Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Predictive testing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMed2003

Psychological consequences and predictors of adverse events in the first 5 years after predictive testing for Huntington's disease.

The promise of genetic medicine is to provide information, based on genotype, to persons not yet sick about their risk of future illness. However, little is known of the long-term psychological effects for asymptomatic persons learning their risk of having a serious disease. Predictive genetic testing for Huntington's disease (HD) has been offered for the longest time for any disease. In the present study, the psychological consequences of predictive testing were assessed prospectively in individuals at risk for HD during seven visits over 5 years. Questionnaires of standard measures of psychological distress (the General Severity Index of the Symptom Check List-90-Revised), depression (the Beck Depression Inventory), and general well-being (the General Well-Being Scale) were administered to the participants. A significant reduction in psychological distress was observed for both result groups throughout 2 years (p < 0.001) and at 5 years (p = 0.002). Despite the overall improvement of the psychological well-being, 6.9% (14 of 202) of the participants experienced an adverse event during the first 2 years after predictive testing that was clinically significant. The frequency of all defined adverse events in the participants was 21.8%, with higher frequency in the increased risk group (p = 0.03) and most occurring within 12 months of receiving results.

Adult↗
PubMed1996

Prediction of psychological functioning one year after the predictive test for Huntington's disease and impact of the test result on reproductive decision making.

For people at risk for Huntington's disease, the anxiety and uncertainty about the future may be very burdensome and may be an obstacle to personal decision making about important life issues, for example, procreation. For some at risk persons, this situation is the reason for requesting predictive DNA testing. The aim of this paper is two-fold. First, we want to evaluate whether knowing one's carrier status reduces anxiety and uncertainty and whether it facilitates decision making about procreation. Second, we endeavour to identify pretest predictors of psychological adaptation one year after the predictive test (psychometric evaluation of general anxiety, depression level, and ego strength). The impact of the predictive test result was assessed in 53 subjects tested, using pre- and post-test psychometric measurement and self-report data of follow up interviews. Mean anxiety and depression levels were significantly decreased one year after a good test result; there was no significant change in the case of a bad test result. The mean personality profile, including ego strength, remained unchanged one year after the test. The study further shows that the test result had a definite impact on reproductive decision making. Stepwise multiple regression analyses were used to select the best predictors of the subject's post-test reactions. The results indicate that a careful evaluation of pretest ego strength, depression level, and coping strategies may be helpful in predicting post-test reactions, independently of the carrier status. Test result (carrier/ non-carrier), gender, and age did not significantly contribute to the prediction. About one third of the variance of post-test anxiety and depression level and more than half of the variance of ego strength was explained, implying that other psychological or social aspects should also be taken into account when predicting individual post-test reactions.

Adult↗
PubMed2001

Predictive tests for non-return to work in patients with chronic low back pain.

Return to work (RTW) is the primary goal in the rehabilitation of patients with chronic low back pain. In spite of expensive rehabilitative efforts, many patients do not RTW. To increase cost effectiveness, predictive tests for non-RTW are needed to select patients for rehabilitation. The reliability of these tests must be high, to prevent exclusion of patients who might improve. This study evaluates the reliability and predictive validity of four tests and the following psychosocial factors for non-RTW: nationality, off-work duration, unemployment and work load. It was designed as a prospective cohort study of 99 patients with chronic low back pain. Upon entry, physical work load, time off work, unemployment and nationality were recorded. The study investigated four tests with an anticipated prognostic value for non-RTW: the Numeric Pain Rating Scale (NRS, 9-10 of a maximum of 10), the Step Test and Pseudo Strength Test (precipitous cessation) and Behavioural Signs. After 12 months, the RTW rate was obtained from the physicians responsible for sick-listing by postal survey. The response rate regarding RTW was 91% at 1 year. The RTW rate at 1 year was 20%. All investigated tests significantly correlated with non-RTW. Regression analysis showed that the best prediction of non-RTW was obtained when at least two out of the four tests were positive (positive predictive value 0.97, sensitivity 0.45). Unemployment, time off work, nationality and physical work load were less predictive. The results show that the combination of the four prognostic tests allows a very reliable prognosis of non-RTW. The cost effectiveness of rehabilitation aiming at RTW will, therefore, be increased by excluding patients with two or more positive tests.

