Established Risk Assessment Research Articles

Soil fatigue hazard screening analyses framework for spacio-temporally clustered induced seismicity with examples of damage potential due to liquefaction

Current studies that focus solely on the cause of the increase in seismicity neglect to include considerations for effects of small magnitude cluster events on federal infrastructure. These effects can be almost undetectable at first, but if left unchecked can evolve into a larger issue. The need to reassess and potentially modify the established risk assessment practices for evaluations of federal infrastructure needs to be reviewed to ensure the continued ability of the structure to function as intended. The U.S. Army Corps of Engineers (USACE) is responsible for hydroelectric power, flood protection, recreational areas, navigational channels and water supply along the waterways that were either constructed prior to seismic design requirements or designed to a lower seismic level than current seismic activity. The need to establish revised evaluation methods of critical infrastructure has become very apparent to ensure that risk assessments include the stability of these systems and the safety of those that depend on them.

Driving with cardiac devices in Australia. Does a review of recent evidence prompt a change in guidelines?

Australian Driving Guidelines for patients with pacemakers and implanted cardioverter defibrillators are in line with many around the world, with some minor differences. Some aspects of these guidelines lack contemporary evidence in key decision-making areas and make broad recommendations regarding groups with heterogeneous populations. In addition, more recent studies suggest lower rates of adverse events in some patients with these devices than previously thought. Through a systematic literature review, along with discussion of current guidelines, we combine new evidence with well established risk assessment tools to ask the following questions: (i) Given the heterogeneity of patient risk within the defibrillator population, should guidelines allow for further individualisation of risk and subsequent licensing restrictions?; and (ii) Could some patients with primary prevention automated cardioverter defibrillators be able to hold a commercial driving licence?

The impact of coastal flooding on agriculture: A case‐study of Lincolnshire, United Kingdom

AbstractUnder future climate predictions, the incidence of coastal flooding is set to rise. Many coastal regions at risk, such as those surrounding the North Sea, comprise large areas of low‐lying and productive agricultural land. Flood risk assessments typically emphasise the economic consequences of coastal flooding on urban areas and national infrastructure. Impacts on agricultural land have seen less attention, and considerations tend to omit the long‐term effects of soil salinity. The aim of this study is to develop a universal framework to evaluate the economic impact of coastal flooding to agriculture. We incorporated existing flood models, satellite acquired crop data, soil salinity, and crop sensitivity to give a novel and detailed assessment of salt damage to agricultural productivity over time. We focussed our case‐study on low‐lying, highly productive agricultural land with a history of flooding in Lincolnshire, UK. The potential impact of agricultural flood damage varied across our study region. Assuming typical cropping does not change postflood financial losses range from £1,366/ha to £5,526/ha per inundation, these losses would be reduced by between 35% up to 85% in the likely event that an alternative, more salt‐tolerant, cropping, regime is implemented postflood. These losses are substantially higher than loses calculated on the same areas using established flood risk assessment framework conventionally used for freshwater flood assessments, with differences attributed to our longer term salt damage projections impacting over several years. This suggests flood protection policy needs to consider local and long‐term impacts of flooding on agricultural land.

Primary Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) Patients

The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community is a vulnerable populace that accounts for 4.5% of the United States population. Unfortunately, this group of individuals faces discrimination. They need access to quality, prejudice-free health care. This article initiates the discussion of how nurse practitioners, primary care, and family practice providers can provide inclusive, unbiased, quality care to this community that is evidence based. Information is provided about common barriers preventing this population from receiving equitable care. Evidence-based methods are outlined for screening this population for common health conditions, paying particular attention to an established HIV risk assessment and its application in clinical settings to identify candidates for pre-exposure prophylaxis. Finally, pharmacologic information about preexposure prophylaxis and transgender hormone therapy is presented. The information presented prepares nurse practitioners to begin caring for this population.

Mortality attributable to sugar sweetened beverages consumption in Mexico: an update.

