User Ratings

Your rating: None
Your rating: None
Your rating: None
Add your comments

Clinical Validity and Clinical Utility of Genetic Tests

Wylie Burke1

1University of Washington, Seattle, Washington

Unit Number: 
Unit 9.15
DOI: 
10.1002/0471142905.hg0915s60
Online Posting Date: 
January, 2009
GO TO THE FULL TEXT:
PDF or HTML at Wiley Online Library
Are you the author of this protocol? Login or register and return to this page.

Abstract

In considering the appropriate use of new genetic tests, clinicians and health care policymakers must consider the accuracy with which a test identifies a patient's clinical status (clinical validity) and the risks and benefits resulting from test use (clinical utility). Genetic tests in current use vary in accuracy and potential to improve health outcomes, and these test properties may be influenced by the clinical setting in which the test is used. This unit defines clinical validity and clinical utility, provides examples, and considers the implications of these test properties for clinical practice. Curr. Protoc. Hum. Genet. 60:9.15.1-9.15.7. © 2009 by John Wiley & Sons, Inc.

Keywords: clinical validity; clinical utility; predictive value; penetrance

     
 
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Online Library

Table of Contents

  • Introduction
  • Clinical Validity
  • Clinical Utility
  • Acknowledgements
  • Literature Cited
  • Figures
  • Tables
     
 
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Online Library

Figures

  • Figure 9.15.1
    Family with multiple endocrine neoplasia type 2 (MEN2). A definitive diagnosis of MEN2 can be made in the proband (arrow), on the basis of clinical findings of MEN2 (medullary thyroid cancer and hyperparathyroidism), combined with a family pedigree demonstrating autosomal dominant inheritance of the clinical problems associated with MEN2, including medullary thyroid cancer in the proband's father, and pheochromocytoma and C-cell hyperplasia (a precursor of medullary thyroid cancer) in the proband's daughter.

