Genomic Risk Profiling: Attitudes and Use in Personal and Clinical Care of Primary Care Physicians Who Offer Risk Profiling
Genomic Risk Profiling: Attitudes and Use in Personal and Clinical Care of Primary Care Physicians Who Offer Risk Profiling
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DOI：
10.1007/s11606-011-1651-7
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发表时间：
2011-08-01
影响因子：
5.7
通讯作者：
Cho, Alex
中科院分区：
文献类型：
--
作者：
Haga, Susanne B.;Carrig, Madeline M.;Cho, Alex
背景：基因组风险分析涉及通过统计关联与一系列疾病状态相关联的遗传变异的分析。有相当大的争议，如何，甚至是否，将这些测试纳入常规medicalcare.Objective：为了评估医生的态度和摄取基因组风险分析之间的“早期采用者”practicegroup.Design：我们调查了MDVIP，一个国家组的初级保健医生（PCP），目前提供基因组风险分析作为他们的实践的一部分的成员。MDVIP网络中的所有医生（N = 356）结果：我们获得了44%的响应率。三分之一的受访者为自己订购了测试，42%的人为患者订购了测试。对于那些对基因组风险测试有充分了解的人来说，进行个人测试的几率高出10.51倍（p < 0.0001）。在那些没有为自己订购测试的人中，60%的人表示担心患者受到人寿和长期/残疾保险公司的歧视，61%的人担心测试成本，62%的人担心临床效用。在为自己订购检测的受访者中，为患者订购检测的几率高出8.29倍（p < 0.0001）。那些谁下令测试的患者，保险范围（p = 0.014）和不确定的临床效用（p = 0.034）的关注与较低的相对频率的意图，以命令测试再次在future.CONCLUSIONS：我们的研究结果表明，受访者熟悉的医生订购行为和临床效用是一个关键的预测基因组风险分析的主要关注。教育和解释性支持可以提高对基因组风险分析的理解。
BACKGROUND: Genomic risk profiling involves the analysis of genetic variations linked through statistical associations to a range of disease states. There is considerable controversy as to how, and even whether, to incorporate these tests into routine medical care.OBJECTIVE: To assess physician attitudes and uptake of genomic risk profiling among an 'early adopter' practice group.DESIGN: We surveyed members of MDVIP, a national group of primary care physicians (PCPs), currently offering genomic risk profiling as part of their practice.POPULATION: All physicians in the MDVIP network (N = 356)RESULTS: We obtained a 44% response rate. One third of respondents had ordered a test for themselves and 42% for a patient. The odds of having ordered personal testing were 10.51-fold higher for those who felt well-informed about genomic risk testing (p < 0.0001). Of those who had not ordered a test for themselves, 60% expressed concerns for patients regarding discrimination by life and long-term/disability insurers, 61% about test cost, and 62% about clinical utility. The odds of ordering testing for their patients was 8.29-fold higher among respondents who had ordered testing for themselves (p < 0.0001). Of those who had ordered testing for patients, concerns about insurance coverage (p = 0.014) and uncertain clinical utility (p = 0.034) were associated with a lower relative frequency of intention to order testing again in the future.CONCLUSIONS: Our findings demonstrate that respondent familiarity was a key predictor of physician ordering behavior and clinical utility was a primary concern for genomic risk profiling. Educational and interpretive support may enhance uptake of genomic risk profiling.