From public health genomics to precision public health: a 20-year journey

Khoury, Muin J.; Bowen, Michael; Clyne, Mindy; Dotson, W. David; Gwinn, Marta; Green, Ridgely Fisk; Kolor, Katherine; Rodriguez, Juan L.; Wulf, Anja; Yu, Wei

doi:10.1038/gim.2017.211

Cited by 122 publications

(113 citation statements)

References 57 publications

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“…Health care practice and public health genomics have been impacted by the drastic increase in the number of genetic tests available and the advent and uptake of direct‐to‐consumer personal genetic tests. There are currently over 50,000 genetic tests available for more than 5,000 diseases , compared to less than 1,000 genetic tests two decades ago. The Genetic Testing Registry at: https://www.ncbi.nlm.nih.gov/gtr/ provides a central location to locate current information about laboratories and genetic tests (e.g., purpose, methodology, validity, utility, credentials).…”

Section: Genetic Tests With Public Health Dental Implications: Which mentioning

confidence: 99%

“…The vast majority of the currently available genetic tests are Tier 2 with insufficient evidence to support their use in clinical practice. Tier 3 applications have evidence base or other recommendations against their use and should be considered not ready for routine implementation in clinical or public health practice . There are only a small number of genetic tests or services that have been categorized as Tier 3.…”

Section: Genetic Tests With Public Health Dental Implications: Which mentioning

confidence: 99%

“…The core public health function of policy in genomics is to develop standards and guidelines for appropriate use of genetic information including the effectiveness, accessibility, and quality of genetic tests and services . The core public health genomics function of assessment is the systematic collection, analysis, and dissemination of epidemiologic genomic data on the health of the community . The assurance core public health function is to assure genetic information is used appropriately and that genetic tests and services are used based on effectiveness, accessibility, and quality .…”

Section: Examples Of Core Public Health Functions To Consider For Denmentioning

confidence: 99%

“…The core public health genomics function of assessment is the systematic collection, analysis, and dissemination of epidemiologic genomic data on the health of the community . The assurance core public health function is to assure genetic information is used appropriately and that genetic tests and services are used based on effectiveness, accessibility, and quality .…”

Section: Examples Of Core Public Health Functions To Consider For Denmentioning

confidence: 99%

“…The ADA policy and educational materials for genetic testing are examples of two core public health functions (i.e., policy development and assurance), and demonstrate the importance of public health dentistry in the effective translation and implementation of genomic applications. The interleukin‐1 genetic testing example also demonstrates that public health genomics is only one approach to improving health and cannot be used in isolation from other risk factors or determinants of health .…”

Section: Promotion Of Public Health Dental Efforts Related To Inappromentioning

confidence: 99%

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Implementation of public health genomics and applications to public health dentistry

Duquette

2019

J Public Health Dent

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National and state public health genomics efforts exist to effectively and responsibly translate genome‐based knowledge to improve population health and reduce health disparities. Over the past two decades, public health genomics efforts have utilized the core public health functions of assessment, policy development, and assurance. Current evidence for a small number of genomic applications suggests that many lives could be saved if these were implemented in recommended populations. With the drastic increase in new genetic tests and technologies, multidisciplinary public health genomics efforts that should include public health dentistry are of greater importance. There is a need to integrate public health dentistry in efforts to increase use of evidence‐based genomic tests and services to improve health outcomes. Additionally, public health genomic efforts also are utilized to promote awareness about the insufficient evidence of the validity, utility and ethical, legal, and social implications for the vast majority of genomic tests. This is demonstrated by a recent genetic testing policy statement and educational resources from the American Dental Association. These organizational efforts should be considered in other realms of public health genomics to ensure that only genetic tests and preventive services with sufficient evidence for use are being implemented in clinical and public health.

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Section: Genetic Tests With Public Health Dental Implications: Which mentioning

confidence: 99%

Section: Genetic Tests With Public Health Dental Implications: Which mentioning

confidence: 99%

Section: Examples Of Core Public Health Functions To Consider For Denmentioning

confidence: 99%

Section: Examples Of Core Public Health Functions To Consider For Denmentioning

confidence: 99%

Section: Promotion Of Public Health Dental Efforts Related To Inappromentioning

confidence: 99%

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Implementation of public health genomics and applications to public health dentistry

Duquette

2019

J Public Health Dent

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Association of Neighborhood-Level Disadvantage With Alzheimer Disease Neuropathology

et al. 2020

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IMPORTANCE Social determinants of health, such as income, education, housing quality, and employment, are associated with disparities in Alzheimer disease and health generally, yet these determinants are rarely incorporated within neuropathology research. OBJECTIVE To establish the feasibility of linking neuropathology data to social determinants of health exposures using neighborhood disadvantage metrics (the validated Area Deprivation Index) and to evaluate the association between neighborhood disadvantage and Alzheimer disease-related neuropathology. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study consisted of decedents with a known home address who donated their brains to 1 of 2 Alzheimer disease research center brain banks in California and Wisconsin between January 1, 1990, and December 31, 2016. Neither site had preexisting social metrics available for their decedents. Neuropathologic features were obtained from each site for data collected using the standardized Neuropathology Data Set form and from autopsy reports. Data were analyzed from June 7 to October 10, 2019. EXPOSURES Geocoded decedent addresses linked to neighborhood disadvantage as measured by the Area Deprivation Index calculated for the year of death. MAIN OUTCOMES AND MEASURES Presence of Alzheimer disease neuropathology. The association between neighborhood disadvantage and Alzheimer disease neuropathology was evaluated via logistic regression, adjusting for age, sex, and year of death. RESULTS The sample consisted of 447 decedents (249 men [56%]; mean [SD] age, 80.3 [9.5] years; median year of death, 2011) spanning 24 years of donation. Fewer decedents (n = 24 [5.4%]) originated from the top 20% most disadvantaged neighborhood contexts. Increasing neighborhood disadvantage was associated with an 8.1% increase in the odds of Alzheimer disease neuropathology for every decile change on the Area Deprivation Index (adjusted odds ratio, 1.08; 95% CI, 1.07-1.09). As such, living in the most disadvantaged neighborhood decile was associated with a 2.18 increased odds of Alzheimer disease neuropathology (adjusted odds ratio, 2.18; 95% CI, 1.99-2.39). CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that social determinants of health data can be linked to preexisting autopsy samples as a means to study sociobiological mechanisms involved in neuropathology. This novel technique has the potential to be applied to any brain bank within the United States. To our knowledge, this is the first time Alzheimer disease neuropathology has been associated with neighborhood disadvantage.

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Clinical genetic counselors: An asset in the era of precision medicine

Wicklund

Duquette

Swanson

2018

American J of Med Genetics Pt C

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Trying to predict what genetic counseling will look like in the era of precision medicine is a continuous challenge. According to the National Institutes of Health, precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. In order to explore the future of genetic counseling practice in this era, this article examines the current genetic counseling practice, internal and external forces that most likely will continue to shape the genetic counseling profession, and discusses the most important aspects of what genetic counselors have to offer in the era of precision medicine.

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From public health genomics to precision public health: a 20-year journey

Cited by 122 publications

References 57 publications

Implementation of public health genomics and applications to public health dentistry

Implementation of public health genomics and applications to public health dentistry

Association of Neighborhood-Level Disadvantage With Alzheimer Disease Neuropathology

Clinical genetic counselors: An asset in the era of precision medicine

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