Table 2.
Clinical utility and actionability of eMERGE return.
| Condition | Actionability | ||
|---|---|---|---|
| Clinical utility | Counseling and education | Laboratory tests and procedures | |
| Asthma | Early intervention and therapy; 4x more common in AAa | Reduce environmental triggers | Provider encounter (education) |
| Atrial fibrillation | Cost effective screening; early detection | Emphasize healthy lifestyle; assess symptoms | Test ordered (ECG; rhythm monitor) |
| Breast cancer | Enhanced screening & therapy; higher mortality in AA; BOADICEA score returned | Emphasize healthy lifestyle; screening | Imaging order (breast MRI; mammogram) |
| Chronic kidney disease | Early non-invasive screening; high prevalence >10% adults; 3.7x more common in AA | Emphasize healthy lifestyle; screening | Lab order (serum creatinine, urine albumin to creatinine ratio) |
| Colorectal cancer | Early non-invasive screening; risk varies by race & ethnicity | Early screening | Procedure order (stool test, flex sigmoidoscopy, colonoscopy, ct colonography) |
| Coronary heart disease | Non-invasive screening and intervention; highly prevalent disease; pooled cohort equation returned | Emphasize healthy lifestyle; screening | Lab order (lipid profile) imaging order (coronary CT, carotid ultrasound) |
| Hypercholesterolemia | Non-invasive, accessible screenings; disproportionate burden in AA | Emphasize healthy lifestyle; screening; medication | Lab order (lipid profile) |
| Obesity/BMI | Early intervention to modify behavior; weight in childhood is predictive of adult obesity | Emphasize healthy lifestyle; referral | Referral (weight loss or nutrition consultation) |
| Prostate cancer | Non-invasive, accessible screenings; population disparities in incidence and mortality | Shared decision making about early screening | Provider encounter; exam |
| Type 1 diabetes | Treatment dependent on distinguishing between diabetes types | Education regarding symptoms; screening | Lab order (autoantibodies) |
| Type 2 diabetes | Non-invasive screening; highly prevalent disease; racial disparities in care | Emphasize healthy lifestyle; screening | Lab order (fasting blood glucose, A1c) |
a
AA = African American;