BEST PAPER IN PREVENTIVE MEDICINE BY A MEDICAL STUDENT, Jonathan Swanson–Award Winner This paper is the award winner for this year’s annual competition for the “Best Paper in Preventive Medicine by a Medical Student.” Since its inception in 1992, this award has been co-sponsored by the American College of Preventive Medicine, The Association of Teachers of Preventive Medicine, the Association of American Medical Colleges, and the Ulrich and Ruth Frank Foundation for International Health. The monetary prize for the best paper is $1000. Anyone interested in learning more about this award should contact: Erica Frank, MD, MPH, President and Founder of the Ulrich and Ruth Frank Foundation, c/o Department of Family and Preventive Medicine, Emory University School of Medicine, 69 Butler Street, Atlanta GA 30303-3219; (404) 616-5603; (404) 616-6847 fax; E-mail:
[email protected].
Screening Family Members at High Risk for Coronary Disease Why Isn’t It Done? Jonathan R. Swanson, BS, Thomas A. Pearson, MD, PhD Background: The National Cholesterol Education Program strongly recommends screening family members of patients with early cardiovascular disease (CVD) for coronary risk factors, but the physician and patient compliance with this recommendation has not been extensively studied. The American College of Cardiology Evaluation of Preventive Therapeutics (ACCEPT) study, a national survey conducted in 1996 –1997, determined if physicians were screening first-degree relatives of patients with early CVD. Setting/ The ACCEPT study included 5553 patients with either their first bypass surgery, first Participants: angioplasty, an acute myocardial infarction, or myocardia ischemia, admitted to 53 hospitals throughout the United States. Main Outcome Measure:
Self-reported screening of first-degree relatives obtained by interview follow-up 6 months after event.
Results:
Less than 1% of inpatient medical records contained a discharge plan by the physician recommending screening family members of patients younger than age 55. Only 17.8% of these patients had their family screened within 6 months of their cardiovascular event, while only 19.6% with a recognized family history of premature coronary artery disease had their family screened. The only factors that were significant (p⬍0.05) predictors of successful family screening were education (19.4%), having high cholesterol (16.4%), being widowed (18.1%), not smoking (16.4%), and being black (20.5%).
Conclusions: U.S. physicians do not appear to follow national recommendations for the screening of family members of their high-risk patients. These data also suggest that physicians are not ready to use and exploit known genetic factors in treating CVD even as the human genome data become available for clinical use. Medical Subject Headings (MeSH): CAD, genetic screening, mass screening, preventive medicine, primary prevention (Am J Prev Med 2001;20(1):50 –55) © 2001 American Journal of Preventive Medicine
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Am J Prev Med 2001;20(1) 0749-3797/01/$–see front matter © 2001 American Journal of Preventive Medicine • Published by Elsevier Science Inc. PII S0749-3797(00)00252-X