Performance of the eHealth decision support tool, MIPOGG, for recognising children with Li-Fraumeni, DICER1, Constitutional mismatch repair deficiency and Gorlin syndromes.

Clinical Decision-Making Genetic Predisposition to Disease Genetics Medical Oncology Pediatrics

Journal

Journal of medical genetics
ISSN: 1468-6244
Titre abrégé: J Med Genet
Pays: England
ID NLM: 2985087R

Informations de publication

Date de publication:
27 Nov 2023
Historique:
received: 12 05 2023
accepted: 26 06 2023
medline: 29 11 2023
pubmed: 18 7 2023
entrez: 17 7 2023
Statut: epublish

Résumé

Cancer predisposition syndromes (CPSs) are responsible for at least 10% of cancer diagnoses in children and adolescents, most of which are not clinically recognised prior to cancer diagnosis. A variety of clinical screening guidelines are used in healthcare settings to help clinicians detect patients who have a higher likelihood of having a CPS. The McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) is an electronic health decision support tool that uses algorithms to help clinicians determine if a child/adolescent diagnosed with cancer should be referred to genetics for a CPS evaluation. This study assessed MIPOGG's performance in identifying Li-Fraumeni, DICER1, Constitutional mismatch repair deficiency and Gorlin (nevoid basal cell carcinoma) syndromes in a retrospective series of 84 children diagnosed with cancer and one of these four CPSs in Canadian hospitals over an 18-year period. MIPOGG detected 82 of 83 (98.8%) evaluable patients with any one of these four genetic conditions and demonstrated an appropriate rationale for suggesting CPS evaluation. When compared with syndrome-specific clinical screening criteria, MIPOGG's ability to correctly identify children with any of the four CPSs was equivalent to, or outperformed, existing clinical criteria respective to each CPS. This study adds evidence that MIPOGG is an appropriate tool for CPS screening in clinical practice. MIPOGG's strength is that it starts with a specific cancer diagnosis and incorporates criteria relevant for associated CPSs, making MIPOGG a more universally accessible diagnostic adjunct that does not require in-depth knowledge of each CPS.

Sections du résumé

BACKGROUND BACKGROUND
Cancer predisposition syndromes (CPSs) are responsible for at least 10% of cancer diagnoses in children and adolescents, most of which are not clinically recognised prior to cancer diagnosis. A variety of clinical screening guidelines are used in healthcare settings to help clinicians detect patients who have a higher likelihood of having a CPS. The McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) is an electronic health decision support tool that uses algorithms to help clinicians determine if a child/adolescent diagnosed with cancer should be referred to genetics for a CPS evaluation.
METHODS METHODS
This study assessed MIPOGG's performance in identifying Li-Fraumeni, DICER1, Constitutional mismatch repair deficiency and Gorlin (nevoid basal cell carcinoma) syndromes in a retrospective series of 84 children diagnosed with cancer and one of these four CPSs in Canadian hospitals over an 18-year period.
RESULTS RESULTS
MIPOGG detected 82 of 83 (98.8%) evaluable patients with any one of these four genetic conditions and demonstrated an appropriate rationale for suggesting CPS evaluation. When compared with syndrome-specific clinical screening criteria, MIPOGG's ability to correctly identify children with any of the four CPSs was equivalent to, or outperformed, existing clinical criteria respective to each CPS.
CONCLUSION CONCLUSIONS
This study adds evidence that MIPOGG is an appropriate tool for CPS screening in clinical practice. MIPOGG's strength is that it starts with a specific cancer diagnosis and incorporates criteria relevant for associated CPSs, making MIPOGG a more universally accessible diagnostic adjunct that does not require in-depth knowledge of each CPS.

Identifiants

pubmed: 37460202
pii: jmg-2023-109376
doi: 10.1136/jmg-2023-109376
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1218-1223

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Robyn Hebert (R)

Department of Human Genetics, McGill University, Montreal, Québec, Canada.
Genetic Counselling Services, Sudbury Regional Hospital, Sudbury, Ontario, Canada.

