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Effectiveness of the Genomics ADvISER decision aid for the selection of secondary findings from genomic sequencing: a randomized clinical trial.

ABSTRACT: PURPOSE:To evaluate the effectiveness of the Genomics ADvISER (www.genomicsadviser.com) decision aid (DA) for selection of secondary findings (SF), compared with genetic counseling alone. METHODS:A randomized controlled trial (RCT) was conducted to evaluate whether the Genomics ADvISER is superior to genetic counseling when hypothetically selecting SF. Participants were randomized to use the DA followed by discussion with a genetic counselor, or to genetic counseling alone. Surveys were administered at baseline and post-intervention. Primary outcome was decisional conflict. Secondary outcomes were knowledge, preparation for, and satisfaction with decision-making, anxiety, and length of counseling session. RESULTS:Participants (n?=?133) were predominantly White/European (74%), female (90%), and ?50 years old (60%). Decisional conflict (mean difference 0.05; P?=?0.60), preparation for decision-making (0.17; P?=?0.95), satisfaction with decision (-2.18; P?=?0.06), anxiety (0.72; P?=?0.56), and knowledge of sequencing limitations (0.14; P?=?0.70) did not significantly differ between groups. However, intervention participants had significantly higher knowledge of SF (0.39; P?

SUBMITTER: Bombard Y

PROVIDER: S-EPMC7425118 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Effectiveness of the Genomics ADvISER decision aid for the selection of secondary findings from genomic sequencing: a randomized clinical trial.

Bombard Yvonne Y Clausen Marc M Shickh Salma S Mighton Chloe C Casalino Selina S Kim Theresa H M THM Muir Sarah M SM Carlsson Lindsay L Baxter Nancy N Scheer Adena A Elser Christine C Eisen Andrea A Panchal Seema S Graham Tracy T Aronson Melyssa M Piccinin Carolyn C Mancuso Talia T Semotiuk Kara K Evans Michael M Carroll June C JC Offit Kenneth K Robson Mark M Hamilton Jada G JG Glogowski Emily E Schrader Kasmintan K Kim Raymond H RH Lerner-Ellis Jordan J Thorpe Kevin E KE Laupacis Andreas A

Genetics in medicine : official journal of the American College of Medical Genetics 20191211 4

<h4>Purpose</h4>To evaluate the effectiveness of the Genomics ADvISER (www.genomicsadviser.com) decision aid (DA) for selection of secondary findings (SF), compared with genetic counseling alone.<h4>Methods</h4>A randomized controlled trial (RCT) was conducted to evaluate whether the Genomics ADvISER is superior to genetic counseling when hypothetically selecting SF. Participants were randomized to use the DA followed by discussion with a genetic counselor, or to genetic counseling alone. Survey ...[more]

PMID: 31822848

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Project description:INTRODUCTION:Genome sequencing, a novel genetic diagnostic technology that analyses the billions of base pairs of DNA, promises to optimise healthcare through personalised diagnosis and treatment. However, implementation of genome sequencing faces challenges including the lack of consensus on disclosure of incidental results, gene changes unrelated to the disease under investigation, but of potential clinical significance to the patient and their provider. Current recommendations encourage clinicians to return medically actionable incidental results and stress the importance of education and informed consent. Given the shortage of genetics professionals and genomics expertise among healthcare providers, decision aids (DAs) can help fill a critical gap in the clinical delivery of genome sequencing. We aim to assess the effectiveness of an interactive DA developed for selection of incidental results. METHODS AND ANALYSIS:We will compare the DA in combination with a brief Q&A session with a genetic counsellor to genetic counselling alone in a mixed-methods randomised controlled trial. Patients who received negative standard cancer genetic results for their personal and family history of cancer and are thus eligible for sequencing will be recruited from cancer genetics clinics in Toronto. Our primary outcome is decisional conflict. Secondary outcomes are knowledge, satisfaction, preparation for decision-making, anxiety and length of session with the genetic counsellor. A subset of participants will complete a qualitative interview about preferences for incidental results. ETHICS AND DISSEMINATION:This study has been approved by research ethics boards of St. Michael's Hospital, Mount Sinai Hospital and Sunnybrook Health Sciences Centre. This research poses no significant risk to participants. This study evaluates the effectiveness of a novel patient-centred tool to support clinical delivery of incidental results. Results will be shared through national and international conferences, and at a stakeholder workshop to develop a consensus statement to optimise implementation of the DA in practice. TRIAL REGISTRATION NUMBER:NCT03244202; Pre-results.

Dataset Information

Effectiveness of the Genomics ADvISER decision aid for the selection of secondary findings from genomic sequencing: a randomized clinical trial.

Publications

Effectiveness of the Genomics ADvISER decision aid for the selection of secondary findings from genomic sequencing: a randomized clinical trial.

Similar Datasets

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