Laboratory Notices

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2021

February 2022

Discontinuing Select Genomic Testing

Due to low volume Genova Diagnostics will be discontinuing the following tests:

  • CardioGenomicPlus Profile
  • EstroGenomic Profile
  • ImmunoGenomic Profile
  • NeuroGenomic Profile
  • All other Genomics Profiles and SNPS are still available. We apologize for any inconvenience.

    Please call client services at 020 8336 7750 for more information.

    December 2021

    Changes to Collection Pack Tubes

    Due to current supply-chain issues for various collection supplies, you may notice slightly different tubes and collection materials in certain collection packs. These changes will not affect testing. Please reference the instructions or contact us if you have questions.

    We apologize for any inconvenience.

    Please visitour Contact Page if you need more information.

    November 2021

    Changes to Reflexive Blastocystis Subtyping

    Beginning November 22, 2021 Genova Diagnostics will no longer report the reflexive Blastocystis subtyping for our suite of GI Effects Profiles:

    • GI Effects Comprehensive Profile #2200
    • GI Effect Microbial Ecology Profile #2205
    • GI Effects Gut Pathogen Profile #2207

    When initially added to the profile, it was believed this could add to the rapidly evolving conversation regarding the clinical implications of Blastocystis infection and help to inform treatment decisions.

    However, after years of data collection on Blastocystis subtyping powered by Genova's Artificial Intelligence, no obvious patterns emerged as it relates to other biomarkers on the profile, or status of the overall microbiome. With the goal of utmost clinical utility in mind, Genova has decided to discontinue reflex Blastocystis subtyping while continuing to follow ongoing research on the topic. For more information, please see Blastocystis White Paper.

    Important Thyroid Profiles Change Notification

    Due to a change in laboratory instrumentation, the Thyroid Plus Profile is being updated. In addition to reference range changes, we are excited to announce new graphic design report enhancements to aid in a clear understanding of thyroid metabolism. The updated reference ranges will also affect the thyroid markers on the Functional Blood Profile. To streamline our offerings the following profiles will be discontinued.

    • Total Thyroid Screen #END06
    • Reverse T3 #END07

    No changes have been made to the collection pack or instructions so there is no need to replace existing collection materials.

    Important Coeliac Product Change Notification

    Genova Diagnostics is excited to announce a reconfigured Coeliac Profile. The update will include the addition of two new biomarkers, Anti-Tissue Transglutaminase IgG (tTG IgG) and Anti-Deamidated Gliadin IgG (DGP IgG) to further enhance clinical utility and help guide diagnostic decision-making.

    The profile will no longer include the Anti-Gliadin IgA and Anti-Gliadin IgG biomarkers due to the discontinuation of those products by the manufacturer. The Coeliac & Gluten Sensitivity assessment will be retired on November 22, 2021 and replaced by the new Coeliac Profile #1018.

    Current Coeliac & Gluten Sensitivity collection packs can be used with the new upgraded profile, so there is no need to replace any collection packs.

    July 2019

    Immune Testing Updates

    Effective July 10, 2018, Genova Diagnostics has updated our allergy/antibody pricing and combination offerings.

    Our updates include:

    • Updated Pricing
    • Simpler Requisitions
    • Updated Allergy/Antibody Combinations (see the chart below)
    Part # Profile Name
    1000 IgE Food Antibodies (19 IgE foods)
    1001 IgG Food Antibodies (87 IgG foods + Total IgE)
    1002 IgG Vegetarian
    1014 IgE Inhalants (25 IgE inhalants + Total IgE)
    1004 IgE Moulds (15 IgE molds + Total IgE)
    1005 IgG Spices (24 IgG spices + Total IgE)
    1006 Coeliac + Gluten Sensitivity

    For more information on our full line of Immune testing, please contact your account management team at +44 (0)20 8336 7753.

    June 2019

    Now Offering the SIBO Breath Test

    We are pleased to announce the immediate availability of a 2 and 3-hour Small Intestinal Bacterial Overgrowth (SIBO) panel.

    Collection packs will accommodate clinician choice for either a two or three-hour sample collection. The 3-hour SIBO panel provides insight into gas levels over a longer period of time and is recommended for patients with slower gastrointestinal transit time or constipation.

