Dataset Information

Primary care physician use of patient race and polygenic risk scores in medical decision-making.

ABSTRACT:

Purpose

The use of patient race in medicine is controversial for its potential either to exacerbate or address health disparities. Polygenic risk scores (PRSs) have emerged as a tool for risk stratification models used in preventive medicine. We examined whether PRS results affect primary care physician (PCP) medical decision-making and whether that effect varies by patient race.

Methods

Using an online survey with a randomized experimental design among PCPs in a national database, we ascertained decision-making around atherosclerotic cardiovascular disease prevention and prostate cancer screening for case scenario patients who were clinically identical except for randomized reported race.

Results

Across 369 PCPs (email open rate = 10.8%, partial completion rate = 93.7%), recommendations varied with PRS results in expected directions (low-risk results, no available PRS results, and high-risk results). Still, physicians randomized to scenarios with Black patients were more likely to recommend statin therapy than those randomized to scenarios with White patients (odds ratio = 1.74, 95% CI = 1.16-2.59, P = .007) despite otherwise identical clinical profiles and independent of PRS results. Similarly, physicians were more likely to recommend prostate cancer screening for Black patients than for White patients (odds ratio = 1.58, 95% CI = 1.06-2.35, P = .025) despite otherwise identical clinical and genetic profiles.

Conclusion

Despite advances in precision risk stratification, physicians will likely continue to use patient race implicitly or explicitly in medical decision-making.

SUBMITTER: Kerman BJ

PROVIDER: S-EPMC10085844 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Primary care physician use of patient race and polygenic risk scores in medical decision-making.

Kerman Benjamin J BJ Brunette Charles A CA Harris Elizabeth J EJ Antwi Ashley A AA Lemke Amy A AA Vassy Jason L JL

Genetics in medicine : official journal of the American College of Medical Genetics 20230204 4

<h4>Purpose</h4>The use of patient race in medicine is controversial for its potential either to exacerbate or address health disparities. Polygenic risk scores (PRSs) have emerged as a tool for risk stratification models used in preventive medicine. We examined whether PRS results affect primary care physician (PCP) medical decision-making and whether that effect varies by patient race.<h4>Methods</h4>Using an online survey with a randomized experimental design among PCPs in a national database ...[more]

PMID: 36748708

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Dataset Information

Primary care physician use of patient race and polygenic risk scores in medical decision-making.

Purpose

Methods

Results

Conclusion

Publications

Primary care physician use of patient race and polygenic risk scores in medical decision-making.

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