ORCA, a values-based decision aid for selecting additional findings from genomic sequencing in adults: Efficacy results from a randomized trial.

Decision aid Genomic sequencing Incidental results Informed consent Secondary findings

Journal

Genetics in medicine : official journal of the American College of Medical Genetics
ISSN: 1530-0366
Titre abrégé: Genet Med
Pays: United States
ID NLM: 9815831

Informations de publication

Date de publication:
08 2022
Historique:
received: 05 10 2021
revised: 04 04 2022
accepted: 05 04 2022
pubmed: 7 5 2022
medline: 11 8 2022
entrez: 6 5 2022
Statut: ppublish

Résumé

Individuals having genomic sequencing can choose to be notified about pathogenic variants in genes unrelated to the testing indication. A decision aid can facilitate weighing one's values before making a choice about these additional results. We conducted a randomized trial (N = 231) comparing informed values-choice congruence among adults at risk for a hereditary cancer syndrome who viewed either the Optional Results Choice Aid (ORCA) or web-based additional findings information alone. ORCA is values-focused with a low-literacy design. Individuals in both arms had informed values-choice congruence (75% and 73% in the decision aid and web-based groups, respectively; odds ratio [OR] = 1.10, 95% CI = 0.58-2.08). Most participants had adequate knowledge (79% and 76% in the decision aid and web-based groups, respectively; OR = 1.20, 95% CI = 0.61-2.34), with no significant difference between groups. Most had information-seeking values (97% and 98% in the decision aid and web-based groups, respectively; OR = 0.59, 95% CI = 0.10-3.61) and chose to receive additional findings. The ORCA decision aid did not significantly improve informed values-choice congruence over web-based information in this cohort of adults deciding about genomic results. Both web-based approaches may be effective for adults to decide about receiving medically actionable additional results.

Identifiants

pubmed: 35522237
pii: S1098-3600(22)00725-0
doi: 10.1016/j.gim.2022.04.008
pmc: PMC9586129
mid: NIHMS1810472
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1664-1674

Subventions

Organisme : NIGMS NIH HHS
ID : T32 GM007454
Pays : United States
Organisme : NHGRI NIH HHS
ID : U01 HG007292
Pays : United States
Organisme : NHGRI NIH HHS
ID : U01 HG007307
Pays : United States
Organisme : NHGRI NIH HHS
ID : UM1 HG007292
Pays : United States

Informations de copyright

Copyright © 2022 American College of Medical Genetics and Genomics. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest All authors declare no conflicts of interest.

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Auteurs

Elizabeth G Liles (EG)

Kaiser Permanente Center for Health Research, Portland, OR. Electronic address: Beth.G.Liles@kpchr.org.

Michael C Leo (MC)

Kaiser Permanente Center for Health Research, Portland, OR.

Amanda S Freed (AS)

Division of Medical Genetics, Department of Medicine, University of Washington Medical Center, Seattle, WA.

Kathryn M Porter (KM)

Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA.

Jamilyn M Zepp (JM)

Department of Translational and Applied Genomics, Center for Health Research, Kaiser Permanente Northwest, Portland, OR.

Tia L Kauffman (TL)

Kaiser Permanente Center for Health Research, Portland, OR.

Erin Keast (E)

Kaiser Permanente Center for Health Research, Portland, OR.

Carmit K McMullen (CK)

Kaiser Permanente Center for Health Research, Portland, OR.

Inga Gruß (I)

Kaiser Permanente Center for Health Research, Portland, OR.

Barbara B Biesecker (BB)

Genetics, Bioinformatics and Translation, RTI International, Washington, D.C.

Kristin R Muessig (KR)

Department of Translational and Applied Genomics, Center for Health Research, Kaiser Permanente Northwest, Portland, OR.

Donna J Eubanks (DJ)

Kaiser Permanente Center for Health Research, Portland, OR.

Laura M Amendola (LM)

Division of Medical Genetics, Department of Medicine, University of Washington Medical Center, Seattle, WA.

Michael O Dorschner (MO)

Division of Medical Genetics, Department of Medicine, University of Washington Medical Center, Seattle, WA.

Bradley A Rolf (BA)

Division of Medical Genetics, Department of Medicine, University of Washington Medical Center, Seattle, WA.

Gail P Jarvik (GP)

Division of Medical Genetics, Department of Medicine, University of Washington Medical Center, Seattle, WA.

Katrina A B Goddard (KAB)

Department of Translational and Applied Genomics, Center for Health Research, Kaiser Permanente Northwest, Portland, OR.

Benjamin S Wilfond (BS)

Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA; Division of Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.

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