TITLE:
An Evaluation of FaHRAS Computer Programmes’ Utility in Family History Triage of Breast Cancer
AUTHORS:
Áine Gorman, Michael Sugrue, Zuhair Ahmed, Alison Johnston
KEYWORDS:
Breast Cancer, Risk Assessment, Family History
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.3 No.2,
April
17,
2014
ABSTRACT: Introduction: Rapid and
appropriate family risk assessment and triage of patients are essential for
patients presenting to a symptomatic breast unit and international criteria for
review are well established. Family History Risk Assessment Software (FaHRAS)
is a computerized program, involving different modalities of risk assessment,
which is available but has not been widely assessed. Aims: This study evaluated
the FaHRAS software scoring of family history risk. Its analysis was compared
to multi-tool family history risk assessment models in a cohort of 353 patients
on a historic family history waiting list. Methods: A recent published pilot
study assessed and categorized family history risk in 353 patients on a
historic family history waiting list, according to international guidelines
including NICE criteria, Gail and IBIS risk estimates. The current study
involved a reassessment of all 353 patients using the FaHRAS software program
to determine its accuracy and ease of use. Patient demographics and time
required to perform the analysis were documented. Results: FaHRAS identified 73
(20.7%) patients had an IBIS family history score of 17% or greater and 89
(25.2%) patients met the NICE guidelines criteria for management beyond primary
care. In the previous study, this was 79 (22.4%) and 112 (31.7%) respectively.
Using the largest denominator (NICE guidelines), 264/353 (74.8%) patients could
be discharged to primary care using FaHRAS. Using this largest denominator,
FaHRAS also identified a total of 28 (7.9%) patients requiring referral to
tertiary care while the previous study identified 3 (0.8%). Conclusion: This is
one of the first studies to validate FaHRAS, which is accurate and easy to use.
FaHRAS system can enable clinicians to become more efficient gatekeepers to
genetic services.