Patient and public preferences for being recontacted with updated genomic results: a mixed methods study.


Journal

Human genetics
ISSN: 1432-1203
Titre abrégé: Hum Genet
Pays: Germany
ID NLM: 7613873

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 13 04 2021
accepted: 05 09 2021
pubmed: 20 9 2021
medline: 9 11 2021
entrez: 19 9 2021
Statut: ppublish

Résumé

Variants of uncertain significance (VUS) are frequently reclassified but recontacting patients with updated results poses significant resource challenges. We aimed to characterize public and patient preferences for being recontacted with updated results. A discrete choice experiment (DCE) was administered to representative samples of the Canadian public and cancer patients. DCE attributes were uncertainty, cost, recontact modality, choice of results, and actionability. DCE data were analyzed using a mixed logit model and by calculating willingness to pay (WTP) for types of recontact. Qualitative interviews exploring recontact preferences were analyzed thematically. DCE response rate was 60% (n = 1003, 50% cancer patient participants). 31 participants were interviewed (11 cancer patients). Interviews revealed that participants expected to be recontacted. Quantitatively, preferences for how to be recontacted varied based on certainty of results. For certain results, WTP was highest for being recontacted by a doctor with updates ($1075, 95% CI: $845, $1305) and for contacting a doctor to request updates ($1038, 95% CI: $820, $1256). For VUS results, WTP was highest for an online database ($1735, 95% CI: $1224, $2247) and for contacting a doctor ($1705, 95% CI: $1102, $2307). Qualitative data revealed that preferences for provider-mediated recontact were influenced by trust in healthcare providers. Preferences for a database were influenced by lack of trust in providers and desire for control. Patients and public participants support an online database (e.g. patient portal) to recontact for VUS, improving feasibility, and provider-mediated recontact for certain results, consistent with usual care.

Identifiants

pubmed: 34537903
doi: 10.1007/s00439-021-02366-0
pii: 10.1007/s00439-021-02366-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1695-1708

Subventions

Organisme : Canadian Centre for Applied Research in Cancer Control
ID : 2015-703549
Organisme : CIHR
ID : 333703
Pays : Canada
Organisme : CIHR
ID : 333703
Pays : Canada

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Chloe Mighton (C)

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Marc Clausen (M)

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Agnes Sebastian (A)

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Sarah M Muir (SM)

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Salma Shickh (S)

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Nancy N Baxter (NN)

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Adena Scheer (A)

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.

Emily Glogowski (E)

Sanofi Genzyme, New York, NY, USA.

Kasmintan A Schrader (KA)

BC Cancer, Vancouver, BC, Canada.
Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.

Kevin E Thorpe (KE)

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Theresa H M Kim (THM)

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Jordan Lerner-Ellis (J)

Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, ON, Canada.

Raymond H Kim (RH)

University Health Network, Toronto, ON, Canada.
The Hospital for Sick Children, Toronto, ON, Canada.
Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Dean A Regier (DA)

BC Cancer, Vancouver, BC, Canada.
School of Population and Public Health (SPPH), University of British Columbia, Vancouver, BC, Canada.

Ahmed M Bayoumi (AM)

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Division of General Internal Medicine, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.

Yvonne Bombard (Y)

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. yvonne.bombard@utoronto.ca.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. yvonne.bombard@utoronto.ca.

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