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Genetic Tests Not Triggering More Health Care Use

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Researchers at Group Health Research Institute in Seattle, National Institutes of Health, Henry Ford Hospital in Detroit, and Abt Associates in Bethesda, Maryland found patients who receive genetic tests for susceptibility to disease were no more likely to use medical services after receiving the results than before the tests. The study results appear online today in the journal Genetics in Medicine.

The study involves patients taking part in the Multiplex Initiative, a collaboration of Group Health, Henry Ford Hospital, and NIH’s National Human Genome Research Institute and National Cancer Institute to evaluate multiplex genetic testing with patients who are members of a large managed care organization. Multiplex tests give individuals feedback on a range of genetic variants, and the number of these test services has proliferated.

In this study, 217 healthy people between the ages of 25 and 40 participated in genetic susceptibility testing for eight conditions, offered by their health plan. The researchers then analyzed health care usage by the participants in the 12 months before genetic testing and the 12 months following the testing, using electronic health care records rather than self-reported behavior. The team also compared the test group’s behavior with a group of about 400 similar plan members who declined the testing offer.

All of the participants in the multiplex test carried at least one at-risk genetic marker, with the majority carrying an average of nine at-risk variants. The tests performed for the Multiplex Initiative include a set of genetic variants reliably associated with an increase in disease risk and for which some corrective health behavior has been shown to prevent illness.

The researchers measured health care use by the number of physician visits and laboratory tests or procedures the people received, particularly those services associated with four of the eight conditions in the multiplex test array. Most of the procedures or screening tests counted are not among those recommended for people in this age group who don’t have symptoms. The researchers found that participants in genetic testing do not change their overall use of health care services compared with those not tested.

The findings show no statistically significant differences by either group in the prior use of any common medical tests or procedures associated with four common health conditions. When changes in physician and medical test or procedure use after the genetic tests were compared among the groups, no statistically significant differences are observed for any category of medical care use.

Colleen McBride, who heads the social and behavioral branch of NIH’s National Human Genome Research Institute and one of the study authors, says the study can start answering questions about the use of genetic test results to guide people towards making positive lifestyle and health behavior changes. “This study goes a long way towards bringing data to these debates,” says McBride, “and shows that people are not likely to make inappropriate demands of health delivery systems if they are properly informed about the limitations of genetic tests.”

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