School of Medicine, Autonomous University of the State of Morelos, Cuernavaca, México.
Independent researcher, México.
Int J Health Plann Manage. 2019 Jan;34(1):e46-e71. doi: 10.1002/hpm.2698. Epub 2018 Nov 8.
To present a systematic narrative review, informed by international experience, on the use of genomic analysis technologies in the primary care of noncommunicable chronic diseases (NCDs) during the last 20 years.
We used the methodology for conducting systematic reviews proposed by the Center for Coordination and Information on Evidence for Policies and Practices. The selected articles were organized by time, place, study design, and type of DNA sequencing. Finally, we analyzed the implications of our findings for health systems in middle-income and low-income countries focusing on a NCD high prevalence country such as México.
Evidence concerning the use of DNA sequencing in primary care for NCDs was scarce and geographically concentrated in high-income countries. Use was limited by costs, insufficient knowledge among health care personnel, and a lack of confidence on the part of users.
The use of DNA sequencing for primary care of NCDs is a challenge for low- and middle-income countries. More evidence is needed on cost effectiveness, public funding mechanisms, and the training of health care personnel for its implementation.
根据国际经验，对过去 20 年来基因组分析技术在非传染性慢性病（NCD）初级保健中的应用进行系统叙述性综述。
我们使用了协调和信息中心提出的证据进行政策和实践系统评价方法。选择的文章按时间、地点、研究设计和 DNA 测序类型进行组织。最后，我们分析了我们的发现对中低收入国家卫生系统的影响，重点关注墨西哥等 NCD 高流行国家。
有关 DNA 测序在 NCD 初级保健中的应用的证据很少，且在地理上集中在高收入国家。由于成本、医疗保健人员知识不足以及用户信心不足，其应用受到限制。
DNA 测序在 NCD 初级保健中的应用对中低收入国家来说是一个挑战。需要更多关于成本效益、公共资金机制和医疗保健人员培训的证据，以实施该技术。
