Video Intervention to Address Pre-Test Patient Education for Tumor Genomic Testing

项目总结 每年有数以千计的患者被诊断为转移性癌症和下一代躯体(肿瘤) 测序(NGS)测试对于这些癌症的治疗越来越重要。专业指导方针 声明治疗肿瘤学家在测试偶发生殖系的可能性之前应与患者讨论 体细胞(肿瘤)下一代的临床应用和解释中的发现和疾病特异性限制 测序(NGS)结果。然而，肿瘤学家对遗传学和时间限制有不同的理解。 使提供者在以下背景下充分告知患者有关肿瘤NGS的信息具有挑战性 常规的临床护理。因此，考试前的教育往往是不完整的，而且在各个领域都有很大的差异。 医疗服务提供者造成不公平的照顾。该项目的总体目标是开发和评估一系列视频 用于对接受肿瘤NGS检测的患者进行检测前教育，作为其临床护理的一部分。之前 为了启动项目，我们进行了一项提供者调查，以评估当前提供者与肿瘤相关的做法 NGS测试和患者焦点小组，以确定常见的错误信息领域和偏好 信息展示。根据该提供者和患者的反馈以及国家建议，我们将 制作3个简短的动画视频(大约2分钟长)：一个与肿瘤无关的视频(目标1)以及 包含转移性肺癌(MLC)或转移性肺癌患者特定肿瘤类型内容的视频 乳腺癌(MBC)(目标2)。转移性癌症患者将被邀请在办公室观看这段视频 肿瘤学家计划下令进行肿瘤NGS测试。研究参与者将完成问卷以评估 消息特定的和一般的基因组学知识、对不确定性的容忍度以及提供商的信任 视频后查看。我们的方法是创新的，因为除了知识之外，我们还将评估对 对供应商的不确定性和信任度，这些都没有在这方面进行调查。这项研究具有重要意义 因为我们将确定是否可以在非常简短、高度可扩展、 视频消息。我们的长期目标是在一项随机对照的多中心试验中研究这段视频 具有不同人口统计结构的学术和社区环境。

PROJECT SUMMARY Thousands of patients are diagnosed with metastatic cancers each year and somatic (tumor) next generation sequencing (NGS) testing is increasingly important for the treatment of these cancers. Professional guidelines state that treating oncologists should discuss with patients prior to testing the possibility of incidental germline findings and disease-specific limitations in clinical utility and interpretation of somatic (tumor) next generation sequencing (NGS) results. However, oncologists have varied understanding of genetics and time limitations make it challenging for providers to adequately inform their patients about tumor NGS within the context of routine clinical care. As a result, pre-test education is often incomplete and has significant variability across providers resulting in inequitable care. The overall goal of this project is to develop and evaluate series of videos to be used for pre-test education of patients who undergo tumor NGS testing as part of their clinical care. Prior to project initiation, we conducted a provider survey to assess current provider practice as it pertains to tumor NGS testing and patient focus groups to identify common areas of misinformation and preferences for information presentation. Based on this provider and patient feedback and national recommendations, we will develop 3 brief animated videos (approximately 2 minutes in length): a tumor-agnostic video (Aim 1) as well as videos that contain tumor type-specific content for patients with metastatic lung cancer (MLC) or metastatic breast cancer (MBC) (Aim 2). Metastatic cancer patients will be invited to view this video in-office when their oncologists plan to order tumor NGS testing. Study participants will complete questionnaires to assess message-specific and general genomics knowledge, tolerance of uncertainty, and provider trust both pre- and post-video viewing. Our approach is innovative because in addition to knowledge, we will evaluate tolerance for uncertainty and trust in provider, which have not been investigated in this context. The study is significant because we will determine if effective pre-tumor NGS education can be achieved in a very brief, highly scalable, video message. Our long-term goal is to study the video in a randomized-controlled, multi-center trial in academic and community settings with diverse demographics.