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分析:秘书遗传、健康与社会咨询委员会的报告存在不足。

Analysis: Secretary's Advisory Committee on Genetics, Health, and Society Report falls short.

作者信息

Klein Roger D

机构信息

Department of Oncologic Sciences, Molecular Diagnostics, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Hematopathology and Laboratory Medicine, FL 33612, USA.

出版信息

Hum Pathol. 2009 Feb;40(2):147-55. doi: 10.1016/j.humpath.2008.09.007. Epub 2008 Dec 11.

Abstract

On April 30, 2008, the Secretary's Advisory Committee on Genetics, Health, and Society released its Report, "US System of oversight of genetic testing: a response to the charge of the Secretary of HHS." Positive features of this Report include recommendations for increased funding for the development and characterization of reference materials and methods; enhanced support for the growth and improvement of public reference sequence databases; encouragement for the implementation of electronic medical records; promotion of the efforts of clinical utility-oriented study groups such as the Evaluation of Genomic Applications in Practice and Prevention Working Group; and enforcement of the prohibitions against clinical testing by laboratories that lack Clinical Laboratory Improvement Amendments certification. The Committee reaffirmed recommendations set forth in its publication, "Coverage and reimbursement of genetic tests and services," that would expand Medicare coverage and increase payment rates for appropriately performed genetic tests. However, in its Report, the Secretary's Advisory Committee on Genetics, Health, and Society used an overly broad definition of genetic testing that is neither scientifically sound nor practically workable. This definition led to the Committee's inability to distinguish genetic tests from other complex laboratory assays. The Report has fallen short by unnecessarily advocating for Food and Drug Administration review of all laboratory developed tests and proposing the creation of a mandatory registry for all clinical laboratory tests.

摘要

2008年4月30日,秘书遗传、健康与社会咨询委员会发布了其报告《美国基因检测监管体系:对卫生与公众服务部部长指令的回应》。该报告的积极之处包括建议增加对参考材料和方法的开发与特性鉴定的资金投入;加强对公共参考序列数据库发展与完善的支持;鼓励实施电子病历;推动以临床效用为导向的研究小组(如实践与预防中基因组应用评估工作组)的工作;以及对未获得《临床实验室改进修正案》认证的实验室进行临床检测的禁令予以执行。委员会重申了其出版物《基因检测与服务的覆盖范围及报销》中提出的建议,这些建议将扩大医疗保险覆盖范围并提高适当进行的基因检测的支付费率。然而,在其报告中,秘书遗传、健康与社会咨询委员会对基因检测的定义过于宽泛,既不符合科学原理,也不具有实际可行性。这一定义导致委员会无法区分基因检测与其他复杂的实验室检测。该报告存在不足,不必要地主张食品药品监督管理局对所有实验室自行开发的检测进行审查,并提议为所有临床实验室检测创建一个强制性登记册。

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