Your Disease Risk

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Your Disease Risk is a publicly available health risk assessment tool on the Internet. [1] Launched in early 2000 and continually updated, the site offers risk assessments for twelve different cancers and four other important chronic diseases: heart disease, stroke, diabetes, and osteoporosis.

Contents

The site began in 1998 as a pen and paper questionnaire called the Harvard Cancer Risk Index. [2] In January 2000, The Harvard Cancer Risk Index developed into an online assessment and was renamed Your Cancer Risk, and offered assessments for four cancers: breast, colon, lung, and prostate. Six months later, eight additional cancers were added. [3]

In 2004, the site was renamed Your Disease Risk to reflect the addition of four further conditions: heart disease, stroke, diabetes, and osteoporosis. Since many common chronic diseases share risk factors, the renaming promoted the importance of a healthy lifestyle to lowering disease risks.

In 2007, the site moved to the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

In 2012, researchers released a related iPad app, called Zuum, that offers customized advice for healthier living based on an individual's diet, exercise and other habits. [4]

In December 2018, the site was re-designed to work across multiple screen sizes - from smartphone to desktop - and a new "Snapshot" tool was added, which provides a quick estimate of 6 diseases from one brief questionnaire.

User experience

Your Disease Risk has a simple, straightforward interface. Questionnaires can be completed in a matter of minutes, and for each disease, the site offers both a visual and verbal risk estimate as well as personalized tips for prevention. The site can also show users what their risk could be should they adopt various healthy behaviors. Tailored screening tips and recommendations for making health changes in communities are also part of site results.

Methodology

The calculations and algorithms used to calculate and display risk estimates in Your Disease Risk are the product of an ongoing process of expert consensus. [2] Epidemiologists, clinicians, and other health specialists regularly review the current scientific evidence for each disease, identifying established and probable risk factors for each. This information is then used to develop or revise calculations that generate a user's risk of disease compared to average risk in the population for someone of the same age and sex.

A validation study found Your Disease Risk to provide well calibrated estimates [5] of cancer risk in the general population. For individual women, the discriminatory accuracy [5] for colon cancer was 0.67, for ovarian cancer 0.59, and for pancreatic cancer was 0.71. For individual men, the discriminatory accuracy [5] for colon cancer was 0.71 and for pancreatic cancer was 0.72. These values exceed the performance of many other cancer risk prediction tools. [6] [7]

The approach used to calculate cancer risks in Your Disease. Risk is also used to calculate the risks of the other diseases. [8] Validation studies for these non-cancer estimates are ongoing. [9]

Awards and media

A winner of the eHealthcare Leadership Award, [10] Your Disease Risk has also been the topic of articles in major media outlets. [11] [12] [13] [14]

Related Research Articles

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Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone sterility, and consequent increase in fracture risk. It is the most common reason for a broken bone among the elderly. Bones that commonly break include the vertebrae in the spine, the bones of the forearm, the wrist, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. After the broken bone heals, the person may have chronic pain and a decreased ability to carry out normal activities.

<span class="mw-page-title-main">Cardiovascular disease</span> Class of diseases that involve the heart or blood vessels

Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases, stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, abnormal heart rhythms, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.

<span class="mw-page-title-main">Preventive healthcare</span> Prevent and minimize the occurrence of diseases

Preventive healthcare, or prophylaxis is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

<span class="mw-page-title-main">Women's Health Initiative</span> Long-term U.S. health study

The Women's Health Initiative (WHI) was a series of clinical studies initiated by the U.S. National Institutes of Health (NIH) in 1991, to address major health issues causing morbidity and mortality in postmenopausal women. It consisted of three clinical trials (CT) and an observational study (OS). In particular, randomized controlled trials were designed and funded that addressed cardiovascular disease, cancer, and osteoporosis.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Zoledronic acid</span> Chemical compound

Zoledronic acid, also known as zoledronate and sold under the brand name Zometa by Novartis among others, is a medication used to treat a number of bone diseases. These include osteoporosis, high blood calcium due to cancer, bone breakdown due to cancer, Paget's disease of bone and Duchenne muscular dystrophy (DMD). It is given by injection into a vein.

