You have your Sanford Chip genetic test results. Now what?

A genetic counselor details how you and providers can use the information.

Megan Baldridge discusses her genetic test results with her genetic counselor, Erin Royer.
Megan Baldridge discusses her genetic test results with her genetic counselor, Erin Royer.

Whether it’s to get answers to lingering questions or fears, or to help guide care moving forward, or simply to learn more about their health, thousands of Sanford Health patients have taken the Sanford Chip genetic test.

They’ve had their basic questions answered, know the conditions and medications the test covers, enrolled for the test, understand how the test works and are now ready for the next step — getting the results of their test.

Here, genetic counselor Erin Royer addresses some questions patients may have about the results of the Sanford Chip.

How will I get my Sanford Chip results?

You’ll receive a message in My Sanford Chart under “Test Results,” listed by the date your blood was drawn. One message will include your basic pharmacogenetic panel results, and one will include your disease predisposition results.

You can access your results at any time through My Sanford Chart. They also will be part of your electronic medical record for your providers to review and consult.

Additionally, you’ll receive a letter in the mail from Sanford Imagenetics with a report that gives more explanation and detail about your results.

What does the mailed report say about my results?

The report has three sections of information about your pharmacogenetic test results:

  • A table of potentially affected medications, based on your genetic results
  • Drug dosing recommendations, based on your genetic results
  • Test details and methodology

Potentially impacted medications

The categories in this table work like a stoplight.

Medications listed in the green section are good to go — you can use those at the standard dosing, because your genetics aren’t giving any indication you would have any different reactions than the general public with those medications.

Medications listed in the yellow section are ones to maybe use with caution. For these, your provider might consider a different dose, or consider closely monitoring for things like side effects or whether the medication is working well.

And medications listed in the red section, it’s not quite a “stop,” but it’s “maybe we should think about other medications.” Maybe this medication will cause a side effect that’s not good, or maybe it won’t work for you as well as other people, so other medications might work better for you.

Drug dosing recommendations

This section of your Sanford Chip results letter lists specific drugs that go through one of the genes the Sanford Chip tests. Here, it lays out how you metabolize — or break down and process — the specific medications and offers recommendations of the doses of the medication you may need, depending on whether you have a normal sensitivity to it, or whether you’re more sensitive or less sensitive than other people.

Test details and methodology

This part of the letter lists more specific breakdowns of the genes that were tested, as well as additional information about how these results were created from your DNA.

Under the test details, you’ll see four columns: gene, genotype, phenotype and alleles tested. These details are also listed in the results you access through My Sanford Chart:

  • The gene column lists the scientific name of the gene that was tested.
  • Next to that, the genotype tells us how that gene is spelled — it’s what makes up that gene.
  • The phenotype listed tells how you process the enzyme the gene makes.
  • And the alleles listed are simply the names used for the different changes that can be found in that gene — it’s all the variations tested for in that gene.

This level of information might not always be as helpful to you, the patient, but it’s very helpful to doctors and pharmacists when they’re reviewing or prescribing your medications.

We use all of this information when looking at a particular medication — we look at whether the enzyme breaks it down quickly or slowly, and based on that medication, how being broken down too quickly affects it versus too slowly. It’s not the same for every medication, so it’s great to have the additional support and review from our pharmacists.

Do I need to bring the results letter to my medical appointments?

No, the letter is just for your reference as a way to help interpret this complicated information. All the information from your Sanford Chip test is stored electronically in your medical record. It’s listed with your lab test results, just like a cholesterol level or blood sugar or blood panel that your doctor may have ordered in the past.

What does an ‘uninformative’ result mean for the disease predisposition portion of the Sanford Chip?

An “uninformative” result is what most people will get for this portion of the test.

We test 59 different genes that have medically actionable predispositions, where we look for common changes in those genes that we know greatly increase the risk of certain conditions or cancers. If that gene has a change, there’s some medical action we can take to help you with that particular risk or condition. We can start screenings or modify medications, for example.

If your results show you have a positive disease predisposition, you’ll be referred to a genetics specialist for next steps.

If your results show you don’t have any of these common changes in these 59 genes, it’s called uninformative.

Uninformative says you’re negative for all the predispositions we tested for, which is helpful to rule out some for the genetic causes of those issues.

But this doesn’t change your family history, which is also a factor in your risk of developing certain conditions. An uninformative result for these specific genes doesn’t mean you’ll never get cancer or have a heart attack or have high cholesterol.

So if you’re worried about anything in your family history, you can always meet with a genetic counselor or provider who specializes in cancer or cardiovascular disease to talk through your family history and see if any other testing might be useful, or any other screening should be started to monitor your risk.

What does my doctor do with the Sanford Chip results?

Your results are built into the decision support in all your medical reports. This means the next time your doctor wants to prescribe a medication, if something in your genes tells us you may not react well to that medication, or it may not work well, an alert will pop up to tell your doctor that that medication might not be best for you. It will suggest whether a lower dose or higher dose would work better, or other medications that might be better for you to try.

We also have pharmacists who review your results and your current medications to see if anything you’re using right now as a medication might not work that well or might need to be adjusted based on your genetics. Our pharmacists will communicate back to your doctor right away about any potential issues with your current medications.

That’s something unique to Sanford Health’s testing; since the lab results are entered directly into your chart, any Sanford Health provider you see in any specialty has access to them as they treat you.

What do I do now?

This is different for everyone who takes the Sanford Chip test, depending on what your results are.

If medication changes need to be made, or actions need to be taken to help treat or prevent a condition, our team will contact you and be with you every step of the way to make sure you’re getting the care you need.

For people with no complications from medications, or with uninformative predisposition results, it likely means you don’t have to do anything differently. It rules out some genetic causes of certain conditions, and it equips your provider with helpful knowledge regarding medications you may need in the future.

The Sanford Chip is a laboratory developed test that is not required to be reviewed by the FDA. Your Sanford Health doctor orders the test and receives the results.

Learn more about the Sanford Chip genetic test.

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Posted In Genetics, Health Information, Innovations, Pathology

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