Literature Cited

Literature Cited
    Abboud, R.T., Ford, G.T., and Chapman, K.R. Standards Committee of the Canadian Thoracic Society. 2001. 1-antitrypsin deficiency: A position statement of the Canadian Thoracic Society. Can. Respir. J. 8:81-8.
    Allen, K.J., Gurrin, L.C., Constantine, C.C., Osborne, N.J., Delatycki, M.B., Nicoll, A.J., McLaren, C.E., Bahlo, M., Nisselle, A.E., Vulpe, C.D., Anderson, G.J., Southey, M.C., Giles, G.G., English, D.R., Hopper, J.L., Olynyk, J.K., Powell, L.W., and Gertig, D.M. 2008. Iron-overload-related disease in HFE hereditary hemochromatosis. N. Engl. J. Med. 358:221-230.
    Altshuler, D. and Daly, M. 2007. Guilt beyond a reasonable doubt. Nat. Genet. 39:813-815.
    Asberg, A., Hveem, K., Kannelønning, K., and Irgens, W.Ø. 2007. Penetrance of the C28Y/C282Y genotype of the HFE gene. Scand. J. Gastroentero. 42:1073-1077.
    Ashley-Koch, A., Yang, Q., and Olney, R.S. 2000. Sickle hemoglobin (Hb S) allele and sickle cell disease. Am. J. Epidemiol. 151:839-845.
    Begg, C.B. 2002. On the use of familial aggregation in population-based case probands for calculating penetrance. J. Natl. Cancer Inst. 94:1221-1226.
    Beutler, E. Iron storage disease: Facts, fiction and progress. 2007. Blood Cells Mol. Dis. 39:140-147.
    Billings, P.R., Kohn, M.A., de Cuevas, M., Beckwith, J., Alper, J.S., and Natowicz, M.R. 1992. Discrimination as a consequence of genetic testing. Am. J. Hum. Genet. 50:476-482.
    Brandi, M.L., Gagel, R.F., Angeli, A., Bilezekian, J.P., Beck-Peccoz, P., Bordi, C., Conte-Devolx, B., Falchetti, A., Gheri, R.G., Libroia, A., Lips, C.J., Lombardi, C., Mannelli, M., Pacini, F., Pnder, B.A., Raue, F., Skogseid, B., Tamburrano, G., Thakker, R.V., Thompson, N.W., Tomassetti, P., Tonelli, F., Wells, S.A. Jr., and Mar, S.J. 2001. Guidelines for diagnosis and therapy of MEN type 1 and type 2. J. Clin. Endocrinol. Metab. 86:5658-5671.
    Burke, W. and Austin, M.A. 2002. Genetic risk in context: Calculating the penetrance of BRCA1 and BRCA2 mutations. J. Natl. Cancer Inst. 94:1185-1187.
    Burke, W. and Psaty, B.M. 2007. Personalized medicine in the era of genomics. JAMA 298:1682-4.
    Burke, W., Atkins, D., Gwinn, M., Guttmacher, A., Haddow, J., Lau, J., Palomaki, G., Press, N., Richards, C.S., Wideroff, L., and Wiesner, G.L. 2002. Genetic test evaluation: Information needs of clinicians, policy-makers and the public. Am. J. Epidemiol. 156:311-318.
    Ford, D., Easton, D.F., Bishop, D.T., Narod, S.A., and Goldgar, D.E. 1994. Risks of cancer in BRCA1-mutation carriers: Breast Cancer Linkage Consortium. Lancet 343:692-695.
    Hampton, T. 2008. Congress passes bill to ban discrimination based on individuals' genetic makeup. JAMA 299:2493.
    Hansen, E., Imperatore, P., and Burke, W. 2001. HFE gene and hemochromatosis: A HuGE review. Am. J. Epidemiol. 154:193-206.
    Holtzman, N.A. and Watson, M.S. 1999. "Promoting safe and effective genetic testing in the United States". Final report of the Task Force on Genetic Testing. Johns Hopkins University Press, Baltimore.
    Humphries, S., Ridker, P.M., and Talmud, P.J. 2004. Genetic testing for cardiovascular disease susceptibility: A useful clinical management tool or possible misinformation. Arteroscler. Thromb. Vasc. Biol. 24:1-9.
    Jarvinen, H.J., Aarnio, M., Mustonene, H., Aktan-Collan, K., Aaltonen, L.A., Peltomaki, P., De La Chapelle, A., and Mecklin, J.P. 2000. Controlled 15-year trial on screening for colorectal cancer in families with hereditary nonpolyposis colorectal cancer. Gastroenterol. 118:829-834.
    Lapham, E.V., Kozma, C., and Weiss, J.O. 1996. Genetic discrimination: Perspectives of consumers. Science 274:621-624.
    Lebo, R.V. and Grody, W.W. 2007. Testing and reporting ACMG cystic fibrosis mutation panel results. Genet. Test. 11:11-31.
    Levy-Lahad, E. and Friedman, E. 2007. Cancer risks among BRCA1 and BRCA2 mutation carriers. Br. J. Cancer 96:11-15.
    Nebert, D.W., Zhang, G., and Vesell, E.S. 2008. From human genetics and genomics to pharmacogenetics and pharmacogenomics: Past lessons, future directions. Drug Metab. Rev. 40:187-224.
    U.S. Preventive Services Task Force. 2006. Screening for hemochromatosis: Recommendation statement. Ann. Intern. Med. 145:204-208.
    Wilken, B. 2001. Rare disease and the assessment of intervention: What sorts of clinical trials can we use J. Inherit Metabol. Dis. 24:291-298.
    Woolf, S.H. 2000. Evidence-based medicine and practice guidelines: An overview. Cancer Control 7:362-367.
    World Health Organization (WHO). 1997. 1-Antitypsin deficiency: Memorandum from a WHO meeting. Bull. World Health Org. 75:397-415.
 Internet Resources
    http://www.cms.hhs.gov/clia/

Clinical Laboratory Improvement Amendments (CLIA) Home Page.

    http://www.genetests.org

GeneTests Web site with link to online journal GeneReviews, containing the following articles:

Shohat, M. and Halpern, G.J. 2008. Familial Mediterranean fever.

Weisner, G.L. and Snow-Bailey, K. 2005. Multiple endocrine neoplasia type 2.

     
 
GO TO THE FULL PROTOCOL:
PDF or HTML at Wiley Online Library
Looking for Answers?
Do you have tips, tricks, or improvements to share?

Join the Conversation

Post new comment

The content of this field is kept private and will not be shown publicly.
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.