    The new panel reflects the current state of scientific understanding related to SIBO diagnostics and results interpretation – and is designed to optimise management of the symptomatic patient.

    Please visit the SIBO Breath Test webpage to view the sample report, see the available commentary, and a patient-focused specimen collection video.

    If you have questions regarding what it means for your patients, please contact us at +44 (0)20 8336 7753 to speak with one of our Client Services Representatives.

    May 2019

    Methylation Panel

    Genova is excited to announce the release of our new Methylation Panel. The Methylation Panel is an innovative genotypic and phenotypic assessment designed to offer insight into the critical biochemical methylation pathway.

    Genova's Methylation Panel measures plasma levels of key amino acids and intermediate metabolites involved in the cycles of methylation, homocysteine transsulfuration, and folate metabolism. Additionally, single nucleotide polymorphisms are analysed using a buccal swab to give insight into genetic predispositions that affect enzymatic activity within these pathways.

    Visit the Methylation Panel product page.

    If you have questions regarding what it means for your patients, please contact us at +44 (0)20 8336 7753 to speak with one of our Client Services Representatives.

    February 2019

    BloodspotSM Amino Acids and BloodspotSM Fatty Acids Updates

    Genova Diagnostics has enhanced the BloodspotSM Amino Acids 11 Profile, BloodspotSM Amino Acids 20 Profile, and the BloodspotSM Fatty Acids Profile with updated supplement recommendations. These tests include an algorithm to assist with clinical interpretation and pattern recognition. We have been working to update these algorithms, and they have now been implemented in our tests.

    What you can expect from these updates:

    • Each report will include an algorithm-based nutritional needs assessment. Nutrient needs will be categorised as high, moderate, and low, based on the individual test results.
    • Each nutritional need category will be accompanied by a potential dosage range that can be used as a starting place to guide personalised nutritional intervention.

    If you have questions regarding what it means for your patients, please contact us at +44 (0)20 8336 7753 to speak with one of our Client Services Representatives.

    January 2019

    Introducing PCR Parasitology

    Genova is NOW OFFERING the addition of PCR parasites to the GI Effects Comprehensive #2200, GI Effects Microbial Ecology Profile #2205, and as part of a brand new Gut Pathogen Profile #2207.

    The GI Effects 2200 and 2005 now include 6 PCR targets (replacing EIA) that detect common protozoan parasites:

    • Blastocystis spp. with reflex subtyping 1-9
    • Cryptosporidium spp.
    • Cyclospora cayetanensis
    • Dientamoeba fragilis
    • Entamoeba histolytica
    • Giardia

    The GI Effects upgrade also includes several ease of use report enhancements:

    • The microscopic O&P results section now contains an extensive list of positive and negative findings
    • Commensal and Biomarker Clinical Association Charts have been moved to the end of the report
    • Add-on markers are consolidated into fewer pages

    Download GI Effects Comprehensive Sample Report

    Additionally, this PCR technology is part of a brand new Gut Pathogen Profile. This profile provides a comprehensive evaluation of organisms known to contribute to common GI symptoms including:

    • 6 PCR targets including Blastocystis subtyping 1-9
    • Microscopic O&P, including an extensive list of positive and negative findings
    • Macroscopic exam for worms
    • Bacterial culture and sensitivities
    • Yeast culture and sensitivities
    • KOH prep for yeast
    • Add-ons available: Clostridium difficile, Campylobacter spp., Shiga toxin Escherichia coli, Helicobacter pylori stool antigen

    If you have questions regarding what it means for your patients, please contact us at +44 (0)20 8336 7753 to speak with one of our Client Services Representatives.

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    UK

    2018

    December 2018

    Introducing PCR Parasitology

    Beginning January 21, 2019, Genova will offer the addition of PCR parasites to the GI Effects Comprehensive #2200, GI Effects Microbial Ecology Profile #2205, and as part of a brand new Gut Pathogen Profile #2207.