Adult↗
PubMed1991

The value of tests predicting renovascular hypertension in patients with renal artery stenosis treated by angioplasty.

The aim of this study was to evaluate tests predicting renovascular hypertension. This was done by relating the results of renal vein renin tests, the captopril test, and renal scintigraphic tests to the blood pressure outcome 12 months after relief of renal artery stenosis by percutaneous transluminal renal angioplasty in 31 patients. Cure was seen in eight (26%). Improved blood pressure was obtained in 12 patients (39%), and in 11 patients (35%), the result for blood pressure was a failure. The accuracies of the two mathematical models used to analyze the renal vein renin assays were 44% and 60%. The captopril test showed a sensitivity of 36% and an accuracy of 43%. Renal captopril technetium Tc 99m-labeled pentetic acid scintigraphy gave a sensitivity of 60%. Stepwise logistic regression analysis of clinical variables in relation to blood pressure response revealed age as the only factor significantly related to blood pressure outcome. We conclude that the tests used are unfit for helping select patients for percutaneous transluminal renal angioplasty and that age may have an important influence on outcome.

Adolescent↗
PubMed2000

[Genetic tests: predict or curse].

Genetic testing is aimed to the goal of i) confirming the diagnosis of a genetic disease in an affected individual and ii) of determining the status of relatives and the genetic risk to the progeny. Genetic testing also allows to determine whether an at risk individual is the carrier of the disease gene prior to symptoms. Genetic tests should be carried out for the benefit of the patients only. They deserve extensive preliminary explanation and informed consent of the subjects, gathered during a genetic counseling consultation.

Family↗
PubMed2003

Activated protein C resistance determined with a thrombin generation-based test predicts for venous thrombosis in men and women.

Activated protein C (APC) resistance, determined with a thrombin-generation-based APC resistance test, may explain risk differences of venous thrombosis in users of second- and third-generation oral contraceptives (OC). To clinically validate this test, we analysed the Leiden thrombophilia case-control study (474 patients with a first episode of deep vein thrombosis and 474 age- and sex-matched control subjects). Data for men and women were analysed separately. As hormonal status in women is known to strongly influence the APC sensitivity ratio (APCsr), additional strata (OC use and menopausal state) were defined. The APCsr was higher in all patients than in control subjects. Odds ratios (OR), using the 90th percentile of all control subjects (APCsr > 4.5) as cut-off, were: 7.5 [95% confidence interval (CI) 1.6-33.8] for men, 3.0 (95% CI 1.0-8.8) for premenopausal women not using OC, 4.8 (95% CI 1.6-14.7) for premenopausal women using OC and 4.7 (95% CI 1.4-15.6) for postmenopausal women. After excluding the carriers of factor V Leiden, the OR became infinite for men (no control had an APCsr > 4.5), 1.4 (95% CI 0.2-8.2) for premenopausal women not using OC, 3.4 (95% CI 1.1-10.8) for premenopausal women using OC and 3.6 (95% CI 0.6-20.5) for postmenopausal women. A high APCsr, determined with the thrombin-generation-based APC resistance test, predicts venous thrombotic risk, in populations with and without factor V Leiden. In addition, acquired APC resistance resulting from OC use predicts an increased risk for venous thrombosis independent of factor V Leiden.

Activated Protein C Resistance↗
PubMed1995

Predictive testing for Huntington's disease: risk perception, reasons for testing and psychological profile of test applicants.

