Canadian College of Medical Geneticists: clinical practice advisory document - responsibility to recontact for reinterpretation of clinical genetic testing.

Delivery of Health Care Genetic Testing

Journal

Journal of medical genetics
ISSN: 1468-6244
Titre abrégé: J Med Genet
Pays: England
ID NLM: 2985087R

Informations de publication

Date de publication:
03 Oct 2024
Historique:
received: 18 08 2024
accepted: 26 09 2024
medline: 4 10 2024
pubmed: 4 10 2024
entrez: 3 10 2024
Statut: aheadofprint

Résumé

Advances in technology and knowledge have facilitated both an increase in the number of patient variants reported and variants reclassified. While there is currently no duty to recontact for reclassified genetic variants, there may be a responsibility. The purpose of this clinical practice advisory document is to provide healthcare practitioners guidance for recontact of previously identified and classified variants, suggest methods for recontact, and principles to consider, taking account patient safety, feasibility, ethical considerations, health service capacity and resource constraints. The target audience are practitioners who order genetic testing, follow patients who have undergone genetic testing and those analysing and reporting genetic testing. A multidisciplinary group of laboratory and ordering clinicians, patient representatives, ethics and legal researchers and a genetic counsellor from the Canadian Association of Genetic Counsellors reviewed the existing literature and guidelines on responsibility to recontact in a clinical context to make recommendations. Comments were collected from the Canadian College of Medical Geneticists (CCMG) Education, Ethics, and Public Policy, Clinical Practice and Laboratory Practice committees, and the membership at large. Following incorporation of feedback, and external review by the Canadian Association of Genetic Counsellors and patient groups, the document was approved by the CCMG Board of Directors. The CCMG is the Canadian organisation responsible for certifying laboratory and medical geneticists who provide medical genetics services, and for establishing professional and ethical standards for clinical genetics services in Canada. The document describes the ethical and practical factors and suggests a shared responsibility between patients, ordering clinician and laboratory practitioners.

Sections du résumé

BACKGROUND BACKGROUND
Advances in technology and knowledge have facilitated both an increase in the number of patient variants reported and variants reclassified. While there is currently no duty to recontact for reclassified genetic variants, there may be a responsibility. The purpose of this clinical practice advisory document is to provide healthcare practitioners guidance for recontact of previously identified and classified variants, suggest methods for recontact, and principles to consider, taking account patient safety, feasibility, ethical considerations, health service capacity and resource constraints. The target audience are practitioners who order genetic testing, follow patients who have undergone genetic testing and those analysing and reporting genetic testing.
METHODS METHODS
A multidisciplinary group of laboratory and ordering clinicians, patient representatives, ethics and legal researchers and a genetic counsellor from the Canadian Association of Genetic Counsellors reviewed the existing literature and guidelines on responsibility to recontact in a clinical context to make recommendations. Comments were collected from the Canadian College of Medical Geneticists (CCMG) Education, Ethics, and Public Policy, Clinical Practice and Laboratory Practice committees, and the membership at large.
RESULTS RESULTS
Following incorporation of feedback, and external review by the Canadian Association of Genetic Counsellors and patient groups, the document was approved by the CCMG Board of Directors. The CCMG is the Canadian organisation responsible for certifying laboratory and medical geneticists who provide medical genetics services, and for establishing professional and ethical standards for clinical genetics services in Canada.
CONCLUSION CONCLUSIONS
The document describes the ethical and practical factors and suggests a shared responsibility between patients, ordering clinician and laboratory practitioners.

Identifiants

pubmed: 39362754
pii: jmg-2024-110330
doi: 10.1136/jmg-2024-110330
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Elaine Suk-Ying Goh (ES)

Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada elaine.goh@thp.ca.
Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.

Lauren Chad (L)

The Hospital for Sick Children, Toronto, Ontario, Canada.

Julie Richer (J)

Medical Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Yvonne Bombard (Y)

Genomics Health Services Research Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Chloe Mighton (C)

Genomics Health Services Research Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Ron Agatep (R)

Genomics, Shared Health Diagnostic Services, Winnipeg, Manitoba, Canada.

Melanie Lacaria (M)

Newborn Screening Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Blaine Penny (B)

Lumiio, Calgary, Alberta, Canada.

Mary Ann Thomas (MA)

Departments of Medical Genetics and Pediatrics, University of Calgary, Calgary, Alberta, Canada.

Ma'n H Zawati (MH)

Human Genetics, Centre of Genomics and Policy - McGill University, Montreal, Quebec, Canada.

Julie MacFarlane (J)

Screening Programs, Perinatal Services BC, Vancouver, British Columbia, Canada.

Anne-Marie Laberge (AM)

Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada.
Medical Genetics, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada.

Tanya N Nelson (TN)

Genome Diagnostics, Pathology and Laboratory Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada.
Genome Diagnostics, Pathology and Laboratory Medicine, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.

Classifications MeSH