In 2010, sugar sweetened beverages (SSBs) were estimated to cause 12% of all diabetes, cardiovascular disease (CVD) and obesity-related cancer deaths in Mexico. Using new risk estimates for SSBs consumption, we aimed to update the fraction of Mexican mortality attributable to SSBs, and provide subnational estimates by region, age, and sex. We used an established comparative risk assessment framework. All-cause mortality estimates were calculated from a recent pooled cohort analysis. Age- and sex-specific relative risks for SSBs-disease relationships were obtained from updated meta-analyses. Demographics and nationally representative estimates of SSBs intake were derived from the National Health and Nutrition Survey 2012; and mortality rates, from the National Institute of Statistics and Geography. Attributable mortality was calculated by estimating the population attributable fraction of each disease, with uncertainty in data inputs propagated through Monte Carlo probabilistic sensitivity analyses. In Mexican adults 20 years and older, 6.9% (95%UI: 5.4-8.5) of all cause-mortality was attributable to SSBs, representing 40,842 excess deaths/year (95%UI: 31,950-50,138). Furthermore, 19% of diabetes, CVD and obesity-related cancer mortality was attributable to SSBs (95%UI: 11.0-26.5), representing 37,000 excess deaths/year (95%UI 21,240-51,045). Of these, 35.6% were diabetes-related (95%UI 16.4-52.0). Proportional burden was highest in the South (22.8%), followed by the Center (18.0%) and North (17.4%). Men aged 45-64-years in the Center region had highest proportional mortality (37.2%), followed by 20-44-year-old men living in the South (35.7%) and both men and women aged 20-44 living in the Center (34.4%). Utilizing current evidence linking SSBs to cardiometabolic disease and obesity-related cancers, earlier estimates of Mexican mortality attributable to SSBs could have been underestimated. Mexico urgently needs stronger policies to reduce SSBs consumption and reduce these burdens.

A Risk Assessment Model of Coalbed Methane Development Based on the Matter-Element Extension Method

Coalbed methane development represents a complex system engineering operation that involves complex technology, many links, long cycles, and various risks. If risks are not controlled in a timely and effective manner, project operators may easily cause different levels of casualties, resource waste and property loss. To evaluate the risk status of coalbed methane development projects, this paper constructs a coalbed methane development risk assessment index system that consists of six first grade indexes and 45 second grade indexes. The weight of each index is calculated based on the structure entropy weight method. Then, a theoretical model for risk assessments of coalbed methane development is established based on the matter-element extension method. Finally, the model is applied to analyze a coalbed methane development project in the southern Qinshui Basin of China. The results show that the overall risk level of the coalbed methane development project is Grade II, indicating that the overall risk of the project is small, but the local risk of the project needs to be rectified in time. The assessment results are consistent with the actual operation of the project, indicating that the established risk assessment model has good applicability and effectiveness.

What does radiation biology tell us about potential health effects at low dose and low dose rates?

The health risks to humans exposed to low dose and low dose rate ionising radiation remain ambiguous and are the subject of debate. The need to establish risk assessment standards based on the mechanisms underlying low dose/low fluence radiation exposures has been recognised by scholarly and regulatory bodies as critical for reducing the uncertainty in predicting adverse health risks of human exposure to low doses of radiation. Here, a brief review of laboratory-based evidence of molecular and biochemical changes induced by low doses and low dose rates of radiation is presented. In particular, two phenomena, namely bystander effects and adaptive responses that may impact low-level radiation health risks, are discussed together with the need for further studies. The expansion of this knowledge by considering the important variables that affect the radiation response (e.g. genetic susceptibility, time after exposure), and using the latest advances in experimental models and bioinformatics tools, may guide epidemiological studies towards reducing the uncertainty in predicting the potential health hazards of exposure to low-dose radiation.

A Principled Approach to the Construction of Risk Assessment Categories: The Council of State Governments Justice Center Five-Level System.

Consistent risk category placement of criminal justice clients across instruments will improve the communication of risk. Efforts coordinated by the Council of State Governments (CSG) Justice Center led to the development of a principled (i.e., a system based on a given set of procedures) method of developing risk assessment levels. An established risk assessment instrument (Level of Service Inventory-Revised [LSI-R]) was used to assess the risk-level concordance of the CSG Justice Center Five-Level system. Specifically, concordance was assessed by matching the defining characteristics of the data set with its distribution qualities and by the level/category similarity between the observed reoffending base rate and the statistical probability of reoffending. Support for the CSG Justice Center Five-Level system was found through a probation data set (N = 24,936) having a greater proportion of offenders in the lower risk levels than a parole/community data set (N = 36,303). The statistical probabilities of reoffending in each CSG Justice Center system risk level had greater concordance to the observed Five-Level base rates than the base rates from the LSI-R original categories. The concordance evidence for the CSG Justice Center Five-Level system demonstrates the ability of this system to place clients in appropriate risk levels.

