Christine Rini1, Cynthia M Khan2, Elizabeth Moore3, Myra I Roche4,5,6, James P Evans4,6,7, Jonathan S Berg4,6, Bradford C Powell6, Giselle Corbie-Smith7,8,9, Ann Katherine M Foreman4,6, Ida Griesemer10, Kristy Lee6, Julianne M O'Daniel4,6, Gail E Henderson4,8. 1. John Theuer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA. christine.rini@hackensackmeridian.org. 2. Econometrica, Inc., Bethesda, Maryland, USA. 3. Blue Cross and Blue Shield of North Carolina, Durham, North Carolina, USA. 4. Center for Genomics and Society, University of North Carolina, Chapel Hill, North Carolina, USA. 5. Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA. 6. Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 7. Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 8. Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 9. Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 10. Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Abstract
PURPOSE: In a diagnostic exome sequencing study (the North Carolina Clinical Genomic Evaluation by Next-Generation Exome Sequencing project, NCGENES), we investigated adult patients' intentions to request six categories of secondary findings (SFs) with low or no medical actionability and correlates of their intentions. METHODS: At enrollment, eligible participants (n = 152) completed measures assessing their sociodemographic, clinical, and literacy-related characteristics. Prior to and during an in-person diagnostic result disclosure visit, they received education about categories of SFs they could request. Immediately after receiving education at the visit, participants completed measures of intention to learn SFs, interest in each category, and anticipated regret for learning and not learning each category. RESULTS: Seventy-eight percent of participants intended to learn at least some SFs. Logistic regressions examined their intention to learn any or all of these findings (versus none) and interest in each of the six individual categories (yes/no). Results revealed little association between intentions and sociodemographic, clinical, or literacy-related factors. Across outcomes, participants who anticipated regret for learning SFs reported weaker intention to learn them (odds ratios (ORs) from 0.47 to 0.71), and participants who anticipated regret for not learning these findings reported stronger intention to learn them (OR 1.61-2.22). CONCLUSION: Intentions to request SFs with low or no medical actionability may be strongly influenced by participants' desire to avoid regret.
PURPOSE: In a diagnostic exome sequencing study (the North Carolina Clinical Genomic Evaluation by Next-Generation Exome Sequencing project, NCGENES), we investigated adult patients' intentions to request six categories of secondary findings (SFs) with low or no medical actionability and correlates of their intentions. METHODS: At enrollment, eligible participants (n = 152) completed measures assessing their sociodemographic, clinical, and literacy-related characteristics. Prior to and during an in-person diagnostic result disclosure visit, they received education about categories of SFs they could request. Immediately after receiving education at the visit, participants completed measures of intention to learn SFs, interest in each category, and anticipated regret for learning and not learning each category. RESULTS: Seventy-eight percent of participants intended to learn at least some SFs. Logistic regressions examined their intention to learn any or all of these findings (versus none) and interest in each of the six individual categories (yes/no). Results revealed little association between intentions and sociodemographic, clinical, or literacy-related factors. Across outcomes, participants who anticipated regret for learning SFs reported weaker intention to learn them (odds ratios (ORs) from 0.47 to 0.71), and participants who anticipated regret for not learning these findings reported stronger intention to learn them (OR 1.61-2.22). CONCLUSION: Intentions to request SFs with low or no medical actionability may be strongly influenced by participants' desire to avoid regret.
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