PURPOSE: Array comparative genomic hybridization is an emerging test used clinically to identify the etiology of children with developmental delay, yet little data are available regarding how physicians use these results. This pilot study evaluated how positive test results were used to influence patient management. METHODS: We surveyed 14 physicians of 48 patients who had copy number changes detected by microarray technology. RESULTS: Of 48 patients, 34 (70.8%) had 65 management changes after receiving the test result (with individual patients having 1-3 changes). Most commonly, physicians provided patients' families with a recurrence risk for affected subsequent pregnancies (35% of patients). Patients avoided other forms of testing (35%) and had improved access to services (25%). In 27% of patients, physicians altered medical management by referring patients to a specialist or recommending medical screening. Patients with known syndromes had multiple changes, but patients with novel copy number changes also had recommendations made based on the array result. CONCLUSIONS: Overall, physicians reported making changes in management among most patients with positive test results, in ways similar to abnormalities detected by conventional cytogenetics. Our study demonstrates that this testing, in our clinical setting, is affecting management of children with developmental delay.
PURPOSE: Array comparative genomic hybridization is an emerging test used clinically to identify the etiology of children with developmental delay, yet little data are available regarding how physicians use these results. This pilot study evaluated how positive test results were used to influence patient management. METHODS: We surveyed 14 physicians of 48 patients who had copy number changes detected by microarray technology. RESULTS: Of 48 patients, 34 (70.8%) had 65 management changes after receiving the test result (with individual patients having 1-3 changes). Most commonly, physicians provided patients' families with a recurrence risk for affected subsequent pregnancies (35% of patients). Patients avoided other forms of testing (35%) and had improved access to services (25%). In 27% of patients, physicians altered medical management by referring patients to a specialist or recommending medical screening. Patients with known syndromes had multiple changes, but patients with novel copy number changes also had recommendations made based on the array result. CONCLUSIONS: Overall, physicians reported making changes in management among most patients with positive test results, in ways similar to abnormalities detected by conventional cytogenetics. Our study demonstrates that this testing, in our clinical setting, is affecting management of children with developmental delay.
Authors: Robin Z Hayeems; Jasmin Bhawra; Kate Tsiplova; M Stephen Meyn; Nasim Monfared; Sarah Bowdin; D James Stavropoulos; Christian R Marshall; Raveen Basran; Cheryl Shuman; Shinya Ito; Iris Cohn; Courtney Hum; Marta Girdea; Michael Brudno; Ronald D Cohn; Stephen W Scherer; Wendy J Ungar Journal: Eur J Hum Genet Date: 2017-11-20 Impact factor: 4.246
Authors: Rolph Pfundt; Kat Kwiatkowski; Alan Roter; Anju Shukla; Eric Thorland; Richard Hockett; Barbara DuPont; Eric T Fung; Alka Chaubey Journal: Genet Med Date: 2015-04-16 Impact factor: 8.822
Authors: Victoria Q Tao; Kelvin Y K Chan; Yoyo W Y Chu; Gary T K Mok; Tiong Y Tan; Wanling Yang; So Lun Lee; Wing Fai Tang; Winnie W Y Tso; Elizabeth T Lau; Anita S Y Kan; Mary H Tang; Yu-Lung Lau; Brian H Y Chung Journal: PLoS One Date: 2014-10-15 Impact factor: 3.240