A quantitative risk assessment method for synthetic biology products in the environment

The need to prevent possible adverse environmental health impacts resulting from synthetic biology (SynBio) products is widely acknowledged in both the SynBio risk literature and the global regulatory community. To-date, however, discussions of potential risks of SynBio products have been largely speculative, and the limited attempts to characterize the risks of SynBio products have been non-uniform and entirely qualitative. As the SynBio discipline continues to accelerate and bring forth novel, highly-engineered life forms, a standardized risk assessment framework will become critical for ensuring that the environmental risks of these products are characterized in a consistent, reliable, and objective manner that incorporates all SynBio-unique risk factors. In their current forms, established risk assessment frameworks – including those that address traditional genetically modified organisms – fall short of the features required of this standard framework. To address this gap, we propose the Quantitative Risk Assessment Method for Synthetic Biology Products (QRA-SynBio) – an incremental build on established risk assessment methodologies that supplements traditional paradigms with the SynBio risk factors that are currently absent, and necessitates quantitative analysis for more transparent and objective risk characterizations. We demonstrate through a hypothetical case study that the proposed framework facilitates defensible quantification of the environmental risks of SynBio products in both foreseeable and hypothetical use scenarios. Additionally, we show how the quantitative nature of the proposed method can promote increased experimental investigation into the true likelihood of hazard and exposure parameters and highlight the most sensitive parameters where uncertainty should be reduced, ultimately leading to more targeted SynBio risk research and yielding more precise characterizations of risk.

Toxicogenomic analysis of publicly available transcriptomic data can predict food, drugs, and chemical-induced asthma.

Background: With the increasing incidence of asthma, more attention is focused on the diverse and complex nutritional and environmental triggers of asthma exacerbations. Currently, there are no established risk assessment tools to evaluate asthma triggering potentials of most of the nutritional and environmental triggers encountered by asthmatic patients.Purpose The objective of this study is to devise a reliable workflow, capable of estimating the toxicogenomic effect of such factors on key player genes in asthma pathogenesis.MethodsGene expression extracted from publicly available datasets of asthmatic bronchial epithelium were subjected to a comprehensive analysis of differential gene expression to identify significant genes involved in asthma development and progression. The identified genes were subjected to Gene Set Enrichment Analysis using a total of 31,826 gene sets related to chemical, toxins, and drugs to identify common agents that share similar asthma-related targets genes and signaling pathways.ResultsOur analysis identified 225 differentially expressed genes between severe asthmatic and healthy bronchial epithelium. Gene Set Enrichment Analysis of the identified genes showed that they are involved in response to toxic substances and organic cyclic compounds and are targeted by 41 specific diets, plants products, and plants related toxins (eg adenine, arachidonic acid, baicalein, caffeic acid, corilagin, curcumin, ellagic acid, luteolin, microcystin-RR, phytoestrogens, protoporphyrin IX, purpurogallin, rottlerin, and salazinic acid). Moreover, the identified chemicals share interesting inflammation-related pathways like NF-κB.ConclusionOur analysis was able to explain and predict the toxicity in terms of stimulating the differentially expressed genes between severe asthmatic and healthy epithelium. Such an approach can pave the way to generate a cost-effective and reliable source for asthma-specific toxigenic reports thus allowing the asthmatic patients, physicians, and medical researchers to be aware of the potential triggering factors with fatal consequences.

The Aachen Falls Prevention Scale: Multi-Study Evaluation and Comparison.

