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1
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Wand H, Lambert SA, Tamburro C, Iacocca MA, O'Sullivan JW, Sillari C, Kullo IJ, Rowley R, Dron JS, Brockman D, Venner E, McCarthy MI, Antoniou AC, Easton DF, Hegele RA, Khera AV, Chatterjee N, Kooperberg C, Edwards K, Vlessis K, Kinnear K, Danesh JN, Parkinson H, Ramos EM, Roberts MC, Ormond KE, Khoury MJ, Janssens ACJW, Goddard KAB, Kraft P, MacArthur JAL, Inouye M, Wojcik GL. Improving reporting standards for polygenic scores in risk prediction studies. Nature 2021; 591:211-219. [PMID: 33692554 DOI: 10.1101/2020.04.23.20077099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 01/15/2021] [Indexed: 05/25/2023]
Abstract
Polygenic risk scores (PRSs), which often aggregate results from genome-wide association studies, can bridge the gap between initial discovery efforts and clinical applications for the estimation of disease risk using genetics. However, there is notable heterogeneity in the application and reporting of these risk scores, which hinders the translation of PRSs into clinical care. Here, in a collaboration between the Clinical Genome Resource (ClinGen) Complex Disease Working Group and the Polygenic Score (PGS) Catalog, we present the Polygenic Risk Score Reporting Standards (PRS-RS), in which we update the Genetic Risk Prediction Studies (GRIPS) Statement to reflect the present state of the field. Drawing on the input of experts in epidemiology, statistics, disease-specific applications, implementation and policy, this comprehensive reporting framework defines the minimal information that is needed to interpret and evaluate PRSs, especially with respect to downstream clinical applications. Items span detailed descriptions of study populations, statistical methods for the development and validation of PRSs and considerations for the potential limitations of these scores. In addition, we emphasize the need for data availability and transparency, and we encourage researchers to deposit and share PRSs through the PGS Catalog to facilitate reproducibility and comparative benchmarking. By providing these criteria in a structured format that builds on existing standards and ontologies, the use of this framework in publishing PRSs will facilitate translation into clinical care and progress towards defining best practice.
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Affiliation(s)
- Hannah Wand
- Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Inherited Cardiovascular Disease, Stanford, CA, USA
| | - Samuel A Lambert
- Cambridge Baker Systems Genomic Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Baker Systems Genomic Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | | | | | - Jack W O'Sullivan
- Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Inherited Cardiovascular Disease, Stanford, CA, USA
| | | | - Iftikhar J Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robb Rowley
- National Human Genome Research Institute, Bethesda, MD, USA
| | - Jacqueline S Dron
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Western University, London, Ontario, Canada
| | - Deanna Brockman
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Eric Venner
- Baylor College of Medicine, Houston, TX, USA
| | - Mark I McCarthy
- Department of Human Genetics, Genentech, South San Francisco, CA, USA
- Wellcome Centre for Human Genetics, Oxford, UK
| | - Antonis C Antoniou
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Amit V Khera
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karen Edwards
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Katherine Vlessis
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Kim Kinnear
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - John N Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
| | - Helen Parkinson
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | - Erin M Ramos
- National Human Genome Research Institute, Bethesda, MD, USA
| | - Megan C Roberts
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Kelly E Ormond
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
| | - Muin J Khoury
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Cecile J W Janssens
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Katrina A B Goddard
- Department of Translational and Applied Genomics, Kaiser Permanente Northwest, Portland, OR, USA
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaqueline A L MacArthur
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | - Michael Inouye
- Cambridge Baker Systems Genomic Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Baker Systems Genomic Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - Genevieve L Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Wand H, Lambert SA, Tamburro C, Iacocca MA, O'Sullivan JW, Sillari C, Kullo IJ, Rowley R, Dron JS, Brockman D, Venner E, McCarthy MI, Antoniou AC, Easton DF, Hegele RA, Khera AV, Chatterjee N, Kooperberg C, Edwards K, Vlessis K, Kinnear K, Danesh JN, Parkinson H, Ramos EM, Roberts MC, Ormond KE, Khoury MJ, Janssens ACJW, Goddard KAB, Kraft P, MacArthur JAL, Inouye M, Wojcik GL. Improving reporting standards for polygenic scores in risk prediction studies. Nature 2021; 591:211-219. [PMID: 33692554 PMCID: PMC8609771 DOI: 10.1038/s41586-021-03243-6] [Citation(s) in RCA: 200] [Impact Index Per Article: 66.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 01/15/2021] [Indexed: 11/09/2022]
Abstract
Polygenic risk scores (PRSs), which often aggregate results from genome-wide association studies, can bridge the gap between initial discovery efforts and clinical applications for the estimation of disease risk using genetics. However, there is notable heterogeneity in the application and reporting of these risk scores, which hinders the translation of PRSs into clinical care. Here, in a collaboration between the Clinical Genome Resource (ClinGen) Complex Disease Working Group and the Polygenic Score (PGS) Catalog, we present the Polygenic Risk Score Reporting Standards (PRS-RS), in which we update the Genetic Risk Prediction Studies (GRIPS) Statement to reflect the present state of the field. Drawing on the input of experts in epidemiology, statistics, disease-specific applications, implementation and policy, this comprehensive reporting framework defines the minimal information that is needed to interpret and evaluate PRSs, especially with respect to downstream clinical applications. Items span detailed descriptions of study populations, statistical methods for the development and validation of PRSs and considerations for the potential limitations of these scores. In addition, we emphasize the need for data availability and transparency, and we encourage researchers to deposit and share PRSs through the PGS Catalog to facilitate reproducibility and comparative benchmarking. By providing these criteria in a structured format that builds on existing standards and ontologies, the use of this framework in publishing PRSs will facilitate translation into clinical care and progress towards defining best practice.
