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医生对人类遗传变异的了解、对种族和遗传学的信念,以及在临床决策中使用种族的情况。

Physician Knowledge of Human Genetic Variation, Beliefs About Race and Genetics, and Use of Race in Clinical Decision-making.

机构信息

College of Education, Health & Society, Miami University, 210 E. Spring Street, Oxford, OH, 45056, USA.

Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street Se, Rm 420, MMC 381, Minneapolis, MN, 55414, USA.

出版信息

J Racial Ethn Health Disparities. 2019 Feb;6(1):110-116. doi: 10.1007/s40615-018-0505-y. Epub 2018 Jun 20.

Abstract

BACKGROUND

Race in the USA has an enduring connection to health and well-being. It is often used as a proxy for ancestry and genetic variation, although self-identified race does not establish genetic risk of disease for an individual patient. How physicians reconcile these seemingly paradoxical facts as they make clinical decisions is unknown.

OBJECTIVE

To examine physicians' genetic knowledge and beliefs about race with their use of race in clinical decision-making DESIGN: Cross-sectional survey of a national sample of clinically active general internists RESULTS: Seven hundred eighty-seven physicians completed the survey. Regression models indicate that genetic knowledge was not significantly associated with use of race. However, physicians who agreed with notions of race as a biological phenomenon and those who agreed that race has clinical importance were more likely to report using race in their decision-making.

CONCLUSIONS

Genomic and precision medicine holds considerable promise for narrowing the gap in health among racial groups in the USA. For this promise to be realized, our findings suggest that future research and education efforts related to race, genomics, and health must go beyond educating health care providers about common genetic conditions to delving into assumptions about race and genetics.

摘要

背景

在美国,种族与健康和福祉有着持久的联系。它经常被用作祖先和遗传变异的代名词,尽管个体患者的自我认定种族并不能确定其疾病的遗传风险。当医生在做出临床决策时,他们如何调和这些看似矛盾的事实尚不清楚。

目的

研究医生在临床决策中使用种族时的遗传知识和对种族的看法。

设计

对全国范围内临床活跃的普通内科医生进行的横断面调查。

结果

787 名医生完成了调查。回归模型表明,遗传知识与种族的使用没有显著相关性。然而,那些认同种族是一种生物现象的观点以及那些认为种族具有临床重要性的医生更有可能在决策中使用种族。

结论

基因组学和精准医学为缩小美国不同种族群体之间的健康差距带来了巨大的希望。为了实现这一承诺,我们的研究结果表明,未来与种族、基因组学和健康相关的研究和教育工作必须超越教育医疗保健提供者有关常见遗传疾病,深入研究有关种族和遗传学的假设。

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