Background: Identifying patients at risk of hereditary cancer based on their family health history is a highly nuanced task. Frequently, patients at risk are not referred for genetic counseling as providers lack the time and training to collect and assess their family health history. Consequently, patients at risk do not receive genetic counseling and testing that they need to determine the preventive steps they should take to mitigate their risk.
Objective: This study aims to automate clinical practice guideline recommendations for hereditary cancer risk based on patient family health history.
Methods: We combined chatbots, web application programming interfaces, clinical practice guidelines, and ontologies into a web service-oriented system that can automate family health history collection and assessment. We used Owlready2 and Protégé to develop a lightweight, patient-centric clinical practice guideline domain ontology using hereditary cancer criteria from the American College of Medical Genetics and Genomics and the National Cancer Comprehensive Network.
Results: The domain ontology has 758 classes, 20 object properties, 23 datatype properties, and 42 individuals and encompasses 44 cancers, 144 genes, and 113 clinical practice guideline criteria. So far, it has been used to assess >5000 family health history cases. We created 192 test cases to ensure concordance with clinical practice guidelines. The average test case completes in 4.5 (SD 1.9) seconds, the longest in 19.6 seconds, and the shortest in 2.9 seconds.
Conclusions: Web service-enabled, chatbot-oriented family health history collection and ontology-driven clinical practice guideline criteria risk assessment is a simple and effective method for automating hereditary cancer risk screening.
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http://dx.doi.org/10.2196/29289 | DOI Listing |
Obstet Gynecol
January 2025
Medical Practice Evaluation Center, the Division of Infectious Disease, and the Division of Maternal Fetal Medicine, Massachusetts General Hospital, Boston, Massachusetts; the Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; and the Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York.
The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic childhood hearing loss in the United States. The risk of congenital CMV infection from transplacental viral transfer depends on the gestational age at the time of maternal infection and whether the infection is primary or nonprimary.
View Article and Find Full Text PDFNeurology
February 2025
Department of Advanced Biomedical Sciences, University "Federico II," Naples, Italy.
Background And Objectives: Although multiple sclerosis (MS) can be conceptualized as a network disorder, brain network analyses typically require advanced MRI sequences not commonly acquired in clinical practice. Using conventional MRI, we assessed cross-sectional and longitudinal structural disconnection and morphometric similarity networks in people with MS (pwMS), along with their relationship with clinical disability.
Methods: In this longitudinal monocentric study, 3T structural MRI of pwMS and healthy controls (HC) was retrospectively analyzed.
Purpose: The Hematology Oncology Pharmacist Association Oral Chemotherapy Collaborative (HOPA OCC) developed practice-based tools to use in program development and improvement for the management of patients receiving oral anticancer agents (OAAs).
Methods: These tools include a baseline OAA program assessment, clinical OAA adherence tool, and OAA dashboard. HOPA OCC distributed these tools to teams participating in the 6-month HOPA ASCO Quality Training Programs (QTPs).
Am J Med Qual
January 2025
Improving Health Outcomes, American Medical Association, Chicago, IL.
Randomized clinical trials and clinical practice guidelines recommend the use of self-measured blood pressure (SMBP) to help improve the treatment of patients with hypertension. Many clinicians use SMBP in their practices, but there is significant variability in how SMBP is implemented in their day-to-day practice. This quality improvement study details the pragmatic and real-world approach clinicians and administrators used at 3 sites of the IHA Medical Group, a part of Trinity Healthcare, to implement the American Medical Association (AMA) 7-Step SMBP framework as part of the larger AMA hypertension quality improvement program AMA MAP BP.
View Article and Find Full Text PDFJ Cardiovasc Pharmacol
January 2025
Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
Patient-reported outcome measures (PROMs) are vital tools in cardiovascular disease (CVD) research and care, providing insights that complement traditional clinical outcomes like mortality and morbidity. PROMs capture patient experiences with CVD, such as quality of life, functional capacity, and emotional well-being, allowing clinicians to assess how interventions impact daily life. PROMs are integral to cardiovascular investigations as well as management, especially in chronic conditions and rehabilitation, where they inform on the impact of personalized care plans by tracking symptom progression and patient adherence.
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