ABSTRACT
BACKGROUND: Although renal cell carcinoma (RCC) is believed to have a strong hereditary component, there is a paucity of published guidelines for genetic risk assessment. A panel of experts was convened to gauge current opinions. METHODS: A North American multidisciplinary panel with expertise in hereditary RCC, including urologists, medical oncologists, clinical geneticists, genetic counselors, and patient advocates, was convened. Before the summit, a modified Delphi methodology was used to generate, review, and curate a set of consensus questions regarding RCC genetic risk assessment. Uniform consensus was defined as ≥85% agreement on particular questions. RESULTS: Thirty-three panelists, including urologists (n = 13), medical oncologists (n = 12), genetic counselors and clinical geneticists (n = 6), and patient advocates (n = 2), reviewed 53 curated consensus questions. Uniform consensus was achieved on 30 statements in specific areas that addressed for whom, what, when, and how genetic testing should be performed. Topics of consensus included the family history criteria, which should trigger further assessment, the need for risk assessment in those with bilateral or multifocal disease and/or specific histology, the utility of multigene panel testing, and acceptance of clinician-based counseling and testing by those who have experience with hereditary RCC. CONCLUSIONS: In the first ever consensus panel on RCC genetic risk assessment, 30 consensus statements were reached. Areas that require further research and discussion were also identified, with a second future meeting planned. This consensus statement may provide further guidance for clinicians when considering RCC genetic risk assessment. LAY SUMMARY: The contribution of germline genetics to the development of renal cell carcinoma (RCC) has long been recognized. However, there is a paucity of guidelines to define how and when genetic risk assessment should be performed for patients with known or suspected hereditary RCC. Without guidelines, clinicians struggle to define who requires further evaluation, when risk assessment or testing should be done, which genes should be considered, and how counseling and/or testing should be performed. To this end, a multidisciplinary panel of national experts was convened to gauge current opinion on genetic risk assessment in RCC and to enumerate a set of recommendations to guide clinicians when evaluating individuals with suspected hereditary kidney cancer.
Subject(s)
Carcinoma, Renal Cell , Kidney Neoplasms , Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/genetics , Consensus , Genetic Testing , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/genetics , Risk AssessmentABSTRACT
PURPOSE: Approximately 13.3% of Mississippi's adult population lives with diabetes, with a higher prevalence among racial, ethnic, and socioeconomic minorities. However, there is no recorded data regarding the effectiveness of education on foot ulcer prevention provided to patients in the rural clinic network. Future studies to evaluate the effectiveness of foot care education would benefit from a racially-, ethically-, and socioeconomically-diverse education program. METHODS: This study combined verbal and visual education tools to improve the acquisition of knowledge and measure the effectiveness of knowledge the diabetic type 2 patients retained. A convenience sample of patients (N = 9) completed pre-and post-intervention questionnaires. A convenience sample of the clinic's nurses (N = 4) completed only a pre-intervention questionnaire. Data collection for this project included a 5-min formative one-on-one interview, pre- and post-test approach. The Statistical Package for the Social Science (SPSS) 20.0 was used to analyze the transcripts from the focus group, descriptive statistics from the demographic sheet, the questionnaire, and surveys. RESULTS: Qualitative themes were used to evaluate the effectiveness of the program and to capture the participants' perception of their experiences. Descriptive statistics were used to analyze the demographic data and the knowledge retained. Variables were calculated using central tendency of mean, median, and mode. Satisfaction score with the education provided yielded a mean of 4.56 and standard deviation (SD) of .527. CONCLUSIONS: Detailed prospective research is required to determine if implementing education early in the patient's plan of care will improve the patient's overall health care status thus, decreasing facility costs.
