APOE4 question
How do I talk to a doctor who isn't prevention-minded, or who tells me to come back when I have symptoms?
Many carriers hear 'come back when you have symptoms', partly because research takes years to reach practice and few clinicians feel prepared to discuss genetic risk. Our guests suggest going in collaborative, bringing a short summary of your situation rather than a stack of papers, and opening with what worries you and the questions you want answered rather than a list of tests, and asking for a referral if your doctor will not help. Keep a doctor in the loop, especially for anything with side effects.
This is not medical advice. Phoenix educates. Your doctor decides what is right for you.
What the research and Kevin's videos say
What the research says
Grade CAPOE4-specific evidence: none
Studies suggest new research takes many years to reach routine care and few clinicians feel ready to discuss genetic risk, while short question lists brought to visits tend to help patients ask more and get better information.
Key studies
Ramlakhan 2023, Health Expect
Scoping review of 57 studies: question lists brought to visits were linked to patients asking more questions and getting better information; 88% of studies reported at least one benefit, even for single-page lists.
Read on PubMed (opens in a new tab)Morris 2011, J R Soc Med
Review of 23 papers that measured how long health research takes to reach practice (17 years in its title): few were comparable, and the authors judged current knowledge of time lags of limited use.
Read on PubMed (opens in a new tab)Goldman 2011, Genet Med
ACMG and NSGC practice guideline: APOE testing has limited clinical utility, few clinicians are prepared to discuss genetic risk, and it sets out counselling steps.
Read on PubMed (opens in a new tab)
1 more key study
Plunkett-Rondeau 2015, Genet Med
Survey of US and Canadian medical schools: most genetics course leaders felt teaching time was not enough for clinical practice.
Read on PubMed (opens in a new tab)
What Kevin and experts say
Now showing: Dr. Kevin Tran · 0:02
Open on YouTube (opens in a new tab)
Doctors lag research by about 17 years.
“It takes an average of 17 years for medical research to reach your doctor's office.”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
Bring a clear question, your records and a trusted person.
“a clear question that you have for your physician, a record of what changed, and someone you trust beside you”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
Bring a two-page summary, not a stack of papers.
“that little two-page cheat sheet that you can bring to your doctor”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
Lead with your story, not a list of test demands.
“I want this test, this test, this test, and this test, right? And I think that as a physician, I've been there and I feel a little assaulted”
Dr. Ashanthi Gajaweera, Board-certified neurologist, Menopause Society certified practitioner (Healthspan Neurology)
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