Department of Internal Medicine, Stefanie Spielman Comprehensive Breast Center, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Amy
authors.identifier: 0000000298317641
authors.initials: A
authors.lastname: Rettig
authors.affiliation: Department of Internal Medicine, Center for Biostatistics, Department of Biomedical Informatics, Columbus, Ohio, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: McElroy
authors.affiliation: 1] Division of Human Genetics, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA [2] Division of Surgical Oncology, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Doreen
authors.initials: D
authors.lastname: Agnese
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D005190:Family; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics*; D009820:Ohio / Q000453:epidemiology; D012017:Referral and Consultation; D018570:Risk Assessment; D064878:Web Browser