BackgroundFall risk assessment is a time-consuming and resource-intensive activity. Patient-driven self-assessment as a preventive measure might be a solution to reduce the number of patients undergoing a full clinical fall risk assessment.ObjectiveThe aim of this study was (1) to analyze test accuracy of the Aachen Falls Prevention Scale (AFPS) and (2) to compare these results with established fall risk assessment measures identified by a review of systematic reviews.MethodsSensitivity, specificity, and receiver operating curves (ROC) of the AFPS were calculated based on data retrieved from 2 independent studies using the AFPS. Comparison with established fall risk assessment measures was made by conducting a review of systematic reviews and corresponding meta-analysis. Electronic databases PubMed, Web of Science, and EMBASE were searched for systematic reviews and meta-analyses that reviewed fall risk assessment measures between the years 2000 and 2018. The review of systematic reviews was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. The Revised Assessment of Multiple SysTemAtic Reviews (R-AMSTAR) was used to assess the methodological quality of reviews. Sensitivity, specificity, and ROC were extracted from each review and compared with the calculated values of the AFPS.ResultsSensitivity, specificity, and ROC of the AFPS were evaluated based on 2 studies including a total of 259 older adults. Regarding the primary outcome of the AFPS subjective risk of falling, pooled sensitivity is 57.0% (95% CI 0.467-0.669) and specificity is 76.7% (95% CI 0.694-0.831). If 1 out of the 3 subscales of the AFPS is used to predict a fall risk, pooled sensitivity could be increased up to 90.0% (95% CI 0.824-0.951), whereas mean specificity thereby decreases to 50.0% (95% CI 0.42-0.58). A systematic review for fall risk assessment measures produced 1478 articles during the study period, with 771 coming from PubMed, 530 from Web of Science, and 177 from EMBASE. After eliminating doublets and assessing full text, 8 reviews met the inclusion criteria. All were of sufficient methodological quality (R-AMSTAR score ≥22). A total number of 9 functional or multifactorial fall risk assessment measures were extracted from identified reviews, including Timed Up and Go test, Berg Balance Scale, Performance-Oriented Mobility Assessment, St Thomas’s Risk Assessment Tool in Falling Elderly, and Hendrich II Fall Risk Model. Comparison of these measures with pooled sensitivity and specificity of the AFPS revealed a sufficient quality of the AFPS in terms of a patient-driven self-assessment tool.ConclusionsIt could be shown that the AFPS reaches a test accuracy comparable with that of the established methods in this initial investigation. However, it offers the advantage that the users can perform the self-assessment independently at home without involving trained health care professionals.

Clinical classification of fall risk using visually obtained information at a memory clinic

There are few studies concerning the classification of fall risk by nurses without established fall risk assessment tools. In the present study, clinical classification of fall risk using visually obtained information was compared with the assessment of fall risk in order to evaluate the rationale and validity of the clinical classification of fall risk by nurses. New patients who visited the center of comprehensive care and research for memory disorders at the National Center for Geriatrics and Gerontology were enrolled in the present study.Day-shift nurses separately recorded the clinical classification of fall risks through visually obtained information during the 10-minutes waiting time for outpatients.Fall risk assessments such as the Fall Risk Index and Timed Up & Go test, were performed by non-nurse medical staffs. Data were analyzed by an independent researcher who was not involved in obtaining clinical information. Nurse's clinical classification of fall risk using visually obtained information correlated well with Fall Risk Index, Timed Up & Go test, One-leg Standing test and Dorsiflex meter. In addition, subjects classified as having high fall risk were more frequently judged to be frail than classes of moderate or little fall-risk. Nurse's clinical classification of fall risk using visually obtained information was judged on their integrated impression including their evaluation of the muscle strength, gait speed and balance.

Research on Risk Assessment of Water Inrush Caused by Fault Activation Based on Unascertained Mathematics Theory

With increasing of mining depth, mining disasters become complex and serious. In deep coal mining, confined water inrush caused by fault activation has become an important constraint to safety and normal mining. This paper summarized influence factors to fault activation, and evaluated risk of water inrush based on unascertained mathematics theory. Main works and conclusions as followed. (1) Based on AHP theory, with analyzed influence factors to fault activation and water inrush, established risk assessment indicator system synthetically. (2) Established an unascertained risk assessment mathematical model to water inrush caused by fault activation, and determined classification standard of indicator, specific evaluation procedure, measure function of single indicator, and confidence criterion to risk. (3) With happened water inrush disaster and accident, tested and verified feasibility and reliability of assessment system and method. Finally, it is proved that risk assessment system based on unascertained mathematical theory can be used to evaluate confined water inrush caused by fault activation effectively.

DYNAMIC RISK ASSESSMENT METHOD AND APPLICATION OF LARGE DEFORMATION OF HIGH GROUND STRESS TUNNEL DURING CONSTRUCTION PERIOD

A simple and practical tunnel large deformation risk assessment method is of great value for disaster prevention and engineering applications. We applied the index scoring method to establish a dynamic risk assessment method for large deformation of high ground stress tunnels during construction. Then we established a risk assessment index system of large deformation, which includes three primary indicators consisted of geological factors, design factors and construction factors, and 18 secondary indicators such as rock strength and surrounding rock integrity. Statistical analysis was used to determine the weight of each index. Through the on-site scoring of each indicator, the risk probability level was determined according to the large deformation risk probability level standard. Then we used expert surveys to estimate direct economic losses, delays in construction, and determine severity level. Considering the possibility of risk occurrence and the severity of the loss, we used the risk matrix method to obtain the risk comprehensive level. Furthermore, we applied the established risk assessment method to the Miyaluo Tunnel No. 3 in the Wenma Expressway under construction. The evaluation results were consistent with the actual excavation results, which verified the effectiveness and practicability of the method. This risk assessment method provides a scientific basis for the prevention and control of large deformation during tunnel construction.

