News

20-10-2016

The latest recommendations for Australian Medical experts on the screening, testing and treatment of a range of conditions have been released under the Choosing Wisely Australia initiative. The four Australia medical societies and colleges represent are the Human Genetics Society of Australasia, the Gastroenterological Society of Australia, the Royal Australasian and New Zealand College of Radiology's Faculty of Radiation Oncology and the Australasian Chapter of Sexual Health Medicine.

The Genetics Society want to raise awareness regarding how unnecessary genetic testing can lead to further unnecessary investigations, worry, ethical, social and legal ( like Insurance) issues. Of concern is the direct to consumer genetic testing for MTHFR and APOE genes. MTHFR is an enzyme that converts folate. MTHFR variants are very common in the general population and folic acid supplementation has been shown to increase folate levels, regardless of MTHFR status. Having a variant in the gene does not generally cause health problems. APOE is considered a risk or susceptibility factor for Alzheimer's disease, but having a test only shows a probability. Genetic testing is best performed in a clinical setting with personalised genetic counselling and professional nterpretation of test results to understand the further implications of the test.

Some of the recommendations to take note of include:

 

  • Coeliac disease genetic testing is discouraged because results can be misleading
  • There is poor correlation between people who test positive to the Alzheimer's genetic marker and people who actually develop Alzheimer's
  • People should not undertake genetic testing without consulting their doctor as tests can cause false concern and false reassurance
  • Doctors should not undertake carrier state testing for rare recessive disorders where a partner has a family history
  • Patients should talk to their doctor about persisting vaginal thrush treatment because there are many causes and treatments
  • Don't do a herpes serology test if you don't have any symptoms as it may produce a misleading result
  • Don't use opioids for migraines except in rare circumstances
  • People with lower back pain should not be given epidural injections if they don't have any symptoms of specific pain in their legs
  • Patients who need long-term acid reflux medication should consult their doctor about the need to take it and the dosage
  • For people with tumours, there is new advice for doctors on how to treat them
  • Doctors should not perform brain imaging for people with non-acute primary headache disorders

- www.evolve.edu.au

- www.choosingwiselyorg.au/recommendations

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