Noelle Cullinan (N)

Department of Paediatric Haematology-Oncology, Children's Health Ireland, Dublin, Ireland.
Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.

Linlea Armstrong (L)

Medical Genetics, The University of British Columbia, Vancouver, British Columbia, Canada.

Katherine A Blood (KA)

Medical Genetics, The University of British Columbia, Vancouver, British Columbia, Canada.
Hereditary Cancer Program, BC Cancer Agency, Vancouver, British Columbia, Canada.

Josee Brossard (J)

Division of Pediatric Hematology-Oncology, Centre intégré universitaire de santé et de services sociaux de l'Estrie Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.

Ledia Brunga (L)

Department of Genetics and Genome Biology, University of Toronto, Toronto, Ontario, Canada.

Chantel Cacciotti (C)

Department of Pediatric Hematology-Oncology, London Health Sciences Centre, London, Ontario, Canada.

Kimberly Caswell (K)

Department of Genetics and Genome Biology, University of Toronto, Toronto, Ontario, Canada.

Sonia Cellot (S)

Charles-Bruneau Cancer Centre, Pediatric Hematology-Oncology Division, Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Québec, Canada.

Hallie Coltin (H)

Charles-Bruneau Cancer Centre, Pediatric Hematology-Oncology Division, Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Québec, Canada.
Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Rebecca J Deyell (RJ)

Division of Pediatric Hematology/Oncology/BMT, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.

Kathleen Felton (K)

Pediatric Hematology/Oncology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Conrad V Fernandez (CV)

Division of Hematology/Oncology, Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada.

Adam J Fleming (AJ)

Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.

Paul Gibson (P)

Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada.

Rawan Hammad (R)

Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Haematology, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia.

Nada Jabado (N)

Department of Human Genetics, McGill University, Montreal, Québec, Canada.
Division of Hematology-Oncology, Department of Pediatrics, McGill University Health Centre, Montreal, Québec, Canada.

Donna L Johnston (DL)

Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Lucie Lafay-Cousin (L)

Section of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada.

Valérie Larouche (V)

Department of Pediatrics, Centre mère-enfant Soleil du CHU de Québec-Université Laval, Quebec City, Quebec, Canada.

Cassandra Leblanc-Desrochers (C)

Centre de recherche du CHUS, Centre intégré universitaire de santé et de services sociaux de l'Estrie Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.

Orli Michaeli (O)

Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Division of Hematology/Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.

Renee Perrier (R)

Medical Genetics, Alberta Children's Hospital, Calgary, Alberta, Canada.

Meghan Pike (M)

Division of Hematology/Oncology, Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada.

Jemma Say (J)

Paediatric Haematology/Oncology Programme, Bristol Royal Hospital for Children, Bristol, UK.

Ian Schiller (I)

Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.

Annie-Kim Toupin (AK)

Department of Medicine, University Laval, Québec, Québec, Canada.

Stéphanie Vairy (S)

Division of Pediatric Hematology-Oncology, Centre intégré universitaire de santé et de services sociaux de l'Estrie Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
Charles-Bruneau Cancer Centre, Pediatric Hematology-Oncology Division, Centre Hospitalier Universitaire Sainte-Justine Centre de Recherche, Montreal, Québec, Canada.

Kalene van Engelen (K)

Medical Genetics Program of Southwestern Ontario, London Health Sciences Centre, London, Ontario, Canada.

Nicolas Waespe (N)

Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatric Oncology and Hematology, University Children's Hospital Bern, University of Bern, Bern, Switzerland.

Anita Villani (A)

Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.

William D Foulkes (WD)

Departments of Human Genetics, Oncology and Medicine, McGill University, Montreal, Quebec, Canada.

David Malkin (D)

Department of Pediatrics, Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.

Lara Reichman (L)

Department of Human Genetics, McGill University, Montreal, Québec, Canada lara.reichman@muhc.mcgill.ca.
Department of Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.

Catherine Goudie (C)

Division of Hematology-Oncology, Department of Pediatrics, McGill University Health Centre, Montreal, Québec, Canada.
Department of Child Health and Human Development, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada.

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