Utility and Evaluation of MeTree on Family Health History Collection in Sri Lanka

Abstract

Introduction: Information about family history of illness is increasingly important to ensure each patient receive optimal promotion advice, preventive health services and appropriate treatment. MeTree is a web-based tool used to collect family health history directly from participants through a website. Despite growing evidence regarding the importance and efficacy of using family history, and the need for healthcare providers to have family history triage tools for personalized healthcare delivery, tools like MeTree have not been broadly applied in clinical practice. Little is known about its utility in settings with different disease profiles, health care systems and traditions and different cultural and socioeconomic contexts.

Methods: This study enrolled 304 medical students from the University of Ruhuna in Sri Lanka. Participants constructed family pedigree and entered family health history in MeTree with the help of the researcher and a local research assistant. Once participants had created a full family pedigree, they were asked to complete a paper-based questionnaire asking about their experience with MeTree and what perceived to be the benefits of MeTree.

Results: The proportion of males and females were relatively similar, 52.6% and 47.4%, respectively. Family health histories were entered for 3352 relatives in total. All diseases were divided into 21 groups. Diabetes was the most common disease group reported and accounted for 24.58% of all diseases reported. The following two most frequent diseases were hypertension (14.51%) and cardiovascular diseases

(12.06%). Relatives had much higher numbers of all disease groups compared to index participants. Prevalence for each disease was different between index participants and the relatives. Hypertension was present in at least one or more family members in 65.13% of all pedigrees. On average, 29.92% of relatives in each family have diabetes. The mean time to complete entering information into MeTree was 36.3 minutes. The overall feelings and satisfaction level towards MeTree were favorable. Over 90% of participants indicated that MeTree could be generalized in the context of Sri Lanka. Results from t-test at the significance level of 5% didn’t indicate any significant preference for completion time used by males (M = 35.51, SD = 11.47) over completion time used by females (M = 37.04, SD =11.04), t = 0.65, p = 0.5177. A significant effect of grade on completion time wasn’t observed at the p< 0.05 level in the ANOVA procedure either, for the three conditions F (3, 83) = 1.80, p = 0.1539. According to the correlation procedure, completion time and age were not correlated (r = 0.2129, p = 0.13182). Among all questions in the questionnaire, significant difference was only observed between males and females for reported awareness (p=0.0184) and knowledge (p<0.0001) change after being introduced to MeTree.

Conclusions: Most medical students found it easy to use MeTree and considered it a useful experience. The majority of the students thought it possible to generalize MeTree in the context of Sri Lanka, while barriers still needs to be overcome to have a web-based tool like MeTree put into real practice in Sri Lanka.