Taking and recording a family history

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Taking and recording a family history

You may need to take a family history to help answer a specific clinical question or as recommended in a national clinical guideline.

What is a genetic family history?

Taking a family history involves asking questions about each member of the family to determine

  • how family members are related to each other (their biological relationships) and
  • any medical conditions they may have.

This information is usually gathered by asking a series of questions about each person in a family – moving from person to person in each generation in a systematic way.

The information collected is usually recorded pictorially as a pedigree drawing.  

There are other ways of collecting family history information: for instance, the patient or family may agree to complete a family history form.

Example of a form for collecting family history

General questions to gain a quick overview of a genetic family history

 Although it is usually best to be systematic and ask about each branch of a family, some general questions can often give a quick overview.    

“Do you have any concerns about diseases or conditions that seem to run on either your or your partner’s side of the family?”
“Does anyone have a major medical, physical or mental health problem?
Has anyone ever needed treatment in hospital?  Has anyone ever had any serious illnesses or operations? How old were they at diagnosis?” (Avoid just asking “Is everyone well?” as past medical history may not be offered!)
“Have any adults, children or babies died? How old were they and what was the cause of death? Have there been any miscarriages or babies who were stillborn?”


Some answers may require that a full pedigree is taken to gain more information.   If several people have the same condition and they are closely related to each other, this  may suggest there is an increased genetic risk which needs further investigation or specialist referral.

How do I know how many generations to include?

This depends on the reason for taking the family history, but information about three generations would usually be collected.

In some clinical situations, we may need details on everyone in the whole family and their medical conditions. 

In others, we may need information on a specific condition in the family. 

 

Am I allowed to ask for information on other members of a family and record it in medical notes?

Yes!  You may record information about other people in a family and pass it to healthcare colleagues (under Schedule 3 of the Data Protection Act) without the consent of all those shown on the pedigree if this is necessary for medical purposes (including preventative medicine, medical diagnosis, medical research, the provision of care and treatment and the management of healthcare services).

It is good practice to discuss with the person giving you their family history that information from the pedigree may be used to determine how a condition is inherited,  and that it could be shared with other family members and health professionals if necessary for the care of family members.

Further information can be found in the report from the Joint Committee on Medical Genetics: Consent and confidentiality in genetic practice: Guidance on genetic testing and sharing genetic information, 2011

How do I record medical information on a pedigree?

For each key person, record the following under the pedigree symbol:

  • First name and surname
    Date of birth (DOBs are preferable to current ages or estimates)
    Relevant symptoms and/or diagnoses and age at diagnosis (if known)
    Cause of death and age at death (if known)

Depending on the medical condition, you might also want to record:

  • Pregnancy and birth history
    Occupational/environmental exposures
    Medications.

In which order should I ask about people in the family?

It is best to ask for Information about each person in turn, usually starting with your patient and moving through the family generation by generation.   The diagram shows  how to move from branch to branch of the family. Parts of the family have been numbered; recording details of relatives in this order works well in practice.

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A booklet summarising taking and drawing a family history

This 28 page booklet includes key points; what is a genetic family history and why is it important; the symbols to use; how much information to be included and how to gather it.

Download the booklet

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