In the Center for Human Genetics in Leuven, predictive DNA-testing for Huntington's disease is available as a clinical service since November 1987, initially by DNA-linkage and since mid 1993 by direct mutation analysis. The multidisciplinary approach as well as the detailed test protocol are described. The present paper gives a sociodemographic description of the test applicants, their subjective evaluation of the risk and their motives for requesting the predictive test. Major attention is paid to the personality profile of the applicants who proceeded with testing. Psychometric testing revealed that this group of test applicants did not differ significantly from the general population for most characteristics and even had a number of more positive characteristics e.g. a higher ego-strength. The latter may reflect a self-selection of a more resourceful and emotionally healthier subgroup of at-risk persons. Nevertheless psychological evaluation also has identified a number of applicants with extremely high anxiety levels and other problems, who needed extra pretest and posttest counseling. The relatively high number of withdrawals from the test programme is another indication of the importance of adequate pretest counseling.

Adult↗
PubMedDate not supplied

Course of distress experienced by persons at risk for an autosomal dominant inheritable disorder participating in a predictive testing program: an explorative study. Rotterdam/Leiden Genetics Workgroup.

OBJECTIVE: To compare the effects of predictive DNA testing on participants at risk for either Huntington disease (HD), or familial adenomatous polyposis (FAP), or hereditary breast and ovarian cancer (HBOC). METHOD: Psychological distress was measured with the Impact of Event Scale before testing and at 1 week and 6 months after the test result, in individuals at 50% risk for either HD (N = 25), FAP (N = 23), or HBOC (N = 10). RESULTS: A marginally significant trend was found indicating that carriers of the disease genes tended to show unchanged levels of distress during the study period whereas noncarriers showed the expected decrease. Men reported significantly less distress than women, and 1 week after the test result male noncarriers showed a sharp significant increase in the reported distress followed by a steady decline up to 6 months later. CONCLUSIONS: The course of distress over time reported by carriers and noncarriers of the three disease genes was similar, which leads one to conclude that the previous experience with predictive testing for Huntington Disease may be a useful paradigm. However, those formerly at risk for HD reported more distress than those at risk for FAP and HBOC. From our clinical experience we learned that individuals at risk for FAP and HBOC are more inclined to ward off the emotions involved. Additional qualitative studies should be undertaken to investigate this.

Adult↗
PubMed1992

Improved predictive test for MEN2, using flanking dinucleotide repeats and RFLPs.

Gene(s) for the autosomal dominant endocrine cancer syndromes, multiple endocrine neoplasia type 2A (MEN2A), multiple endocrine neoplasia type 2B (MEN2B), and familial medullary thyroid carcinoma (MTC1) all map to the pericentromeric region of chromosome 10. Predictive testing for the inheritance of mutant alleles in individuals at risk for these disorders has been limited by the availability of highly informative and closely linked flanking markers. We describe the development of eight new markers, including two PCR-based dinucleotide repeat polymorphisms and six RFLPs that flank the disease loci. One of the dinucleotide repeat markers (sJRH-1) derives from the RBP3 locus on 10q11.2 and has a PIC of .88. The other dinucleotide repeat (sTCL-1) defines a new locus, D10S176, that maps by in situ hybridization to 10p11.2 and has a PIC of .68. We have constructed a new genetic linkage map of the pericentromeric region of chromosome 10, on the basis of 13 polymorphisms at six loci, which places the MEN2A locus between the dinucleotide repeat markers, with odds of 5,750:1 over the next most likely position. Using this set of markers, predictive genetic testing of 130 at-risk individuals from six families segregating MEN2A revealed that 95% were jointly informative with flanking markers, representing a significant improvement in genetic testing capabilities.

Base Sequence↗
PubMed2001

Anonymous predictive testing for Huntington's disease in the United States.

The widespread use of a predictive genetic test for Huntington's disease (HD) since 1993 has brought to the forefront issues regarding genetic privacy. Although the possibility of anonymous genetic testing has been discussed, its use in the United States has not been described previously. We review the experiences of 11 genetics specialists with anonymous predictive testing for HD. We found that more men than women requested anonymous testing, for reasons that more often related to personal privacy than to insurance or discrimination concerns. A number of approaches to anonymity were used, and genetics specialists varied in the degree to which they were comfortable with the process. A number of legal, medical, and practical questions are raised, which will require resolution if anonymous testing is to be performed with a greater frequency in the future.