Risk Assessment Tools and Data-Driven Approaches for Predicting and Preventing Suicidal Behavior.

Risk assessment of suicidal behavior is a time-consuming but notoriously inaccurate activity for mental health services globally. In the last 50 years a large number of tools have been designed for suicide risk assessment, and tested in a wide variety of populations, but studies show that these tools suffer from low positive predictive values. More recently, advances in research fields such as machine learning and natural language processing applied on large datasets have shown promising results for health care, and may enable an important shift in advancing precision medicine. In this conceptual review, we discuss established risk assessment tools and examples of novel data-driven approaches that have been used for identification of suicidal behavior and risk. We provide a perspective on the strengths and weaknesses of these applications to mental health-related data, and suggest research directions to enable improvement in clinical practice.

Dissemination of resistance genes in duck/fish polyculture ponds in Guangdong Province: correlations between Cu and Zn and antibiotic resistance genes.

Duck/fish polyculture farming is a typical farming model in the Pearl River delta in southern China. We examined soil, water, and sediment samples from three duck-fish farms in Guangdong Province in September and December 2014. We determined the abundance of three metal resistance genes, 16S rDNA, and 23 antibiotic resistance genes encoding resistance to tetracycline, sulfonamides, quinolones, chloramphenicol, and β-lactamases. Microbial community structure was quantified by Illumina high-throughput sequencing of 16S rDNA genes. We found a prevalence of antibiotic resistance genes and the sul1, sul2, tetA, tetM, aac(6')-Ib, and floR genes were the most abundant. Levels of Cu and Zn were significantly correlated with numerous ARG types and sul2, floR, and tetM were identified as potential antibiotic resistance gene indicators. Cu levels were significantly and positively correlated with the relative abundance of sul3, tetT, tetW, qnrB, qnrS, fexB, sul1, sul2, tetM, and qnrA. Zn was significantly correlated to relative abundance of sul2, sul3, tetM, tetA, tetT, tetW, qnrA, qnrB, qnrS, aac(6')-Ib, qepA, blaSHV, cmlA, floR, fexA, cfr, and fexB. The levels of Acinetobacter, Brevibacillus, and Wautersiella showed significant positive correlations with metal resistance genes as well as qnrB, oqxA, oqxB, and blaSHV (p > 0.8). Sphingobacterium, Flavobacterium, Acidothermus, and Corynebacterium had significant correlations with abundance of tetracycline resistance genes, sulfonamide resistance genes, blaTEM, blaCTX, and cfr (p > 0.8). Sphingobacterium, Flavobacterium, Acidothermus, and Corynebacterium were most abundant in soil samples while Acinetobacter, Brevibacillus, and Wautersiella were most abundant in water samples. Dissemination of antibiotic resistance genes in aquaculture environments is extensive and tracing their origins is necessary to establish risk assessment methods required for aquatic environmental protection.

Geochemical baseline establishment, environmental impact and health risk assessment of vanadium in lake sediments, China

Lakes are essential water resources in China and their water quality is vital to the sustainability. However, the geochemical processes of trace elements, especially those of seldom-monitored trace elements, have not been adequately studied. Here, the regional geochemical baseline (RGB) of vanadium (V) was established using cumulative frequency and normalization methods. Then, the RGB was applied to quantitatively calculate the anthropogenic contribution rate in sediments of the Poyang Lake (PYL), which is the largest freshwater lake in China. The pollution level and ecological risk of V were evaluated using the geoaccumulation index (Igeo) and potential ecological risk index (EI) with respect to three different reference values, namely local soil background values (BV), the RGB, and the median value of V concentrations. The health risk of V accumulation in residents through fish consumption during sediment resuspension was assessed by combining the environmental impact assessment model and health risk assessment model. The mean concentration of V in PYL sediments was 94.37 mg/kg (33.80–148.53 mg/kg), which was slightly higher than the levels in stream sediments in China, but lower than the local BV. The calculated RGB was slightly higher than the average V content in PYL sediments, but similar to the local BV. The average anthropogenic contribution rate was calculated as 11.48%, demonstrating low anthropogenic influence. Moreover, the result of Igeo and EI showed that V in PYL sediments was uncontaminated and posed a low ecological risk. In addition, based on the calculation by the two models, the human health risk result (target hazard quotient <1) indicated that the average human health risk from fish consumption due to sediment resuspension was negligible.