    The GI Effects 2200 and 2005 will include 6 PCR targets (replacing EIA) that detect common protozoan parasites:

    • Blastocystis spp. with reflex subtyping 1-9
    • Cryptosporidium spp.
    • Cyclospora cayetanensis
    • Dientamoeba fragilis
    • Entamoeba histolytica
    • Giardia

    The GI Effects upgrade also includes several ease of use report enhancements:

    • The microscopic O&P results section will now contain an extensive list of positive and negative findings
    • Commensal and Biomarker Clinical Association Charts will be moved to the end of the report
    • Add-on markers will be consolidated into fewer pages

    Download GI Effects Comprehensive Sample Report

    Additionally, this PCR technology will be part of a brand new Gut Pathogen Profile. This profile will provide a comprehensive evaluation of organisms known to contribute to common GI symptoms including:

    • 6 PCR targets including Blastocystis subtyping 1-9
    • Microscopic O&P, including an extensive list of positive and negative findings
    • Macroscopic exam for worms
    • Bacterial culture and sensitivities
    • Yeast culture and sensitivities
    • KOH prep for yeast
    • Add-ons available: Clostridium difficile, Campylobacter spp., Shiga toxin Escherichia coli, Helicobacter pylori stool antigen

    Download Gut Pathogen Profile Sample Report

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    Vitamin D

    As of December 3, 2018, the reporting for Vitamin D, as part of the NutrEval FMV (NUT06), the ONE FMV (NUT04), the CV Health Profile (MET13), the CV Health Plus Genomics (MET14), the Vitamin D Profile (NUT12), and the Hormonal Health Profile (END15) has been changed in an effort to standardize the reference range between all of our nutritional products, we will be adjusting the reference range for 25-Hydroxyvitamin D to be set at 30-100 ng/mL. This follows a literature analysis into the clinical relevance of particular vitamin D results. We will also be providing commentary on the report to summarize the result ranges based on the Vitamin D Council along with other research. These ranges are listed below.

    • Deficiency <20 ng/mL
    • Insufficiency 20-29 ng/mL
    • Sufficient 30-100 ng/mL
    • Recommended 50-80 ng/mL
    • Excessive >100 ng/mL

    There is no consensus in the literature regarding optimal levels of 25-hydroxyvitamin D. Higher levels of 25-hydroxyvitamin D may be concerning in some clinical conditions, such as renal failure. Levels below 30 ng/mL are considered insufficient by most medical associations. Results falling outside the reference range will be flagged as abnormal.

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    October 2018

    Update to Zonulin Testing

    A recent research paper published in Frontiers in Endocrinology1 suggested that the zonulin kits from Immundiagnostik (IDK) did not detect zonulin (a precursor of Haptoglobin 2). This issue was further confirmed by the kit manufacturer, Immundiagnostik, in a statement released to clinical laboratories. To the best of Genova's knowledge, the recent Scheffler paper1 has impacted the zonulin assay for many laboratories, including Genova's serum and stool zonulin tests. Because some researchers are conducting studies and have received data from the current zonulin kits, Genova has decided to provide the test for research use only with the manufacturer's suggested name: zonulin family peptide. Here is what we know about the zonulin family peptide that IDK kits detect in serum and stool.

    The Scheffler paper suggests that the kits may detect properdin, a protein involved in the alternative complement pathway and inflammation1, 2. Preliminary study results from an external investigator suggest that properdin may be structurally and functionally similar to zonulin.

    Genova's unpublished data analysis (of 13,613 tests) demonstrated that the test results of the current stool zonulin kit (now called zonulin family peptide) were strongly and positively associated with stool EPX and sIgA (but not calprotectin). Levels of zonulin family peptide detected by this kit were also associated with a commensal bacterial profile related to intestinal inflammation. In addition, they were also positively associated with stool biomarkers such as fecal PE-1 and cholesterol. Some biomarkers, such as stool fat and short-chain fatty acids, showed "bell-shaped" distributions. High or low levels of the zonulin family peptide were associated with low levels of stool fat and short-chain fatty acids.

    Because of the lack of information on the mechanism of action and clinical utility of zonulin family peptide, Genova will not provide support on interpreting the test results. Genova will continue monitoring this issue and provide clients with new information as it becomes available.