Anonyms and Pseudonyms↗
PubMed1994

Do "screening" coagulation tests predict bleeding in patients undergoing fiberoptic bronchoscopy with biopsy?

OBJECTIVE: To determine if preprocedure coagulation testing predicts bleeding in patients undergoing flexible fiberoptic bronchoscopy (FOB) with biopsy. DESIGN: Retrospective chart review. SETTING: Southeastern, urban Veteran Affairs Medical Center. MEASUREMENTS AND MAIN RESULTS: Two hundred seventy-four patient charts representing 305 FOB with biopsy were reviewed for clinical predictors of bleeding, prebronchoscopy laboratory abnormalities, and incidence of bleeding complications. Thirty-five patients bled, and 3 had abnormal results of coagulation studies. Normal results of coagulation studies and no clinical risk factors were noted in 68 percent of patients who bled. CONCLUSION: Patients undergoing flexible FOB with biopsy do not benefit from preprocedure coagulation testing.

Biopsy↗
PubMed2006

Fifteen years of experience in predictive testing for Huntington disease at a single testing center in Victoria, Australia.

PURPOSE: This retrospective study describes 15 years of experience in predictive testing for Huntington disease at a single center in Victoria, Australia. METHOD: Data collected on 756 participants included age, gender, family history, prior risk and the age at which this risk became known, exposure to Huntington disease, number of children, and proximity to the testing center. RESULTS: Some 57.8% of participants were female, and 88.8% had a 50% risk of developing Huntington disease. The mean age at entry was 40.4 years and was gender-independent. Of all completed tests (n = 648), 37.5% gave high-risk results, and 3.2% were in the zone of reduced penetrance. The 14.3% who withdrew from testing tended to be younger and childless, lacked exposure to severe Huntington disease, and more often at 25% or less risk. Some 32.4% of candidates presented for testing within 1 year of becoming aware of their risk, and most of these individuals had little or no exposure to severe Huntington disease. Those whose exposure was considerable waited on average for more than 13 years. Among the most inexperienced candidates were a group of "adoptees" (raised away from their biological family). Maternal transmission was the source of risk for 19 of 20 adoptees. CONCLUSION: This study illustrates the significance of exposure to Huntington disease and its impact on the timing of testing.

Adolescent↗
PubMed1990

An in vitro predictive test for clinical graft-versus-host disease in allogeneic bone marrow transplant recipients.

An in vitro skin explant model has been used in an attempt to predict the severity of graft-versus-host disease (GVHD) in HLA-identical donor-recipient pairs. The skin explant model involves the use of donor lymphocytes which have been sensitized against recipient lymphocytes in vitro and then co-cultured with the recipient's skin. Thirteen patients were studied in a prospective manner and results from the skin explant model compared with the clinical status of the patient post-transplant showed good correlation (p less than 0.001). Results from T cell-depletion studies indicated a role for both CD4 and CD8 positive cells in GVHD. In conclusion the results confirmed that the skin explant assay is a useful and predictive test of GVHD in humans.

Adult↗
PubMed1981

The topically irritant substance: essentials - bio-tests - predictions.

The paper describes a method for judging the irritative potentialities of substances; proposes a scoring system with which the 'ordinary' risks of many of the abundant marketed products for washing, cleaning etc. may be predicted without biological testing; discusses pharmacodynamic and pharmacokinetic aspects of topical irritancy and points to the problems of extrapolating from animal experiments to man.

Animals↗
PubMed1985

[Lymphoscintigraphy. A predictive test of post-traumatic lymphedema of the lower limbs].

Post-traumatic oedema after fractures of the tibia results from several causes which are often associated together. In addition to venous thrombosis, the lymphatic origin of oedema is not inconsiderable. Lymphatic scintigraphy was performed in 32 patients with tibial fractures, either open or closed. All were fixed internally. All had preventive treatment of venous thrombosis by calciparin. The intact leg was also investigated by scintigraphy which was done two to ten days after the trauma. The possible anomalies of scintigraphy are described and discussed. The patients were divided into two groups. Group one developed oedema at three months and group two did not. The anomalies of scintigraphy were significantly higher in group one. It is concluded that early scintigraphy is a safe test for the prediction of residual oedema after tibial fractures. The possible early prevention of oedema of a lymphatic origin is discussed.