<span class="mw-page-title-main">Osteopenia</span> Medical condition

Osteopenia, known as "low bone mass" or "low bone density", is a condition in which bone mineral density is low. Because their bones are weaker, people with osteopenia may have a higher risk of fractures, and some people may go on to develop osteoporosis. In 2010, 43 million older adults in the US had osteopenia. Unlike osteoporosis, osteopenia does not usually cause symptoms, and losing bone density in itself does not cause pain.

The Nurses' Health Study is a series of prospective studies that examine epidemiology and the long-term effects of nutrition, hormones, environment, and nurses' work-life on health and disease development. The studies have been among the largest investigations into risk factors for major chronic diseases ever conducted. The Nurses' Health Studies have led to many insights on health and well-being, including cancer prevention, cardiovascular disease, and type 2 diabetes. They have included clinicians, epidemiologists, and statisticians at the Channing Laboratory, Harvard Medical School, Harvard School of Public Health, and several Harvard-affiliated hospitals, including Brigham and Women's Hospital, Dana–Farber Cancer Institute, Children's Hospital Boston, and Beth Israel Deaconess Medical Center.

<span class="mw-page-title-main">Alkaline diet (alternative medicine)</span> Fad diet

Alkaline diet describes a group of loosely related diets based on the misconception that different types of food can have an effect on the pH balance of the body. It originated from the acid ash hypothesis, which primarily related to osteoporosis research. Proponents of the diet believe that certain foods can affect the acidity (pH) of the body and that the change in pH can therefore be used to treat or prevent disease. However, their claims are false, and there is no evidence supporting the claimed mechanisms of this diet, which is not recommended by dietitians or other health professionals.

<span class="mw-page-title-main">Bone density</span> Amount of bone mineral in bone tissue

Bone density, or bone mineral density, is the amount of bone mineral in bone tissue. The concept is of mass of mineral per volume of bone, although clinically it is measured by proxy according to optical density per square centimetre of bone surface upon imaging. Bone density measurement is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk. It is measured by a procedure called densitometry, often performed in the radiology or nuclear medicine departments of hospitals or clinics. The measurement is painless and non-invasive and involves low radiation exposure. Measurements are most commonly made over the lumbar spine and over the upper part of the hip. The forearm may be scanned if the hip and lumbar spine are not accessible.

Senile osteoporosis has been recently recognized as a geriatric syndrome with a particular pathophysiology. There are different classification of osteoporosis: primary, in which bone loss is a result of aging and secondary, in which bone loss occurs from various clinical and lifestyle factors. Primary, or involuntary osteoporosis, can further be classified into Type I or Type II. Type I refers to postmenopausal osteoporosis and is caused by the deficiency of estrogen. While senile osteoporosis is categorized as an involuntary, Type II, and primary osteoporosis, which affects both men and women over the age of 70 years. It is accompanied by vitamin D deficiency, body's failure to absorb calcium, and increased parathyroid hormone.

<span class="mw-page-title-main">Frailty syndrome</span> Weakness in elderly person

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Graham Andrew Colditz MD, DrPH is an Australian chronic disease epidemiologist. He is the inaugural Niess-Gain Professor at Washington University School of Medicine, where he is associate director for Prevention and Control at the Alvin J. Siteman Cancer Center. He directs the Master of Population Health Science at Washington University School of Medicine. During medical training he was excited by the potential for prevention of chronic diseases. With encouragement from mentors he pursued training in the US as it was routine for academics in Australia to obtain overseas training at that time. He is internationally recognized for leadership in cancer prevention, and is often interviewed by media for input on this topic. With members of Cancer Prevention and Control at Siteman, he blogs on issues relating to cancer prevention and screening. According to Google Scholar statistics, Colditz has a h-index of more than 300.

Food frequency questionnaire (FFQ) is a dietary assessment tool delivered as a questionnaire to estimate frequency and, in some cases, portion size information about food and beverage consumption over a specified period of time, typically the past month, three months, or year. FFQs are a common dietary assessment tool used in large epidemiologic studies of nutrition and health. Examples of usage include assessment of intake of vitamins and other nutrients, assessment of the intake of toxins, and estimating the prevalence of dietary patterns such as vegetarianism.

