What is GeneTests?
GeneTests is an online medical genetics information resource developed for physicians, other healthcare providers, and researchers. It is funded by the National Institutes of Health and available at no cost to all interested persons.
Although GeneTests. was initially developed as a resource for genetics professionals, the vast majority of its registered users are not formally trained in genetics and include numerous healthcare providers, most of whom have had a limited exposure to medical genetics.
While GeneTests cannot replace the experience and knowledge of a trained genetic counselor or medical geneticists, it is a great starting point for the primary care physician who may encounter cases involving genomic medicine in his/her daily practice. The site contains information on:
For starters, let's practice navigating GeneTests by reading a couple of their simple backgrounders:
This short tutorial will help you practice locating information on the Genetests.org site about a specific disease.
Let’s practice a bit more using the following case study on hemochromatosis. This tutorial will demonstrate how GeneTests.org can be used in a clinical setting.
Disclaimer: This case study is designed to help you navigate the GeneTests site. It is not necessarily meant to serve as a recommendation for how you should address this issue with a real patient.
A 30-year-old female patient appears at your office in Boring, Oregon with a question about hemochromatosis (HHC). She reports that her brother from Chicago has just been diagnosed with HFE-associated hereditary hemochromatosis (HFE-HHC) –she is not sure what it is – and is now insisting that everyone in the family be tested. She presents a letter from her brother’s doctor that confirms that he has iron overload, diagnosed after an episode of atrial fibrillation. He has undergone the removal of 20 units of blood by phlebotomy and now has a serum ferritin less than 50. His HFE genotype is C282Y/H63D.
Her brother tells her there is a genetic test that will determine who is affected. She is skeptical: “he’s always overreacting.†She reports no symptoms. She has one child, aged 5, who is healthy. Her only medication is an oral contraceptive. A hematocrit 2 years ago was 36. [Source: Genetics in Primary Care, Wylie Burke, Kelly Fryer-Edwards, and Linda E. Pinsky, eds., Sept. 2001]
She wants to know the following:
A 30-year-old female patient appears at your office in Boring, Oregon with a question about hemochromatosis (HHC). She reports that her brother from Chicago has just been diagnosed with HFE-associated hereditary hemochromatosis (HFE-HHC) –she is not sure what it is – and is now insisting that everyone in the family be tested. She presents a letter from her brother’s doctor that confirms that he has iron overload, diagnosed after an episode of atrial fibrillation. He has undergone the removal of 20 units of blood by phlebotomy and now as a serum ferritin
Her brother tells her there is a genetic test that will determine who is affected. She is skeptical: “he’s always overreacting.†She reports no symptoms. She has one child, aged 5, who is healthy. Her only medication is an oral contraceptive. A hematocrit 2 years ago was 36.
She wants to know the following:
The answers to your patient's questions can be found in the GeneReview for HFC-HHC. Refer to Tutorial 1 for instructions on locating the GeneReview for HFC-HHC.
This is where you will find answers to her questions.
You can quickly scroll the page by using the left column navigation. Click "Summary" to scroll to the GeneReview Summary.
A description of hemochromatosis can be found in the Summary. As a rule, it is a good idea to browse to Summary section first as it generally can quickly answer many top-level patient questions.
Symptoms are detailed in the Diagnosis section.
Scroll to "Genetic Counseling" to find risk to family members.
Within the Genetic Counseling section, scroll to Related Genetic Counseling.
Return to "Diagnosis" and scroll to "Table 1." Click the Clinical Testing button.
You might have to scroll horizontally to find the Clinical Testing button inside Table 1.
You will be presented with a list of clinics that test for HFC-HHC. Use your Web browser's "find" function to locate a clinic in Oregon.