Interpretation of Family Health History
Red flags are indications that there may be an increased genetic risk and the need for more in-depth probing. The primary red flag for most common diseases is a large number of affected relatives with the same or related condition. Premature onset of disease is also a genetic risk factor and varies depending on the disease ( Table 3 ).
A number of methods have been proposed for assessing and stratifying risk in the presence of red flags. Scheuner and colleagues stratify risk based on family history into 3 groups: high, moderate, and average.
Premature disease in a first-degree relative;
Premature disease in a second-degree relative (coronary artery disease only);
Two affected first-degree relatives;
One first-degree relative with late or unknown disease onset and an affected second-degree relative with premature disease from the same lineage;
Two second-degree maternal or paternal relatives with at least 1 having premature onset of disease;
Three or more affected maternal or paternal relatives; or
Presence of a "moderate-risk" family history on both sides of the pedigree.
One first-degree relative with late or unknown onset of disease; or
Two second-degree relatives from the same lineage with late or unknown disease onset.
No affected relatives;
Only 1 affected second-degree relative from one or both sides of the family;
No known family history; or
Adopted person with unknown family history.
Authors and Disclosures
Lorie M. Vandenbusche, MSN, FNP, Kent State University, College of Nursing, Kent, Ohio
Disclosure: Lorie M. Vandenbusche, MSN, FNP, has disclosed no relevant financial relationships.