BRCA1/2 TESTING--PATIENT UPTAKE AND TREATMENT CHOICES

描述（改编自研究者摘要）：基因检测 与家族性乳腺癌和卵巢癌（BRCA 1和BRCA 2）相关的基因， 最近可用于临床使用，并可能用于 占总人口的很大一部分。 然而， 关于BRCA 1/2测试，因为预测值的不确定性， 缺乏关于治疗或预防措施的有效性的数据， 乳腺癌和卵巢癌，关注 检测，以及患者对基因检测缺乏了解， 卫生保健提供者。 一般认为，病人越多， 通过咨询和知情同意，对检测的理解将导致 最大限度地减少不适当的测试使用或不良的医疗或 测试的结果。 然而，迄今为止， 无论是患者的理解还是广泛的咨询 服务与患者行为有任何关系，或者其他 诸如患者对保密性的担忧或从业者等因素 对测试或医疗管理选择的态度，也是 关联的. 拟议的项目旨在研究与 接受BRCA 1/2基因检测和患者的医疗管理选择 在得知他们的测试结果后 与以前的研究相比， 患者进入基因检测研究方案或假设 测试选择，拟议的项目将研究患者的实际测试 和医疗管理决策在临床实践中，并将审查 实践者的态度在这些决定中的作用。 调查人员将 通过与接受BRCA 1/2治疗的患者进行访谈收集数据 测试，并通过问卷调查他们的从业人员。 会议提出的主要目标 建议的项目是：1）确定健康的特点 对BRCA 1/2检测感兴趣或要求进行BRCA 1/2检测的护理从业人员， 测试的假设，从业者的专业，对测试的态度， 和使用遗传咨询设施是相关的，这些 变量随时间变化。 2)为了验证病人摄取 （决定进行测试或拒绝进行测试）的BRAC 1/2测试是 与患者人口统计学、患者知识和关注相关， 测试，实际和感知的风险因素，医生特征，以及 知情同意程序的范围。 3)审查的作用 患者医疗管理决策中的医生特征 BRCA 1检测

DESCRIPTION (Adapted from the Investigator's Abstract): Tests for genes associated with familial breast and ovarian cancer (BRCA1 and BRCA2) have recently become available for clinical use, and could potentially be used by a large proportion of the general population. However, there is controversy about BRCA1/2 testing because of uncertainty about the predictive value of the tests, lack of data on efficacy of treatments or preventive measures for breast and ovarian cancer, concerns about the psychosocial impacts of testing, and a lack of knowledge about genetic testing among patients and health care providers. It is generally assumed that greater patient understanding of testing, through counseling and informed consent, will lead to a minimization of potential for inappropriate test use or poor medical or emotional outcomes as a result of testing. However, no studies to date have directly addressed whether patient understanding or extensive counseling services have any relationship with patient behavior, or whether other factors such as patient concerns about confidentiality, or practitioner attitudes towards testing or medical management options, are also associated. The proposed project is designed to examine factors associated with the uptake of BRCA1/2 genetic testing and patients' medical management choices after learning their test results. In contrast to previous research on patients entered in genetic testing research protocols or of hypothetical testing choices, the proposed project will study patients' actual testing and medical management decisions in clinical practice and will examine the role of practitioner attitudes in those decisions. The investigators will collect data through interviews with patients who are offered BRCA1/2 testing, and through questionnaires to their practitioners. The main goals of the proposed project are: 1) To determine the characteristics of health care practitioners who are interested in or request the BRCA1/2 test, and to test the hypothesis that practitioner specialty, attitudes toward testing, and use of genetic counseling facilities are associated, and that these variables change over time. 2) To test the hypothesis that patient uptake (decisions to be tested or refusal to be tested) of BRAC1/2 testing is associated with patient demographics, patient knowledge and concerns about testing, actual and perceived risk factors, physician characteristics, and the extent of the informed consent process. 3) To examine the role of practitioner characteristics in patient medical management decisions after receiving BRCA1 testing.