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Objetivo. Comparar la capacidad predictiva del modelo predictivo BRCAPro y de los profesionales de enfermería con distintos niveles de formación/experiencia en la identificación de familias susceptibles de ser estudiadas genéticamente dada su historia personal y familiar de cáncer de mama. Método. Estudio descriptivo en el que 2 enfermeras con diferente grado de formación en consejo genético han estimado la probabilidad de ser portador de mutación en los genes BRCA1/BRCA2 de 157 familias. Se calculó la sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN) de ambas enfermeras y del BRCAPro. Resultados. La enfermera con menor experiencia demostró mayor especificidad (N2:0,84) frente a la enfermera con mayor experiencia (N1:0,23) o a BRCAPro (0,47). La sensibilidad de las profesionales de enfermería fue de 0,95 (N1) y del 0,28 (N2), mientras que la de BRCAPro fue del 0,74. El VPP fue similar en las tres situaciones. El VPN de la enfermera con mayor experiencia (0,93) fue superior al de BRCAPro (0,85) y la enfermera con menor experiencia (0,72). Conclusiones. La experiencia clínica aporta una alta sensibilidad pero a costa de una pérdida significativa de especificidad. El modelo de predicción BRCAPro obtiene valores intermedios entre ambas enfermeras, por lo que podría ser una herramienta que ayudase a mejorar aquellos valores en los que se obtiene menor puntuación, es decir, la especificidad y VPP para enfermeras con mayor experiencia y la sensibilidad y VPN para aquellas con menor experiencia (AU)

Objective. To compare the predictive skills of the BRCAPro predictive model and nurses with different training/experience levels in identifying families with a personal and family history of breast cancer as likely candidates to being studied genetically. Method. Descriptive study in which 2 nurses with different levels of training in genetic counselling have estimated the probability of being carrier of a mutation in the BRCA1/BRCA2 genes of 157 families. The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of both nurses and the BRCAPro model were calculated. Results. The nurse with less experience demonstrated more specificity (N2:0.84) compared to the nurse with more experience (N1:0.23) and to BRCAPro model (0.47). The sensitivity of the nurses was 0.95 (N1) and 0.28 (N2), whereas that of BRCAPro was 0.74. The PPV was similar in the three cases. The NPV of the nurse with more experience (0.93) was higher than that of BRCAPro model (0.85) and the nurse with less experience (0.72). Conclusions. Clinical experience contributes to obtaining a high sensitivity, but with a significant decrease of specificity. The BRCAPro predictive model obtains intermediate values between both nurses. The BRCAPro predictive model could be a useful tool to help improve those values with lower scores, that is, the specificity and PPV for nurses with more experience and the sensitivity and NPV for those with less experience (AU)

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RESUMEN

OBJECTIVE: To compare the predictive skills of the BRCAPro predictive model and nurses with different training/experience levels in identifying families with a personal and family history of breast cancer as likely candidates to being studied genetically. METHOD: Descriptive study in which 2 nurses with different levels of training in genetic counselling have estimated the probability of being carrier of a mutation in the BRCA1/BRCA2 genes of 157 families. The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of both nurses and the BRCAPro model were calculated. RESULTS: The nurse with less experience demonstrated more specificity (N2:0.84) compared to the nurse with more experience (N1:0.23) and to BRCAPro model (0.47). The sensitivity of the nurses was 0.95 (N1) and 0.28 (N2), whereas that of BRCAPro was 0.74. The PPV was similar in the three cases. The NPV of the nurse with more experience (0.93) was higher than that of BRCAPro model (0.85) and the nurse with less experience (0.72). CONCLUSIONS: Clinical experience contributes to obtaining a high sensitivity, but with a significant decrease of specificity. The BRCAPro predictive model obtains intermediate values between both nurses. The BRCAPro predictive model could be a useful tool to help improve those values with lower scores, that is, the specificity and PPV for nurses with more experience and the sensitivity and NPV for those with less experience.

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