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Title: Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness
Authors: Severin, Franziska ×
Borry, Pascal
Cornel, Martina C
Daniels, Norman
Fellmann, Florence
Victoria Hodgson, Shirley
Howard, Heidi C
John, Jürgen
Kääriäinen, Helena
Kayserili, Hülya
Kent, Alastair
Koerber, Florian
Kristoffersson, Ulf
Kroese, Mark
Lewis, Celine
Marckmann, Georg
Meyer, Peter
Pfeufer, Arne
Schmidtke, Jörg
Skirton, Heather
Tranebjærg, Lisbeth
Rogowski, Wolf H #
Issue Date: Jun-2015
Publisher: Nature Publishing Group
Series Title: European Journal of Human Genetics vol:23 issue:6 pages:729-735
Article number: 10.1038/ejhg.2014.190
Abstract: Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management.European Journal of Human Genetics advance online publication, 24 September 2014; doi:10.1038/ejhg.2014.190.
URI: 
ISSN: 1018-4813
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Interfaculty Centre for Biomedial Ethics and Law
× corresponding author
# (joint) last author

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