Incomplete Family History and Meeting Algorithmic Criteria for Genetic Evaluation of Hereditary Cancer

Can a clinical decision support algorithm identify patients who meet criteria for hereditary cancer genetic evaluation when family history data are incompletely documented in the electronic health record, and is data missingness associated with identification patterns in patient subgroups?In this cross-sectional study of 157 207 patients from 2 US health care systems who had documentation of cancer family history, 10% met genetic evaluation criteria. Where data were missing randomly, incomplete documentation was not associated with patient identification; however, when data were missing systematically, older patients and those with relatives with rising mortality cancers were significantly more likely to be identified when incomplete records were excluded.These findings suggest that health care systems should assess their specific missing data patterns when implementing clinical decision support algorithms.

Corresponding Author: Jemar R. Bather, PhD, Center for Anti-racism, Social Justice jemar.bather@nyu.edu).

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