Department of Family Medicine, Medical Faculty Ljubljana, Ljubljana, Slovenia.
Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Eur J Gen Pract. 2022 Dec;28(1):75-86. doi: 10.1080/13814788.2022.2061457.
Many medical family history (FH) tools are available for various settings. Although FH tools can be a powerful health screening tool in primary care (PC), they are currently underused.
This review explores the FH tools currently available for PC and evaluates their clinical performance.
Five databases were systematically searched until May 2021. Identified tools were evaluated on the following criteria: time-to-complete, integration with electronic health record (EMR) systems, patient administration, risk-assessment ability, evidence-based management recommendations, analytical and clinical validity and clinical utility.
We identified 26 PC FH tools. Analytical and clinical validity was poorly reported and agreement between FH and gold standard was commonly inadequately reported and assessed. Sensitivity was acceptable; specificity was found in half of the reviewed tools to be poor. Most reviewed tools showed a capacity to successfully identify individuals with increased risk of disease (6.2-84.6% of high and/or moderate or increased risk individuals).
Despite the potential of FH tools to improve risk stratification of patients in PC, clinical performance of current tools remains limited as well as their integration in EMR systems. Twenty-one FH tools are designed to be self-administered by patients.
有许多医学家族史（FH）工具可用于各种环境。尽管 FH 工具可以成为初级保健（PC）中的强大健康筛查工具，但目前它们的使用不足。
本综述探讨了目前可用于 PC 的 FH 工具，并评估了它们的临床性能。
系统地搜索了五个数据库，直到 2021 年 5 月。评估了确定的工具在以下标准上的表现：完成时间、与电子健康记录（EMR）系统的集成、患者管理、风险评估能力、基于证据的管理建议、分析和临床有效性以及临床实用性。
我们确定了 26 种 PC FH 工具。分析和临床有效性的报告很差，FH 与黄金标准之间的一致性通常报告和评估不足。敏感性是可以接受的；在审查的工具中，有一半的特异性被发现较差。大多数经过审查的工具都显示出能够成功识别疾病风险增加的个体（6.2-84.6%的高风险和/或中度或增加风险个体）的能力。
尽管 FH 工具有可能改善 PC 中患者的风险分层，但目前工具的临床性能仍然有限，并且它们在 EMR 系统中的集成也有限。有 21 种 FH 工具设计为患者自行管理。
