# Family history collected by app and matched to testing criteria automatically

Source: https://onco.cc/ideas/idea-prev-family-history-auto-match/  
OnCo record `idea-prev-family-history-auto-match` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Doctors rarely take a full family history, so eligibility for genetic testing goes undetected. An app that gathers the history from the patient, feeds it into the record and checks it against NCCN or NICE criteria would identify several-fold more eligible people and, the proposal estimates, roughly double the number tested.

## Summary

Doctors rarely take a full family history, so this idea integrates patient-entered family history into the EHR at every new-patient visit, auto-matches it to NCCN or NICE testing criteria and triggers automatic referral or mainstream testing. Tools such as MeTree and CanRisk exist but are not part of routine care, and eligibility is common but rarely detected. The aim is several-fold more guideline-eligible individuals identified and roughly twice as many tested. The test is a cluster RCT in primary care networks. At early-clinical maturity it addresses the bottleneck Inherited risk is mostly unidentified and links to germline testing.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Automated capture increases identification of guideline-eligible individuals at least three-fold and testing at least two-fold.
- Rationale: Eligibility is common (about 5-10% of adults) but rarely detected.
- Proposed test: Run a cluster RCT in primary care networks.
- Maturity: early-clinical
- Actor: engineering

## Sources

- Bottleneck evidence (Inherited risk is mostly unidentified): Childers et al., National estimates of genetic testing in women with breast or ovarian cancer (JCO 2017): https://doi.org/10.1200/JCO.2017.73.6314

## Connected records

- fronts: [Prevention & Risk](https://onco.cc/fronts/prevention/)
- technologies: [Germline (hereditary) testing](https://onco.cc/technologies/germline-testing/)
- bottlenecks: [Inherited risk is mostly unidentified](https://onco.cc/bottlenecks/b-hereditary-risk/)
- key papers: [National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer](https://onco.cc/key-papers/paper-childers-j-clin-oncol/)

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