Water Quality Pollutants and Health Risk assessment for Four Different Drinking Water Sources

Drinking water quality has become a great concern to the whole society, especially in heavily polluted rural areas. This paper analyzes the water quality of 100 water supping the US Environmental Protection Agency's (USEPA) recommended health risk assessment model. The results showed that the microbial indicators exceeded the standard in the whole year, and some of the water supply units which lead, nitrated and dissolved solids exceeding the standard. The model recommended by EPA is applied to establish risk assessment model for health risk assessment of adults in wet and dry seasons, respectively. Results of HRA indicated that carcinogenic risk of chromium was 7.61E-05a-1 and the risk value of arsenic was 9.92E-06a-1 which exceed the maximum acceptable risk level recommended by USEPA 5.0×10-5 closely to the ICPR recommendation 1.0×10-6. Meanwhile we conduct health risk assessment (HRA) on relevant non-carcinogenic indicators: nitrate is 2.95E-09a-1, the risk value of fluoride (F) is 2.49E-09a-1, the risk value of lead is 2.39E-09a-1 and copper (Cu) 9.00E-10a-1 exceeds the maximum acceptable risk level risk value recommended by USEPA 1.0×10-9. The above indicators require priority control and management of pollutants that are prioritized and managed.

Risk assessment model for endpoints of ischemic stroke: A study protocol for a registry study

OBJECTIVETo evaluate the risk of ischemic stroke endpoints by establishing risk assessment models that combine Traditional Chinese Medicine (TCM) and modern medicine indicators. METHODS/DESIGNThe proposed study is a registry-based participant survey conducted in seven hospitals nationwide in China. After obtaining informed consent, 3000 patients diagnosed with ischemic stroke will be recruited. One-year follow-ups will be performed on-site in hospitals and by telephone to track endpoint events. Comparative analysis of the prevalence of endpoint events and other TCM or modern medicine features in different groups will be conducted using frequency analysis and χ2 tests, and the results will be expressed as composition ratios. Comparative analysis of quantitative scores and related patterns or symptoms will be conducted using a rank-sum test. Correlation analysis of endpoint events and TCM or modern medicine factors will be performed using a multivariate Cox proportional hazard model. DISCUSSIONPrevious reports have described modern medicine indicator-based risk assessment models for ischemic stroke endpoint events, but no such studies have included TCM features. Our new risk assessment model combines TCM and modern medicine indicators and thus has the potential to facilitate early warning, early intervention, and early control of ischemic stroke endpoint events.

Hereditary Cancer Risk Assessment and Genetic Testing in the Community-Practice Setting.

To evaluate the feasibility and results of incorporating routine hereditary cancer risk assessment, counseling, and follow-up genetic testing in the community obstetrics and gynecology practice setting without referral to a genetic counselor. This prospective process intervention study was conducted with two obstetrics and gynecology practice groups (five sites). The intervention included baseline process assessment, refinement of clinic-specific patient screening workflows and tools, and training in hereditary cancer risk screening and follow-up. Outcomes related to hereditary cancer assessment and testing were measured during an 8-week postintervention period. Patients and health care providers were surveyed about satisfaction with the process. Data also were collected during the 8 weeks before the intervention to assess the effects of screening process improvements. A total of 4,107 patients were seen during the postintervention period, and 92.8% (3,811) were assessed for hereditary cancer risk. Among those assessed, 906 of 3,811 (23.8%) women met National Comprehensive Cancer Network guidelines for genetic testing, and 813 of 906 (89.7%) eligible patients were offered genetic testing. A total of 165 of 4,107 (4.0%) women completed genetic testing and received a final test result. This represents a fourfold increase over genetic testing immediately before the intervention (1.1%) and an eightfold increase over the previous year (0.5%). Testing identified pathogenic variants in 9 of 165 (5.5%) tested women. All health care providers (15/15) reported that they will continue to use the established hereditary cancer risk assessment process. In addition, 98.8% (167/169) of patients who submitted a sample for genetic testing and completed a patient satisfaction survey stated that they were able to understand the information provided, and 97.6% (165/169) expressed satisfaction with the overall process. It is feasible to incorporate hereditary cancer risk assessment, education, and testing into community obstetrics and gynecology practices. As a result, multigene panel testing identified significant cancer risks that otherwise would not have been recognized.