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How useful is family history as a risk-assessment tool for common diseases that are encountered by primary care clinicians? That question was addressed at a State-of-the-Science Conference, convened by the NIH.
The panel found little evidence to indicate which elements of family history were key for risk assessment. Most of the evidence was not derived from primary care settings and was focused on the accuracy of patient recall of conditions in first-degree relatives. For many conditions, specificity was high, sensitivity was poor, and positive predictive value was <10%. Reports of the absence of disease were more reliable than presence of disease, and reports about first-degree relatives were more accurate than those about more-distant rela…