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Top GRAIDS for AP Benson Genetics
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Early Identification of Cancer Risk: University of Cambridge.
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AP Benson has now completed a project with Dr Jon Emery, Professor Stephen
Sutton and Dejana Braithwaite at the Institute of Public Health,
University of Cambridge (UK). Jon and Steve's groups work from the
Forvie Site, just next door to the world famous Addenbrookes teaching
hospital on the outskirts of Cambridge.
Their research interests revolve around the place of genomics
diagnostics in primary care, principally in the UK, although he works
with research collaborators in the USA. Jon, Steve and Dejana are
interested in how the benefits that are promised by genomics research
can be applied where it matters - when the patient meets the
clinician.
Between 5 and 10% of breast and bowel cancers can now be traced back
to a family history of the disease. Some of the individual genes that
predispose people to these diseases have now been identified, for
example the so called "BrCa" (Breast Cancer) genes and
groups of genes associated with the FAP and HNPCC bowel cancer
syndromes. The clear patterns that show how these diseases "run in
families" can now be explained using our underlying knowledge of the
genes that contribute to the appearance of the disease.
The question is, however, "how should the medical profession use this
type of information in working with their patients?" The torrent of
new associations between patterns of diseases in families, the genes
that contribute to the occurrence of those diseases and the tests,
treatments and (often) lifestyle changes available to identify and
manage disease risk is a huge challenge to the medical
profession.
Jon Emery says that, "a number of companies, including FamilyGenetix,
have, historically, produced software that is used by senior
clinicians, such as our colleague Cyril Chapman, to help manage
families with recognized genetic problems. These tools have been
aimed at expert users, like Cyrillic, and can be very helpful in guiding
treatment decisions in those families."
"Our interest, however," Jon said, "is in how we can extend the
usefulness of tools like FamilyGenetix' Cyrillic product so that they
can be used in preventative medicine by our colleagues at the General
Practitioner level."
"There is great potential for an early recognition of a genetic
predisposition to be picked up in Primary Care, almost as a routine
part of the GP's work. The problem today is that to keep up with
genetic medicine and to take the time needed to gather the detailed
family histories that can help in finding genetic predisposition is
beyond the scope of the busy GP."
In addition, the busy GP will often send patients whose realistic risk
of having a predisposition is, in fact, pretty low. Few GPs can be
confident about saying if a specific family history is a sign of an
underlying problem or not.
AP Benson's Craig Livingstone worked with Dr. Emery and
his colleagues to use the latest software from FamilyGenetix,
a subsidiary of AP Benson, called "GRAIDS" (Genetic Risk
Assessment by Internet with Decision Support).
GRAIDS was used in a decision support trial with General
Practitioners in the Cambridgeshire region of the UK. The aim
was to see if a new system, designed to help GPs gather
detailed family histories from patients, can be used to guide
the GP in deciding if their patients have an increased risk
for, say, breast cancer over that of the general population.
Craig said, "GRAIDS was developed for a FamilyGenetix project with Kaiser Permanente
in Northern California, in which I was involved. It is capable of
gathering a lot of information about a family that can be used in both
identifying a potential problem and then for helping in the management
of the patient's and their family's risks of developing inherited
disease. The software was originally used to follow the course of
disease in patients with inherited cholesterol problems, helping
clinicians manage patients' overall risk of heart disease and stroke.
It's great to have the opportunity of extending GRAIDS so that it
can be used with people who may have an inherited problem predisposing
them to cancer."
The GRAIDS trial involved 45 GP practices in Eastern England. The project
ended in September 2005 and the paper is due for publication shortly.
Dr Emery was a practising general practitioner in Cambridge which he
combined with research into the clinical application of genetic
medicine in primary care, and the use of computer decision support to
aid risk assessment and communication. He has worked previously as a
Cancer Research Campaign research fellow in the Department of Public
Health and Primary Care, University of Oxford and as a general
practitioner in Bath. He is a member of the Royal College of General
Practitioners. Dr Emery has published several papers on genetic
medicine, in particular cancer genetics, and the use of computer
decision support in primary care. He is married with two children and
has recently taken the post of Professor of General Practice at the
University of Western Australia.
This Cambridge-based research is funded by the Cancer Research UK
research charity.
For more information on AP Benson's activities in
the clinical and research genetics market please Contact Us or complete our Contact Form. AP Benson offer
initial free telephone consultations with our industry sector
leaders.
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