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了解遗传性视网膜营养不良基因检测的影响。

Understanding the impact of genetic testing for inherited retinal dystrophy.

机构信息

University of Manchester, Manchester, UK.

出版信息

Eur J Hum Genet. 2013 Nov;21(11):1209-13. doi: 10.1038/ejhg.2013.19. Epub 2013 Feb 13.

Abstract

The capability of genetic technologies is expanding rapidly in the field of inherited eye disease. New genetic testing approaches will deliver a step change in the ability to diagnose and extend the possibility of targeted treatments. However, evidence is lacking about the benefits of genetic testing to support service planning. Here, we report qualitative data about retinal dystrophy families' experiences of genetic testing in United Kingdom. The data were part of a wider study examining genetic eye service provision. Twenty interviewees from families in which a causative mutation had been identified by a genetic eye clinic were recruited to the study. Fourteen interviewees had chosen to have a genetic test and five had not; one was uncertain. In-depth telephone interviews were conducted allowing a thorough exploration of interviewees' views and experiences of the benefits of genetic counselling and testing. Transcripts were analysed using thematic analysis. Both affected and unaffected interviewees expressed mainly positive views about genetic testing, highlighting benefits such as diagnostic confirmation, risk information, and better preparation for the future. Negative consequences included the burden of knowledge, moral dilemmas around reproduction, and potential impact on insurance. The offer of genetic testing was often taken up, but was felt unnecessary in some cases. Interviewees in the study reported many benefits, suggesting genetic testing should be available to this patient group. The benefits and risks identified will inform future evaluation of models of service delivery. This research was part of a wider study exploring experiences of families with retinal dystrophy.

摘要

遗传技术在遗传性眼病领域的应用能力正在迅速扩展。新的基因检测方法将使诊断能力产生重大飞跃,并有可能提供靶向治疗。然而,缺乏遗传检测对支持服务规划的益处的证据。在这里,我们报告了关于英国视网膜营养不良家庭接受基因检测的定性数据。这些数据是一项更广泛的研究的一部分,该研究检查了遗传眼病服务的提供情况。从遗传眼病诊所确定致病突变的家庭中招募了 20 名受访者参加该研究。其中 14 名受访者选择进行基因检测,5 名受访者未进行检测,1 名受访者不确定。进行了深入的电话访谈,以便深入探讨受访者对遗传咨询和检测的益处的看法和经验。使用主题分析对转录本进行了分析。受影响和未受影响的受访者都对基因检测表示了主要的积极看法,强调了诊断确认、风险信息和更好地为未来做准备等益处。负面后果包括知识负担、生殖方面的道德困境以及对保险的潜在影响。遗传检测的提供通常被接受,但在某些情况下被认为是不必要的。研究中的受访者报告了许多益处,这表明应该向这一患者群体提供基因检测。确定的益处和风险将为未来服务提供模式的评估提供信息。这项研究是一项更广泛的研究的一部分,该研究探索了视网膜营养不良家庭的体验。

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