在将多基因疾病风险评分纳入临床实践时,应考虑心理和行为方面的考虑
Saskia C Sanderson1,2,3,4, Michael Inouye5,6,7
1Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. saskia.sanderson@kcl.ac.uk.
多基因风险评分 (PRS) 可以改善疾病预测和预防. 目前的证据表明,尽管存在一些担忧,但将PRS整合到临床实践中对心理或行为伤害最小.
科学领域:
- 遗传学 是一个遗传学.
- 个性化医疗是个性化的医疗.
- 公共卫生 公共卫生
背景情况:
- 多基因风险评分 (PRS) 汇总了常见的DNA变体,以估计个体对特定特征或疾病的遗传倾向.
- 疾病PRS通过增强风险预测,为人口健康提供潜在的好处,从而改善预防,早期干预和治疗策略.
- 对于将PRS整合到临床工具和医疗保健系统中,由于潜在的心理和行为伤害,存在担忧.
研究的目的:
- 批判性地评估针对PRS在物理疾病的临床实施的五个论点,重点关注心理和行为方面的考虑.
- 检查反论证,支持证据,理论依据,并确定每个关注点的证据基础中的差距.
- 提出未来的研究方向和优先事项,以负责任地将PRS纳入医疗保健.
主要方法:
- 系统审查和对现有文献和理论框架的批判性评估.
- 对反对PRS实施的心理和行为论据的分析.
- 对与PRS使用相关的潜在危害的证据的评估.
主要成果:
- 该研究发现,有限的经验证据支持了PRS在临床实践中整合导致的显著心理或行为伤害.
- 虽然关于PRS实施的担忧仍然存在,但评估的论点往往缺乏强有力的支持数据.
- 在证据库中发现的空白突出了进一步研究PRS对患者心理和行为的现实影响的需要.
结论:
- 尽管存在潜在的实施障碍,但目前的证据并没有强烈表明在临床环境中使用PRS会对心理或行为造成不利影响.
- 需要进一步的研究来解决具体问题,并指导PRS在医疗保健中的道德和有效部署.
- 这些发现表明,对心理和行为伤害的担忧可能不是PRS整合的主要障碍.
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