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Clinical utility of polygenic risk scores: a critical 2023 appraisal
Since their first appearance in the context of schizophrenia and bipolar disorder in 2009, polygenic risk scores (PRSs) have been described for a large number of common complex diseases. However, the clinical utility of PRSs in disease risk assessment or therapeutic decision making is likely limited...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576695/ https://www.ncbi.nlm.nih.gov/pubmed/37133683 http://dx.doi.org/10.1007/s12687-023-00645-z |
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author | Koch, Sebastian Schmidtke, Jörg Krawczak, Michael Caliebe, Amke |
author_facet | Koch, Sebastian Schmidtke, Jörg Krawczak, Michael Caliebe, Amke |
author_sort | Koch, Sebastian |
collection | PubMed |
description | Since their first appearance in the context of schizophrenia and bipolar disorder in 2009, polygenic risk scores (PRSs) have been described for a large number of common complex diseases. However, the clinical utility of PRSs in disease risk assessment or therapeutic decision making is likely limited because PRSs usually only account for the heritable component of a trait and ignore the etiological role of environment and lifestyle. We surveyed the current state of PRSs for various diseases, including breast cancer, diabetes, prostate cancer, coronary artery disease, and Parkinson disease, with an extra focus upon the potential improvement of clinical scores by their combination with PRSs. We observed that the diagnostic and prognostic performance of PRSs alone is consistently low, as expected. Moreover, combining a PRS with a clinical score at best led to moderate improvement of the power of either risk marker. Despite the large number of PRSs reported in the scientific literature, prospective studies of their clinical utility, particularly of the PRS-associated improvement of standard screening or therapeutic procedures, are still rare. In conclusion, the benefit to individual patients or the health care system in general of PRS-based extensions of existing diagnostic or treatment regimens is still difficult to judge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12687-023-00645-z. |
format | Online Article Text |
id | pubmed-10576695 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-105766952023-10-16 Clinical utility of polygenic risk scores: a critical 2023 appraisal Koch, Sebastian Schmidtke, Jörg Krawczak, Michael Caliebe, Amke J Community Genet Research Since their first appearance in the context of schizophrenia and bipolar disorder in 2009, polygenic risk scores (PRSs) have been described for a large number of common complex diseases. However, the clinical utility of PRSs in disease risk assessment or therapeutic decision making is likely limited because PRSs usually only account for the heritable component of a trait and ignore the etiological role of environment and lifestyle. We surveyed the current state of PRSs for various diseases, including breast cancer, diabetes, prostate cancer, coronary artery disease, and Parkinson disease, with an extra focus upon the potential improvement of clinical scores by their combination with PRSs. We observed that the diagnostic and prognostic performance of PRSs alone is consistently low, as expected. Moreover, combining a PRS with a clinical score at best led to moderate improvement of the power of either risk marker. Despite the large number of PRSs reported in the scientific literature, prospective studies of their clinical utility, particularly of the PRS-associated improvement of standard screening or therapeutic procedures, are still rare. In conclusion, the benefit to individual patients or the health care system in general of PRS-based extensions of existing diagnostic or treatment regimens is still difficult to judge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12687-023-00645-z. Springer Berlin Heidelberg 2023-05-03 2023-10 /pmc/articles/PMC10576695/ /pubmed/37133683 http://dx.doi.org/10.1007/s12687-023-00645-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Koch, Sebastian Schmidtke, Jörg Krawczak, Michael Caliebe, Amke Clinical utility of polygenic risk scores: a critical 2023 appraisal |
title | Clinical utility of polygenic risk scores: a critical 2023 appraisal |
title_full | Clinical utility of polygenic risk scores: a critical 2023 appraisal |
title_fullStr | Clinical utility of polygenic risk scores: a critical 2023 appraisal |
title_full_unstemmed | Clinical utility of polygenic risk scores: a critical 2023 appraisal |
title_short | Clinical utility of polygenic risk scores: a critical 2023 appraisal |
title_sort | clinical utility of polygenic risk scores: a critical 2023 appraisal |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576695/ https://www.ncbi.nlm.nih.gov/pubmed/37133683 http://dx.doi.org/10.1007/s12687-023-00645-z |
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