BACKGROUND AND OBJECTIVE: The potential application of whole-genome sequencing (WGS) to state-mandated standard newborn screening (NBS) challenges the traditional public health approach to NBS and raises ethical, policy, and clinical practice issues. This article examines the perspectives and values of diverse healthy pregnant women and parents of children diagnosed with a primary immunodeficiency disorder about traditional NBS and expanded NBS with the use of WGS. METHODS: We conducted 4 focus groups (3 in English and 1 in Spanish) with socioeconomically and ethnically diverse pregnant women (n = 26), and a comparison group with parents of children diagnosed with a primary immunodeficiency disorder (n = 5). RESULTS: Pediatric policy-relevant themes that emerged from our analysis of the focus group data are presented within 4 categories: (1) perspectives on traditional NBS, (2) informed consent, (3) return of results, and (4) storage and retrieval of results. Analyses indicate that study participants desired greater inclusion in the NBS process. Despite an optimistic orientation to the potential benefits and limited harms likely to result from genomic applications of NBS, parents voiced concerns about privacy and control over test results. Limited trust in the medical system and the state-run NBS program informed these concerns. CONCLUSIONS: Expanded NBS with WGS for pediatricians may require management of more genetic conditions, including mutations that convey risk to both the child and parents for adult-onset disorders, and an informed-consent process to manage the genomic data and storage of blood spots. Attention to how these technologies are understood in diverse populations is needed for effective implementation.
BACKGROUND AND OBJECTIVE: The potential application of whole-genome sequencing (WGS) to state-mandated standard newborn screening (NBS) challenges the traditional public health approach to NBS and raises ethical, policy, and clinical practice issues. This article examines the perspectives and values of diverse healthy pregnant women and parents of children diagnosed with a primary immunodeficiency disorder about traditional NBS and expanded NBS with the use of WGS. METHODS: We conducted 4 focus groups (3 in English and 1 in Spanish) with socioeconomically and ethnically diverse pregnant women (n = 26), and a comparison group with parents of children diagnosed with a primary immunodeficiency disorder (n = 5). RESULTS: Pediatric policy-relevant themes that emerged from our analysis of the focus group data are presented within 4 categories: (1) perspectives on traditional NBS, (2) informed consent, (3) return of results, and (4) storage and retrieval of results. Analyses indicate that study participants desired greater inclusion in the NBS process. Despite an optimistic orientation to the potential benefits and limited harms likely to result from genomic applications of NBS, parents voiced concerns about privacy and control over test results. Limited trust in the medical system and the state-run NBS program informed these concerns. CONCLUSIONS: Expanded NBS with WGS for pediatricians may require management of more genetic conditions, including mutations that convey risk to both the child and parents for adult-onset disorders, and an informed-consent process to manage the genomic data and storage of blood spots. Attention to how these technologies are understood in diverse populations is needed for effective implementation.
Authors: Jonathan S Berg; Pankaj B Agrawal; Donald B Bailey; Alan H Beggs; Steven E Brenner; Amy M Brower; Julie A Cakici; Ozge Ceyhan-Birsoy; Kee Chan; Flavia Chen; Robert J Currier; Dmitry Dukhovny; Robert C Green; Julie Harris-Wai; Ingrid A Holm; Brenda Iglesias; Galen Joseph; Stephen F Kingsmore; Barbara A Koenig; Pui-Yan Kwok; John Lantos; Steven J Leeder; Megan A Lewis; Amy L McGuire; Laura V Milko; Sean D Mooney; Richard B Parad; Stacey Pereira; Joshua Petrikin; Bradford C Powell; Cynthia M Powell; Jennifer M Puck; Heidi L Rehm; Neil Risch; Myra Roche; Joseph T Shieh; Narayanan Veeraraghavan; Michael S Watson; Laurel Willig; Timothy W Yu; Tiina Urv; Anastasia L Wise Journal: Pediatrics Date: 2017-01-17 Impact factor: 7.124
Authors: Leandra K Tolusso; Kathleen Collins; Xue Zhang; Jennifer R Holle; C Alexander Valencia; Melanie F Myers Journal: J Genet Couns Date: 2016-12-16 Impact factor: 2.537