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人群全外显子组筛查:初级保健提供者对准备情况、信息回避和推动的态度。

Population Whole Exome Screening: Primary Care Provider Attitudes About Preparedness, Information Avoidance, and Nudging.

机构信息

Autism & Developmental Medicine Institute, Geisinger, 120 Hamm Drive, M-C 60-36, Lewisburg, PA 17827, USA; Center for Translational Bioethics and Health Care Policy, Geisinger, Danville, PA 17822, USA. Electronic address: https://twitter.com/P_HECK.

Center for Translational Bioethics and Health Care Policy, Geisinger, Danville, PA 17822, USA; Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger, 100 North Academy Avenue, M-C 30-57, Danville, PA 17822, USA.

出版信息

Med Clin North Am. 2019 Nov;103(6):1077-1092. doi: 10.1016/j.mcna.2019.08.004.

Abstract

Compared to clinicians previously surveyed, primary care providers employed in a health system known for clinical genomics were more likely to have ordered or referred a patient for genetic testing, but had only modestly more genetics training and reported similarly low levels of comfort answering patient questions about genetic risk. Most supported population genomic screening, reported willingness to get screened themselves, and judged a hypothetical patient's decision to be screened favorably relative to a similar patient's decision to decline screening. Stakeholder perceptions of the ethical appropriateness of nudging at-risk patients to discuss testing with counselors were mixed.

摘要

与之前调查的临床医生相比,在以临床基因组学而闻名的医疗体系中工作的初级保健提供者更有可能为患者安排或推荐进行基因检测,但他们只接受了适度更多的遗传学培训,并且报告称回答患者有关遗传风险的问题时的舒适度也相似较低。大多数人支持人群基因组筛查,报告称愿意自己接受筛查,并认为相对于类似患者拒绝筛查的决定,他们更倾向于支持假设患者进行筛查的决定。利益相关者对用顾问来促使有风险的患者讨论检测的伦理适宜性的看法存在分歧。

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