Yvonne Bombard1,2, Marc Clausen3, Salma Shickh4,3, Chloe Mighton4,3, Selina Casalino3, Theresa H M Kim5, Sarah M Muir3, Lindsay Carlsson6, Nancy Baxter4,3,7, Adena Scheer3,8, Christine Elser6,8, Andrea Eisen9, Seema Panchal10, Tracy Graham9, Melyssa Aronson10, Carolyn Piccinin10, Talia Mancuso9, Kara Semotiuk10, Michael Evans3, June C Carroll10,11, Kenneth Offit12, Mark Robson12, Jada G Hamilton12, Emily Glogowski13, Kasmintan Schrader14,15, Raymond H Kim5,6,8, Jordan Lerner-Ellis10,16, Kevin E Thorpe17,18, Andreas Laupacis4,3. 1. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. yvonne.bombard@utoronto.ca. 2. St. Michael's Hospital, Toronto, ON, Canada. yvonne.bombard@utoronto.ca. 3. St. Michael's Hospital, Toronto, ON, Canada. 4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 5. The Hospital for Sick Children, Toronto, ON, Canada. 6. University Health Network, Toronto, ON, Canada. 7. Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. 8. Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 9. Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 10. Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada. 11. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada. 12. Memorial Sloan Kettering Cancer Center, New York, NY, USA. 13. GeneDx, Gaithersburg, MD, USA. 14. Department of Molecular Oncology and Hereditary Cancer Program, BC Cancer Agency, Vancouver, BC, Canada. 15. Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada. 16. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. 17. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 18. Applied Health Research Centre, St. Michael's Hospital, Toronto, ON, Canada.
Abstract
PURPOSE: To evaluate the effectiveness of the Genomics ADvISER (www.genomicsadviser.com) decision aid (DA) for selection of secondary findings (SF), compared with genetic counseling alone. METHODS: A randomized controlled trial (RCT) was conducted to evaluate whether the Genomics ADvISER is superior to genetic counseling when hypothetically selecting SF. Participants were randomized to use the DA followed by discussion with a genetic counselor, or to genetic counseling alone. Surveys were administered at baseline and post-intervention. Primary outcome was decisional conflict. Secondary outcomes were knowledge, preparation for, and satisfaction with decision-making, anxiety, and length of counseling session. RESULTS: Participants (n = 133) were predominantly White/European (74%), female (90%), and ≥50 years old (60%). Decisional conflict (mean difference 0.05; P = 0.60), preparation for decision-making (0.17; P = 0.95), satisfaction with decision (-2.18; P = 0.06), anxiety (0.72; P = 0.56), and knowledge of sequencing limitations (0.14; P = 0.70) did not significantly differ between groups. However, intervention participants had significantly higher knowledge of SF (0.39; P < 0.001) and sequencing benefits (0.97; P = 0.01), and significantly shorter counseling time (24.40 minutes less; P < 0.001) CONCLUSIONS: The Genomics ADvISER did not decrease decisional conflict but reduced counseling time and improved knowledge. This decision aid could serve as an educational tool, reducing in-clinic time and potentially health care costs.
PURPOSE: To evaluate the effectiveness of the Genomics ADvISER (www.genomicsadviser.com) decision aid (DA) for selection of secondary findings (SF), compared with genetic counseling alone. METHODS: A randomized controlled trial (RCT) was conducted to evaluate whether the Genomics ADvISER is superior to genetic counseling when hypothetically selecting SF. Participants were randomized to use the DA followed by discussion with a genetic counselor, or to genetic counseling alone. Surveys were administered at baseline and post-intervention. Primary outcome was decisional conflict. Secondary outcomes were knowledge, preparation for, and satisfaction with decision-making, anxiety, and length of counseling session. RESULTS: Participants (n = 133) were predominantly White/European (74%), female (90%), and ≥50 years old (60%). Decisional conflict (mean difference 0.05; P = 0.60), preparation for decision-making (0.17; P = 0.95), satisfaction with decision (-2.18; P = 0.06), anxiety (0.72; P = 0.56), and knowledge of sequencing limitations (0.14; P = 0.70) did not significantly differ between groups. However, intervention participants had significantly higher knowledge of SF (0.39; P < 0.001) and sequencing benefits (0.97; P = 0.01), and significantly shorter counseling time (24.40 minutes less; P < 0.001) CONCLUSIONS: The Genomics ADvISER did not decrease decisional conflict but reduced counseling time and improved knowledge. This decision aid could serve as an educational tool, reducing in-clinic time and potentially health care costs.
Authors: Elizabeth G Liles; Michael C Leo; Amanda S Freed; Kathryn M Porter; Jamilyn M Zepp; Tia L Kauffman; Erin Keast; Carmit K McMullen; Inga Gruß; Barbara B Biesecker; Kristin R Muessig; Donna J Eubanks; Laura M Amendola; Michael O Dorschner; Bradley A Rolf; Gail P Jarvik; Katrina A B Goddard; Benjamin S Wilfond Journal: Genet Med Date: 2022-05-06 Impact factor: 8.864
Authors: Salma Shickh; Sara A Rafferty; Marc Clausen; Rita Kodida; Chloe Mighton; Seema Panchal; Justin Lorentz; Thomas Ward; Nicholas Watkins; Christine Elser; Andrea Eisen; June C Carroll; Emily Glogowski; Kasmintan A Schrader; Jordan Lerner-Ellis; Raymond H Kim; David Chitayat; Cheryl Shuman; Yvonne Bombard Journal: Genet Med Date: 2021-03-02 Impact factor: 8.864
Authors: Salma Shickh; Daena Hirjikaka; Marc Clausen; Rita Kodida; Chloe Mighton; Emma Reble; Jordan Sam; Seema Panchal; Melyssa Aronson; Tracy Graham; Susan Randall Armel; Emily Glogowski; Christine Elser; Andrea Eisen; June C Carroll; Cheryl Shuman; Emily Seto; Nancy N Baxter; Adena Scheer; Serena Shastri-Estrada; Geoff Feldman; Kevin E Thorpe; Kasmintan A Schrader; Jordan Lerner-Ellis; Raymond H Kim; Hanna Faghfoury; Yvonne Bombard Journal: BMJ Open Date: 2022-04-29 Impact factor: 3.006
Authors: Roderick Clark; Miran Kenk; Kristen McAlpine; Emily Thain; Kirsten M Farncombe; Colin C Pritchard; Robert Nussbaum; Alexander W Wyatt; Johann de Bono; Danny Vesprini; Yvonne Bombard; Justin Lorentz; Steven Narod; Raymond Kim; Neil Fleshner Journal: Can Urol Assoc J Date: 2021-12 Impact factor: 1.862