Utility of a virtual counselor (VICKY) to collect family health histories among vulnerable patient populations: A randomized controlled trial.

The trial was conducted at Boston Medical Center, a safety-net hospital, and enrolled mostly African American or Hispanic/Latino participants with possible or high likelihood of limited literacy, so it may not apply to other populations. The Spanish-language version of My Family Health Portrait became unavailable soon after enrollment, so a small number of Spanish-speaking participants were included. Health literacy interactions could not be tested for less prevalent conditions, including approximately half of the conditions examined, because of insufficient power. Genetic counselors did not always ask about all scripted conditions, so the professional standard used for comparison was imperfect. The study compared counts of relatives and conditions, not whether the same individuals were identified or whether pedigrees could determine inheritance patterns. Differences in concordance were largely explained by whether participants could enter family members; when first-degree relative counts matched, most condition differences were no longer significant.

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Do not conclude VICKY is a better clinical family history tool for all patients. Much of the apparent advantage came from more participants being able to finish the tool; when first-degree relative counts matched between tool and genetic counselor, most condition differences were no longer significant.