    1. Scheffler L, et al. Widely Used Commercial ELISA Does Not Detect Precursor of Haptoglobin2, but Recognizes Properdin as a Potential Second Member of the Zonulin Family. Front Endocrinol. 2018;9:22.
    2. Chen JY, et al. Properdin: A multifaceted molecule involved in inflammation and diseases. Mol Immunol. 2018.

    If you have questions regarding what it means for your patients, please contact us at 800.522.4762 to speak with one of our Client Services Representatives.

    Cortisol Awakening Response (CAR)

    Announcing the addition of the Cortisol Awakening Response (CAR) to our salivary cortisol testing options.

    Clinicians will now be able to order the Cortisol Awakening Response (CAR) as an alternative or an add on to our Adrenal Stress Profile (ASP) and our Comprehensive Adrenal Stress Profile.

    • CAR: Three awakening cortisol samples and one night-time cortisol to help clinicians evaluate HPA axis resiliency. Isolated evening cortisol is associated with insomnia and chronic disease.
    • ASP: Four-point diurnal cortisol to give insight into cortisol's natural circadian rhythm to help clinicians address specific daily stressors.
    CAR ASP (END01) Comp ASP (END02)
    Waking X Add-on Add-on
    30 min post waking X Add-on Add-on
    7:00AM-9:00AM X X X
    11:00AM-1:00PM Add-on X X
    3:00PM-5:00PM Add-on X X
    10:00PM-12:00AM X X X
    sIgA Add-on Add-on X

    Each ordered collection pack will have the option to add on the CAR or ASP tests to convert the four-point test to a six-point test as shown above to offer flexibility in test ordered. The sample collection pack will have all tubes required so you do not need to order add-ons in advance.

    Every panel will have the option of adding sIgA.

    As part of this update total cortisol will no longer be reported.

    The new ASP profile report has been graphically updated. There is no methodology or reference range update.

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    June 2018

    Bone Resorption: Osteoporosis Risk Assessment

    Genova Diagnostics is experiencing delays in our Bone Resorption: Osteoporosis Risk Assessment test due to a vendor supply issue. Currently, we are anticipating that testing materials will be available in July, and we will work to complete and release results swiftly once supplies are received.

    This shortage affects the following test:

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    Updates to ION® and Organix® Reports

    Genova Diagnostics is updating our ION® and Organix® reports. These tests include an algorithm to assist with clinical interpretation and pattern recognition. We have been working to update these algorithms, and they will be available for the Organix* Profiles no later than 19 June 2018, and will be available for the ION Profiles by 15 July 2018.

    What you can expect from these updates:

    • Each report will include an algorithm-based nutritional needs assessment. Nutrient needs will be categorized as high, moderate, and low, based on the individual test results.
    • A "General Supplement Ranges" page will be included with each report to give clinicians additional insight into nutrient ranges often used to support optimal functional need.

    *Organix® Dysbiosis Profile - Urine will not be included in this update.

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    April 2018

    Salivary Progesterone Reference Range Change

    The methodology for salivary progesterone has been updated to EIA. As a result of this change, reference ranges have also been updated.

    This change affects the following panels:

    Product ID
    Rhythm™ #END10
    Rhythm Plus™ #END11
    One Day Progesterone/Oestradiol #END12
    Menopause™ #END13
    Menopause Plus™ #END14

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    January 2018

    8-hydroxy-deoxyguanosine (8-OHdG)

    As of 15 January 2018, the methodology for 8-hydroxy-deoxyguanosine (8-OHdG), as part of the NutrEval®, Optimal Nutritional Evaluation (ONE)™, and Oxidative Stress 2.0 (urine) profiles, has been changed to LC-MS/MS. This change to methodology will accompany a minor reference range change. The clinical interpretation of this marker remains the same.

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7753 for Practitioner Support.

    UK

    2017

    December 2017

    New GI Effects® Reporting Enhancements

    Orders placed for the GI Effects® Comprehensive Profile and GI Effects® Microbial Ecology Profile on or after December 18 will feature innovative reporting enhancements.

    New features include a Commensal Balance infographic designed to provide a more precise view of a patient's commensal bacteria as well as new Clinical Association Charts that allow clinicians to see how patient results compare to commensal bacteria and other biomarker patterns seen in patients with specific clinical conditions.

