City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Beckman Research Institute, Duarte, CA, USA.
J Am Med Inform Assoc. 2018 May 1;25(5):458-464. doi: 10.1093/jamia/ocx150.
Misinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation.
We conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians' genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0-18 and 1-4, respectively, higher score corresponding with improved endpoints).
One hundred and five physicians at a tertiary cancer center participated (29% participation rate): 67% medical, 20% pediatric, 7% radiation, and 7% surgical oncology; 37% female. Prior to viewing the case-based vignettes, 34% of the physicians reported difficulty making treatment recommendations based on the standard static report. After vignette/report exposure, physicians' overall comprehension scores did not differ by report type (mean score: interactive 11.6 vs static 10.5, difference = 1.1, 95% CI, -0.3, 2.5, P = .13). However, physicians exposed to the interactive report were more likely to correctly assess sequencing quality (P < .001) and understand when reports needed to be interpreted with caution (eg, low tumor purity; P = .02). Overall satisfaction scores were higher in the interactive group (mean score 2.5 vs 2.1, difference = 0.4, 95% CI, 0.2-0.7, P = .001).
Interactive genomic reports may improve physicians' ability to accurately assess genomic data and increase report-related satisfaction. Additional research in users' genomic needs and efforts to integrate interactive reports into electronic health records may facilitate the implementation of precision oncology.
复杂基因组数据的解读错误是精准肿瘤学实施的主要挑战。我们旨在确定具有嵌入式临床医生教育和优化数据可视化功能的交互式基因组报告是否能改善基因组数据解读。
我们开展了一项随机、基于病例的调查研究，以确定与静态报告相比，接触体细胞基因panel 的交互式报告是否能提高医生对基因组的理解和报告相关的满意度（通过 3 个病例的综合评分来衡量，范围为 0-18 和 1-4，得分越高表示终点改善越好）。
在一家三级癌症中心有 105 名医生参与（参与率为 29%）：67%为内科医生，20%为儿科医生，7%为放疗医生，7%为外科肿瘤医生；37%为女性。在查看基于病例的病例前，34%的医生报告说根据标准的静态报告难以做出治疗建议。在病例/报告接触后，医生的总体理解评分不因报告类型而异（平均得分：交互式 11.6 与静态 10.5，差值为 1.1，95%置信区间，-0.3，2.5，P=0.13）。然而，接触交互式报告的医生更有可能正确评估测序质量（P<0.001），并理解何时需要谨慎解读报告（例如，肿瘤纯度低；P=0.02）。交互式组的总体满意度评分更高（平均得分 2.5 与 2.1，差值为 0.4，95%置信区间，0.2-0.7，P=0.001）。
交互式基因组报告可能会提高医生准确评估基因组数据的能力，并增加报告相关的满意度。在用户的基因组需求方面进行更多的研究，并努力将交互式报告整合到电子健康记录中，可能会促进精准肿瘤学的实施。