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<span class="mw-page-title-main">Africa/Harvard School of Public Health Partnership for Cohort Research and Training</span>

The Africa/Harvard School of Public Health Partnership for Cohort Research and Training launched in 2008, is a collaborative research project led by Principal Investigators, Dr. Hans-Olov Adami and Dr. Michelle D. Holmes. Together with research scientists, Dr. Shona Dalal and Dr. Todd G. Reid, this team represents the Harvard Coordinating Site of the Partnership with colleagues from five institutions in Nigeria, South Africa, Tanzania, and Uganda. The Africa/HSPH PaCT project plans on investigating the association of lifestyle factors and chronic disease risk in sub- Saharan Africa, through a large epidemiological cohort study that will include approximately 500,000 participants. Africa/HSPH PaCT is the first and largest cohort study conducted in sub-saharan Africa to employ mobile phone technology to follow participants and collect data. Africa/HSPH PaCT will also provide the infrastructure for capacity-building and for training a new generation of health professionals.

QRISK3 is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.

<span class="mw-page-title-main">Polygenic score</span> Numerical score aimed at predicting a trait based on variation in multiple genetic loci

In genetics, a polygenic score (PGS), also called a polygenic index (PGI), polygenic risk score (PRS), genetic risk score, or genome-wide score, is a number that summarizes the estimated effect of many genetic variants on an individual's phenotype, typically calculated as a weighted sum of trait-associated alleles. It reflects an individual's estimated genetic predisposition for a given trait and can be used as a predictor for that trait. In other words, it gives an estimate of how likely an individual is to have a given trait only based on genetics, without taking environmental factors into account. Polygenic scores are widely used in animal breeding and plant breeding due to their efficacy in improving livestock breeding and crops. In humans, polygenic scores are typically generated from genome-wide association study (GWAS) data.

<span class="mw-page-title-main">Radiofrequency Echographic Multi Spectrometry</span> Medical diagnostic

Radiofrequency Echographic Multi Spectrometry (REMS) is a non-ionizing technology for osteoporosis diagnosis and for fracture risk assessment. REMS processes the raw, unfiltered ultrasound signals acquired during an echographic scan of the axial sites, femur and spine. The analysis is performed in the frequency domain. Bone mineral density (BMD) is estimated by comparing the results against reference models.

References

  1. Crocker, Melissa K. (January 26, 2000). "SPH Web Site Predicts Cancer Risk". The Harvard Crimson.
  2. 1 2 Colditz GA, Atwood KA, Emmons K, et al. (July 2000). "Harvard report on cancer prevention volume 4: Harvard Cancer Risk Index. Risk Index Working Group, Harvard Center for Cancer Prevention" (PDF). Cancer Causes Control. 11 (6): 477–88. doi:10.1023/A:1008984432272. PMID   10880030.
  3. Voelker R (July 2000). "Quick uptakes: online risk assessment expands". JAMA. 284 (4): 430–b–430. doi:10.1001/jama.284.4.430-b. PMID   10904490.
  4. Moore, Elizabeth Armstrong. "Free iPad app guesses your risk for common diseases". CNET. Retrieved January 11, 2013.
  5. 1 2 3 Kim DJ, Rockhill B, Colditz GA (April 2004). "Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk". J Clin Epidemiol. 57 (4): 332–40. doi:10.1016/j.jclinepi.2003.08.013. PMID   15135833.
  6. Rockhill B, Spiegelman D, Byrne C, Hunter DJ, Colditz GA (March 2001). "Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention". J. Natl. Cancer Inst. 93 (5): 358–66. doi: 10.1093/jnci/93.5.358 . PMID   11238697.
  7. Park Y, Freedman AN, Gail MH, et al. (February 2009). "Validation of a colorectal cancer risk prediction model among white patients age 50 years and older". J. Clin. Oncol. 27 (5): 694–8. doi:10.1200/JCO.2008.17.4813. PMC   2645089 . PMID   19114700.
  8. "About This Site". Your Disease Risk. 2009.
  9. Colditz, G. Personal Communication. 2009.
  10. "Best Interactive Site 2008 eHealth Leadership Awards". Strategic Health Care Communications.
  11. Parker-Pope, T. (October 31, 2006). "Website Tallies Your Risk of Disease and Tells You What You Can Do About It". Wall Street Journal.
  12. "Favorite Health Resources". New York Times. September 29, 2008.
  13. Revill, Jo (July 4, 2004). "Harvard can now assess your health risks via the internet". The Guardian.
  14. "Health: Finding a Diagnosis". U.S. News & World Report. November 12, 2006.