Challenges in and principles for conducting

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Jonas DE, Wilt TJ, Taylor BC, et al. Challenges in and principles for conducting systematic reviews of genetic tests used as predictive indicators. In: Methods guide for medical test reviews. Available at .
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Clearly define the Key Questions and understand the needs of decisionmakers and the test context. Consider whether test is used to: Determine the future risk of disease in asymptomatic individuals Establish prognostic information that will influence treatment decisions Predict response to treatments (either effectiveness or harms) Clarify the specimens (e.g., patient or tumor genome) to be tested. Clearly describe the PICOTS typology. Doing so will inform development of the analytic framework and vice versa. Principle 2: Develop Analytic Frameworks To Reflect the Predictive Nature of Genetic Tests and Incorporate Appropriate Outcomes (1 of 5) Jonas DE, Wilt TJ, Taylor BC, et al. Challenges in and principles for conducting systematic reviews of genetic tests used as predictive indicators. In: Methods guide for medical test reviews. Available at .
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Principle 2: Develop Analytic Frameworks To Reflect the Predictive Nature of Genetic Tests and Incorporate Appropriate Outcomes (2 of 5) A Generic Analytic Framework for Evaluating Predictive Genetic Tests Considering preanalytic, analytic, and postanalytic factors, as well as outcomes, in analytic frameworks may be useful. Jonas DE, Wilt TJ, Taylor BC, et al. Challenges in and principles for conducting systematic reviews of genetic tests used as predictive indicators. In: Methods guide for medical test reviews. Available at .
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The adverse effects of genetic testing are: Potential effects on family members Psychological distress Potential stigmatization or discrimination Harms particularly occur with the prediction of high disease probability, but no preventative or ameliorative measures exist. For these harms, take into account: Whether testing is for inherited or acquired mutations/ variations Whether the test condition is multifactorial or follows Mendelian inheritance patterns Principle 2: Develop Analytic Frameworks To Reflect the Predictive Nature of Genetic Tests and Incorporate Appropriate Outcomes (3 of 5) Jonas DE, Wilt TJ, Taylor BC, et al. Challenges in and principles for conducting systematic reviews of genetic tests used as predictive indicators. In: Methods guide for medical test reviews. Available at .
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Other outcomes include but are not limited to: Cost Quality of life Long-term morbidity Indirect impact Genetic tests may impact decisions that are difficult to measure yet are very important (e.g., decisions regarding pregnancy).
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