    October 2017

    Lp-PLA2 (PLAC) Assay and Reference Range Change

    As of September 28, 2017, measurement of Lipoprotein-associated phospholipase A2 (Lp-PLA2), as part of the CV Health™ Profile and CV Health Plus Genomics™ Profile, will now be performed using the FDA cleared Diazyme Enzyme Activity Assay. The clinical interpretation of this marker remains the same.

    With this assay change, there will be a few minor changes to report. There will no longer be a result reflecting 1 standard deviation (previously depicted in yellow), therefore the colorimetric box surrounding the result will be either green or red. The Relative Risk for Cardiovascular Disease will also have a new cut-point based on reference range changes.

    September 2017

    We're Pleased to Introduce Our Environmental Profiles to the UK

    We're excited to offer three environmental profiles to our clients in the United Kingdom. These testing options can evaluate possible toxic burden that may be contributing to your patients' chronic symptoms.

    • The Toxic Effects CORE profile is a comprehensive testing option that measures a wide-array of harmful toxic chemicals.
    • The Bisphenol A (BPA) Profile can be ordered on its own as a follow-up or a stand-alone test that measures three toxic endocrine disruptors, including Bisphenol A, triclosan, and 4-nonylphenol.
    • The Volatile Solvents Profile measures exposure to common volatile solvents. Also included in the Toxic Effects Core, the Volatile Solvents Profile can identify a patient's prolonged exposure to volatile solvents that can be found in air, water, at home, and at work.

    Please call us +44 (0)20 8336 7750 or email us at infouk@gdx.net with any questions.

    August 2017

    Final Notice Regarding the Updated Collection Method for NutrEval® and Elemental Analysis

    Beginning Monday, August 14, we will fully convert to the new NutrEval and Elemental Analysis collection method. Please pay careful attention to the labels on the collection packs you use in the office and allow patients to take home.

    Samples that arrive using the old collection method will NO LONGER BE ACCEPTED after this deadline.

    Please call us +44 (0)20 8336 7750 or email us at infouk@gdx.net with any questions.

    July 2017

    We're Adding Three New Tests to Our Environmental Line

    Beginning July 31, you may begin ordering the following environmental profiles:

    The Toxic Effects Core profile provides a comprehensive evaluation of six of the most common classes of toxic chemicals. The Bisphenol A and Volatile Solvents Profiles provides insight into toxic burden by toxicant.

    Please take some time to learn more about these tests by searching for them on our Online Test Menu or by following the links above.

    Important Updates to the NutrEval® and Elemental Analysis Collection Conversion

    Beginning August 14, we will fully convert to the new NutrEval and Elemental Analysis collection methods; NutrEval and Elemental Analysis samples that arrive using the old collection method will NO LONGER BE ACCEPTED after this date.

    Check the Label on Your Test Package

    New Collection Process LabelThe NutrEval package must match this image for order processing after the August 14th deadline.


    New Collection Process LabelThe Elemental Analysis package must match this for order processing after the August 14th deadline.

    Please call us +44 (0)20 8336 7750 or email us at infouk@gdx.net with any questions.

    April 2017

    Updates for the Elemental Analysis Profile

    We've Updated the Collection Process for Elements

    The Elemental Analysis Profile is changing. The link below outlines the specimen matrix updates. Additionally, the collection process is being simplified by reducing required sample volume.

    New Collection Process LabelWe have created a collection update reminder label for Elemental Analysis collection kits. When you see the reminder label, simply follow the collection process instructions included within the labeled kit.

    If you DO NOT see the update reminder label on your Elemental Analysis kit, follow the collection process included within that test kit. Please watch for notification in the coming weeks regarding the discontinuation of this kit and related instructions.

    Specimen-Matrix Updates

    Elemental Markers are currently measured in red blood cells (RBCs) specimen matrix. The updated collection process is part of a change to this specimen matrix.

    For the complete details on these enhancements, view the linked Specimen-Matrix Updates.

    If you have questions regarding this change or what it means for your patients, please contact us at +44 (0)20 8336 7750 to speak with one of our Client Services Representatives.

