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Of course in non-genetic testing in clinical medicine the concept of abnormality is in common use, and this concept is used for deviations from the standard range linked with a slight probability, as well as with greater or absolute certainty that a specific condition will develop. It is also linked with serious as well as non-serious conditions. It should be pointed out, however, that in a patient-doctor relationship these deviations are usually further specified, for example as slightly elevated, slightly abnormal, highly elevated etc., and that further explanations are usually provided with regard to the probability that a specific condition will arise and whether it will be serious or not. Where the possibility of personal communication does not exist or where these explanations are not provided there is reason for more careful use of the concept of abnormality also in clinical medicine. In medical genetics there is even more reason for careful use of the concept of abnormality. Not only because the reference standard is often not clear, but also because its potential for raising anxiety in combination with the term genetic (with - for the layperson - its connotations of inevitability and predetermination) can create greater concern than is necessary. Careful use is especially indicated if test-results are not communicated personally and further counselling is not provided, as for example in written pre-test information or when test-results are provided in writing. Recent reports see this as a real possibility in the (near) future (e.g. Andrews LB et al, see n. 8).
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