Impact of computer-assisted data collection, evaluation and management on the cancer genetic counselor's time providing patient care
Impact of computer-assisted data collection, evaluation and management on the cancer genetic counselor's time providing patient care
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DOI：
10.1007/s10689-011-9417-2
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发表时间：
2011-06-01
期刊：
影响因子：
2.2
通讯作者：
McIlvried, Dawn E.
中科院分区：
文献类型：
--
作者：
Cohen, Stephanie A.;McIlvried, Dawn E.
癌症遗传咨询会议传统上包括收集医疗和家族史信息，评估遗传性癌症综合征遗传易感性的可能性，将该信息传达给患者，在适当的时候提供基因检测，获得同意，随后记录与临床笔记和谱系的遭遇。存在以电子方式收集家族和病史信息的软件程序，旨在提高收集、管理和存储这些数据的效率和简单性。本研究比较了遗传咨询师在传统模式和计算机辅助数据收集模式下进行癌症遗传咨询任务所花费的时间，然后将其用于生成谱系、风险评估和咨询说明。当使用计算机辅助数据收集时，遗传咨询师花费在收集家族和病史以及为新患者提供面对面咨询的时间从平均85-69分钟减少。然而，在遗传咨询过程的各个方面，遗传咨询师的总体时间没有统计学显著变化，这是由于生成电子谱系和咨询说明所花费的时间增加。计算机程序技术设计的改进可能会最大限度地减少数据操纵。该计划的某些方面，如电子收集家族史和风险评估，似乎有效地提高癌症遗传咨询效率，而其他方面，如生成电子谱系和咨询说明，则没有。
Cancer genetic counseling sessions traditionally encompass collecting medical and family history information, evaluating that information for the likelihood of a genetic predisposition for a hereditary cancer syndrome, conveying that information to the patient, offering genetic testing when appropriate, obtaining consent and subsequently documenting the encounter with a clinic note and pedigree. Software programs exist to collect family and medical history information electronically, intending to improve efficiency and simplicity of collecting, managing and storing this data. This study compares the genetic counselor's time spent in cancer genetic counseling tasks in a traditional model and one using computer-assisted data collection, which is then used to generate a pedigree, risk assessment and consult note. Genetic counselor time spent collecting family and medical history and providing face-to-face counseling for a new patient session decreased from an average of 85-69 min when using the computer-assisted data collection. However, there was no statistically significant change in overall genetic counselor time on all aspects of the genetic counseling process, due to an increased amount of time spent generating an electronic pedigree and consult note. Improvements in the computer program's technical design would potentially minimize data manipulation. Certain aspects of this program, such as electronic collection of family history and risk assessment, appear effective in improving cancer genetic counseling efficiency while others, such as generating an electronic pedigree and consult note, do not.