Nonie S Arora1,1, J Kelly Davis2,3,2,3, Christine Kirby2,3,2,3, Amy L McGuire4,4, Robert C Green5,6,7,5,6,7, J S Blumenthal-Barby4,4, Peter A Ubel2,3,8,9,2,3,8,9. 1. University of Michigan Medical School, Ann Arbor, MI 48109, USA. 2. Duke-Margolis Health Policy Center, Durham, NC 27708, USA. 3. Fuqua School of Business, Duke University, Durham, NC 27708, USA. 4. Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, USA. 5. Division of Genetics, Department of Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA. 6. Harvard Medical School, Boston, MA 02115, USA. 7. Partners Healthcare Personalized Medicine, Boston, MA 02139, USA. 8. Sanford School of Public Policy, Duke University, Durham, NC 27708, USA. 9. Duke University School of Medicine, Durham, NC 27710, USA.
Abstract
AIM: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting. MATERIALS & METHODS: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation. RESULTS: Findings included confusion regarding genomic terminology, difficulty with the volume or complexity of information and difficulties communicating complex risk information to patients. We observed a broad dismissal of clinical value of GS by some physicians and sometimes ineffective communication regarding health behavior change. CONCLUSION: Overcoming these behavioral challenges is necessary to make full use of clinical GS results.
AIM: Identify the behavioral challenges to the use of genome sequencing (GS) in a clinical setting. MATERIALS & METHODS: We observed how general internists and nongenetic specialists delivered GS results to patients enrolled in the MedSeq Project. Using transcripts of such disclosure interactions, we made qualitative observations of communication behaviors that could limit the usefulness of GS results until reaching the point of thematic saturation. RESULTS: Findings included confusion regarding genomic terminology, difficulty with the volume or complexity of information and difficulties communicating complex risk information to patients. We observed a broad dismissal of clinical value of GS by some physicians and sometimes ineffective communication regarding health behavior change. CONCLUSION: Overcoming these behavioral challenges is necessary to make full use of clinical GS results.
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