    Specimen-Matrix Updates

    Important Updates to NutrEval®

    We've Updated and Simplified the Collection Process for the NutrEval®

    Redesigned NutrEval kitUpdated blood collection and processing steps will be implemented for our NutrEval. The label shown here will notify the phlebotomist of the revised test components and instructions. The link below provides further details of the specimen matrix updates.

    When you see the reminder label, simply follow the collection process instructions included within the labeled kit.

    If you DO NOT see the update reminder label on your NutrEval kit, follow the collection process included within that test kit.

    Elemental Markers are currently measured in red blood cells (RBCs) specimen matrix. The updated collection process is part of a change to this specimen matrix. Additionally CoQ10 will be measured in serum.

    Highlights of these changes are shown at the Specimen-Matrix Updates link below.

    Easter Holiday Schedule

    We will be closed for business and unable to accept samples on the following days:

    • Friday 14th April
    • Monday 17th April

    Holiday Shipping Schedule

    Please be sure that all samples are received into our premises no later than Tuesday 11th April. We look forward to speaking to you on Tuesday 18th April.

    March 2017

    Reminder: Genova Diagnostics Europe is Moving!

    We are relocating our facility to a new space at the end of March, but will remain in New Malden.

    Our Address, Beginning 27th March, 2017
    46-50 Coombe Road
    New Malden
    Surrey KT3 4QF

    Revised requisition and shipping materials can be obtained from our client services representatives at +44 (0)20 8336 7750 or infouk@gdx.net.


    Due to a variety of reasons; infrequent requests, lack of validated kits, etc., we are reluctantly discontinuing the following tests:

    Genova Diagnostics Europe Discontinued Profiles & Suggested Replacement Profiles
    Discontinued Profiles* Recommended Profiles
    Candida Antibody Profile (Saliva & Serum) GI Effects® Comprehensive Stool Profile #2200 or Yeast Culture with KOH
    Aneamia Profile No Comparable Profile
    IgE Inhalant Panel Coming Soon

    * These tests can no longer be processed as of 20th of March.

    The Following Test Changes Will Apply as of 27th March

    • Cortisol and SIgA reference ranges will be revised as per manufacturer guidelines.
    • PM DHEA will no longer be reported, manufacturer reference ranges are unavailable.
    • FT3/FT4 and T2/T4 ratios will not be reported, manufacturer reference ranges are unavailable.

    Please view current tests available, including turnaround times.


    Exciting Announcements!

    While we make these changes, please know you are still our first priority. To show our appreciation for your business, we are pleased to announce we will not be implementing our annual fee increase. Please see the current Fee Schedule.

    Please feel free to contact us with questions at +44 (0)20 8336 7750 or infouk@gdx.net.
    February 2017

    Genova Diagnostics Europe is Moving!

    We are relocating our facility to a new space at the end of March, but will remain in New Malden. During this time, we will take the opportunity to further align our services with our US laboratory for test processing, quality standards and methodology. This will ultimately enable us to better serve your practice and patients, while also allowing us to offer new and exciting tests.

    Our Address, Beginning 27th March, 2017
    46-50 Coombe Road
    New Malden
    Surrey KT3 4QF

    Revised requisition and shipping materials can be obtained from our client services representatives at +44 (0)20 8336 7750 or infouk@gdx.net

    January 2017
    UK

    2016

    December 2016

    Christmas Closing Times 2016

    In order to avoid any sample rejections over the Christmas holiday, all samples must be received by Tuesday, 20th December 2016.

    Genova Diagnostics will be closed for business from Friday, 23rd December 2016 and will reopen Tuesday, 3rd January 2017.

    Please Note: The laboratory will be unable to accept any samples during this period. Tests received after the 20th December 2016 will result in delays and/or sample rejection.

    Thank You and Best Wishes for a Happy Holiday and New Year!

    November 2016

    GI Effects® Kit Instruction Changes

    Kit instructions for both One-Day and Three-Day GI Effects® Stool Profiles have been reformatted and will appear in all kits beginning November 22, 2016. Updates include:

    • Reformatted and rewritten instructions to increase ease-of-use and patient compliance
    • New kit tube labels will be utilized to reduce name legibility issues on tubes and decrease rejections
    • Paper surveys have been eliminated; patients are encouraged to visit the Patient Resource Center and complete the online health survey