health & wellness

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Local doctor named national organization president, discusses new technology.

Ruthan Brodsky
Contributing
Writer
I

According to Feldman, testing for genetic
disorders is evolving primarily because of
two major changes. First, it is becoming
edical genetics is a changing field
more difficult in an increasingly pan-ethnic
because of new technology and
society to identify a single ethnicity, such as
Gerald Feldman, M.D., Ph.D., a
Ashkenazic Jews whose members may no
professor of molecular medicine and genet-
longer be 100 percent of Ashkenazic decent.
ics, pathology and pediatrics at Wayne State
Fortunately, technology has evolved so that
University School of Medicine, is on top of
screening can now take place for genetic dis-
those changes.
orders independent of ethnicity.
He was recently elected president of the
As a result, many laboratories offer an
American College of Medical Genetics and
expanded carrier screening panel that tests
Genomics (ACMG), the
for up to 100 or more genetic
national professional organi-
disorders, including these
zation for clinical and labora-
original 19 genetic disorders
tory genetics professionals
common to Ashkenazic Jews
committed to the practice of
that have been listed for some
medical genetics.
time. However, insurance
Medical Genetics is a clini-
coverage for genetic screening
cal discipline and a member
varies with individual policies;
of the American Board of
there may or may not be cost
Medical Specialties with its
coverage.
own board certification and
"A second change is that
training program. As ACMG
as a result of the improved
president, Feldman's goals
technology, companies with
are to lead the organization
expanded carrier screening
Dr. Gerald Fel dman
by supporting its efforts to
panels are marketing their ser-
educate its membership and
vices directly to consumers:'
patients, to help resolve issues that relate
Feldman says. "These commercial screening
to clinical and laboratory practice, and to
procedures demonstrate both promise and
promote advocacy at local, state and national challenges.
levels.
"Early screening for genetic disorders
He explained how technology is impacting is important because health risks increase
detection of genetic diseases related to eth-
when patients are born with a genetic
nicity, particularly for Jews.
disease, and diagnosis and treatment are
"The Jewish Ashkenazic population has
delayed:' he says. "At the same time, patients
a history of genetic carrier screening begin-
need to be well informed and need to under-
ning in the 1970s when testing for Tay-Sachs stand what they're being tested for, which
disease took place," says Feldman, also medi- means receiving genetic counseling to go
cal director of the Division of Laboratory
along with the diagnosis and treatment. The
Genetics and Molecular Pathology at
concern is that commercial labs are often
the Detroit Medical Center-University
limited in their ability to provide this service.
Laboratories. its a result, the incidence
"JScreen, for example, an at-home car-
of Tay-Sachs was reduced by 90 percent
rier screening program for Jewish genetic
over the years. Based on the success of that
diseases, has a different approach to its
model, additional diseases that occur more
direct genetic screening service to consum-
frequently in the Ashkenazic population, but ers," Feldman says. "Their program includes
not exclusive to that ethnic group, were also
steps such as receiving approval for testing
selected for genetic screening. Today that
and continued contact with their primary
primary group numbers about 19 genetic
care doctor, using the laboratory at Emory
disorders:'
University in Atlanta for testing, and requir-

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May 7 • 2015

JN

ing that both patients and their primary care
physician receive their screening results.
"JScreen does increase screening options
for patients, but there needs to be long-term
studies to know how this information is
being used by the patients along with their
long-term understanding of the genetic
information being provided:"
Feldman, who lives in West Bloomfield
and is a member of Congregation B'nai
Moshe, says these technologies cultivate
changes in the way physicians practice medi-
cine so they need to have a better under-
standings of how genetics affects different
diseases.
"It's important that we appropriately use
the new available technologies so that the
patient understands what the test means," he
says. "We also need to educate clinicians and
laboratories on the use of expanded carrier
screening tests.
"For instance, the ACMG was one of the
co-authors of a recent document that pro-
vided a summary of the important points a
physician should consider when discussing
expanded carrier screening with patients
because these tests offer testing for many
more conditions than currently recommend-
ed by professional organizations. A referral
for a genetics consultation with a board-
certified clinical geneticist should always be
recommended when appropriate:'
Members of ACMG represent the lead-
ers in the medical genetic areas relating to
diagnosis, treatment and management of
genetic disorders. Physicians throughout the
U.S. and in other countries, including several
Israeli physicians, are trained in the U.S. and
then return to their home country to practice
medicine. WSU and the Detroit Medical
Center are often involved in the training.
"One of the great advantages of being
president of an organization like ACMG
is that it gives Wayne State University, the
Detroit Medical Center and the city itself
more national recognition for the outstand-
ing medical genetics services available here,"
Feldman says. "It also offers opportunities
to collaborate with other geneticists, both
locally and nationally, all with the purpose of
improving patient care

❑

JScreen Offers
In-home Testing

JScreen is a nonprofit public health
program based at Emory University's
School of Medicine in Atlanta. It is
screening program that takes place
at home, allowing individuals and
couples to screen for more than
80 genetic diseases,19 of which
are predominant in the Ashkenazic
Jewish commu-
nity.
Its purpose is
to help prospec-
tive parents
learn about
possible risk for
passing genetic
disorders to
their children and also offers educa-
tion and counseling to help people
understand their results.
Testing is performed by a certified
laboratory and results are reviewed
and reported to participants by
genetic counselors. Doctors and
genetic counselors are involved
throughout the process as opposed
to direct-to-consumer testing where
patients receive their results direct-
ly.
As an online carrier screen pro-
gram, JScreen allows people to
request kits, learn about hereditary
diseases and speak to genetic coun-
selors.
JScreen genetic testing includes a
panel of 40 diseases common in the
Ashkenazic, Sephardic or Mizrahi
Jewish populations. There is also a
panel of more than 80 diseases that
includes 40 Jewish genetic diseases
and others common in the general
population.
Go to www.jscreen.org for more
information.

J Screen