Adult↗
PubMed2003

Psychological distress in the 5-year period after predictive testing for Huntington's disease.

The paper reports on a 5-year longitudinal study on psychological distress after predictive testing for Huntington's disease (HD) and on correlates of post-test distress. Psychometric tests and questionnaires were used. The tested persons were invited to participate in the follow-up study; the uptake rate was 75% (24 carriers, 33 non-carriers). Three time points were included: baseline, 1 year and 5 years post-test. Five years after the test, mean distress scores of both carriers and non-carriers were within the normal range. Carriers did not differ from non-carriers with regard to mean general distress. Compared to non-carriers, however, carriers had significantly less positive feelings (P<0.001) and were more consciously avoiding HD-related situations and thoughts (P<0.01). These findings reflect the carriers' conscious and unconscious attempt to escape from pessimism and to minimise negative consequences of the test result. Psychological distress 5 years post-test was significantly associated with ego-strength (P<0.05 to P<0.001). Except for intrusion and avoidance, distress was also associated with test motivation (P<0.05 to P<0.01). Compared with baseline level, mean depression, general and specific anxiety had significantly decreased 1 year and 5 years post-test (P<0.05 to 0.01). This evolution was independent of the test result. However, based on test motivation, a subgroup of tested persons having long lasting psychological distress could be identified, also irrespective of test result. Persons who asked the test to get rid of the uncertainty, without being able to specify implications for substantial life areas, had more psychological distress before and after the test than those who wanted the test for specific reasons (P<0.001 to P<0.0001). Moreover, the pattern of post-test anxiety differed over time, depending on the test motivation (P<0.05). The findings suggest that pre- and post-test counselling should pay special attention to persons with lower ego-strength and with an unspecified test motivation, because they are at higher risk for long-term psychological distress, independently of the test result.

Adaptation, Psychological↗
PubMed1992

[Hemolytic disease of the newborn due to ABO incompatibility. A predictive test].

A direct 2 stage enzymatic test and the direct anti gamma globulin test were used to predict hemolytic disease of the newborn. Maternal allo-antibodies were determined in cord blood of all newborns from April to June 1988. 0.25% bromelase was used for the 2 Stage Enzymatic Test and a polyspecific anti-gammaglobulin serum was used for the Anti Gamma Globulin Test. Of 618 newborns 97 had parental ABO heterospecificity. Maternal allo-antibodies were present in 20 cases (3.2%). 20 of 86 fullterm newborns developed jaundice presumably due to ABO incompatibility. Blood exchange was required in 6, while phototherapy was sufficient in the rest. The 2 Stage Enzymatic Test was positive in 20 of these cases and the Anti Gamma Globulin Test was positive in 10. Thus, these tests may be used to predict hemolytic disease of the newborn due to ABO incompatibility.

ABO Blood-Group System↗
PubMed2006

Predictive testing of eighteen year olds: counseling challenges.

Genetic counseling of teenagers is challenging and complex. The ability to think abstractly, a sense of self and independence from family all develop during adolescence. Predictive genetic testing counseling protocols presuppose that these qualities exist, requiring the at-risk individual to consider the short and long term consequences of testing as well as their motivations. Eighteen year olds are in transition from adolescence to adulthood; eligible for predictive genetic testing, they may not yet be independent of their family or able to articulate their feelings. This paper presents case studies from the authors' clinical practice to illustrate some of the difficulties faced by genetic counselors when 18 year olds request predictive testing for Hereditary Non-Polyposis Colorectal Cancer. By reflecting upon their experiences with these young adults and their families, the authors' intention is to generate discussion about genetic counseling strategies, particularly for predictive genetic testing, that are both age-appropriate and family-sensitive.

Adolescent↗