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Affiliation(s)
- Hannah Wand
- Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Inherited Cardiovascular Disease, Stanford, CA, USA
| | - Samuel A Lambert
- Cambridge Baker Systems Genomic Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Baker Systems Genomic Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | | | | | - Jack W O'Sullivan
- Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Inherited Cardiovascular Disease, Stanford, CA, USA
| | | | - Iftikhar J Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robb Rowley
- National Human Genome Research Institute, Bethesda, MD, USA
| | - Jacqueline S Dron
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Western University, London, Ontario, Canada
| | - Deanna Brockman
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Eric Venner
- Baylor College of Medicine, Houston, TX, USA
| | - Mark I McCarthy
- Department of Human Genetics, Genentech, South San Francisco, CA, USA
- Wellcome Centre for Human Genetics, Oxford, UK
| | - Antonis C Antoniou
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Amit V Khera
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karen Edwards
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Katherine Vlessis
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Kim Kinnear
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - John N Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
| | - Helen Parkinson
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | - Erin M Ramos
- National Human Genome Research Institute, Bethesda, MD, USA
| | - Megan C Roberts
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Kelly E Ormond
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
| | - Muin J Khoury
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Cecile J W Janssens
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Katrina A B Goddard
- Department of Translational and Applied Genomics, Kaiser Permanente Northwest, Portland, OR, USA
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaqueline A L MacArthur
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | - Michael Inouye
- Cambridge Baker Systems Genomic Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Baker Systems Genomic Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - Genevieve L Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Wetterneck CT, Pinciotti CM, Knott L, Kinnear K, Storch EA. Development and validation of the Adult OCD Impact Scale (AOIS): A measure of psychosocial functioning for adults with obsessive-compulsive disorder. Journal of Contextual Behavioral Science 2020. [DOI: 10.1016/j.jcbs.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Spencer M, Kinnear K, Vieira D. Clinical supervision: a challenge for critical care nurses. Nurs Crit Care 2000; 5:142-7. [PMID: 11249257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Clinical supervision is defined and its implementation nationally is charted. Recognised models and choosing the appropriate model for implementing clinical supervision are discussed. A description of the initiatives undertaken with regard to clinical supervision within Southend Hospital is included, with particular reference to the Adult Intensive Therapy Unit; possible ways forward are identified. Quantitative data, obtained through a pilot questionnaire, from identifiable intensive therapy units across the North Thames and Eastern Region, are analysed.
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Affiliation(s)
- M Spencer
- Southend Hospital NHS Trust, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY.
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Abstract
The report of the 'National Coordinating Group on Paediatric Intensive Care' (NHS Executive 1997) recommended that general (adult) intensive care units in district general hospitals should no longer continue to care for critically ill children apart from providing resuscitation prior to transfer to a specialist centre. This recommendation was made despite a lack of outcome data in the UK to support this conclusion. We wish to report our outcome data from one such unit. Over a four-year period, we have prospectively used Paediatric Risk of Mortality scoring to estimate the risk of death for 95 children cared for in our adult unit in a district general hospital (DGH) and have compared this with the observed outcome. The observed mortality of 2 deaths was less than the predicted mortality of 2.32 deaths. Our results suggest that an adult unit can provide a paediatric intensive care service that is associated with an acceptable outcome in terms of mortality. These data suggest that the role of such units with regard to the provision of paediatric intensive care should be considered further.
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Affiliation(s)
- K Kinnear
- Intensive Care Unit, Southend Hospital, Essex, UK
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Belsey MA, Russell Y, Kinnear K. Cardiovascular disease and oral contraceptives: a reappraisal of vital statistics data. Fam Plann Perspect 1979; 11:84-9. [PMID: 456491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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7
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Andolsek L, Cheng M, Hren M, Ogrinc-Oven M, Ng A, Ratnam S, Belsey M, Edström K, Heiner P, Kinnear K, Tietze C. The safety of local anesthesia and outpatient treatment: a controlled study of induced abortion by vacuum aspiration. Stud Fam Plann 1977; 8:118-24. [PMID: 867453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The safety of early vacuum aspiration performed as an outpatient procedure using local anesthesia was examined in a controlled study sponsored by the World Health Organization and undertaken in two centers in Yugoslavia and Singapore. The sample consisted of healthy women whose pregnancies were between 7 and 12 weeks in duration. Follow-up four weeks after abortion was nearly 100 percent in both centers. No important differences in complication rates were found between the different types of services and anesthesia, even though overall complication rates differed markedly between centers. Overnight postabortion observation was not associated with any decrease in complications.
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Cheng M, Andolsek L, Ng A, Ratnam S, Hren M, Ogrinc-Oven M, Belsey M, Edström K, Heiner P, Kinnear K, Tietze C. Complications following induced abortion by vacuum aspiration: patient characteristics and procedures. Stud Fam Plann 1977; 8:125-9. [PMID: 867454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Complications following early induced abortion by vacuum aspiration were examined in a controlled study. Data were collected on healthy women 7--12 weeks pregnant at the time of abortion. No association was found between complication rates and age, marital status, or parity. However, women in their first pregnancies and those who had experienced an induced or spontaneous abortion in their previous pregnancy had a higher rate of complications following the current induced abortion.
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