What is Evidence-Based Review, and Why is it Important for Genetic Testing?
As new genetic tests and other genomic applications are considered for commercial use, scientists strive to find a good way to evaluate them. Many in the health care community consider evidence-based review (EBR) the preferred method for assessing a treatment or test. EBR is a systematic search for and use of relevant, high-quality, scientific literature and clinical studies. Genomics is a rapidly developing field, but established literature and clinical trials are scant in the case of some new tests. Despite that, EBR can still play a major role in ensuring that genetic tests are safe, useful, and reliable, both before and after they reach the market. Among other things, EBR can show where the biggest gaps in knowledge are.
Evidence-based medicine emerged in the 1990s when many health care providers began to debate the effectiveness of traditional health care treatment. Systematic reviews represent a rigorous method of gathering compelling scientific evidence to answer questions regarding health care issues of treatment, diagnosis, and prevention.
The Agency for Healthcare Research and Quality (AHRQ), supports 13 evidence-based practice centers (EPCs) in the U.S. and Canada to promote evidence-based medicine and review. The EPCs develop evidence reports and technology assessments on topics relevant to clinical, social science/behavioral, economic, and other health care organization and delivery issues. The EPCs produce evidence-based review for many different groups, including the U.S. Preventive Services Task Force and the EGAPP project.
There are other examples of this process as well. In Britain, the National Health Service established the Centre for Evidence-Based Medicine at Oxford University. The Cochrane Collaboration is an international nonprofit organization, dedicated to ensuring up-to-date, accurate information about the effects of health care readily available worldwide. The U.S. Preventive Services Task Force systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. The Task Force on Community Preventive Services prepares the Guide to Community Preventive Services, which provides public health decision makers with recommendations about population-based interventions based on systematic reviews.
Evidence-based review has become widely used in medicine, offering needed assurance that a medical treatment will work. The new field of genomics promises to help large populations avoid or treat common diseases. EBR can help health professionals and the public decide when a test is likely to deliver on these promises or when it is premature or of little use.