Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
Medical Science and Computing, LLC, Rockville, MD, USA.
J Genet Couns. 2021 Jun;30(3):766-773. doi: 10.1002/jgc4.1367. Epub 2020 Dec 15.
The most appropriate strategies for managing secondary genomic findings (SF) in clinical research are being developed and evaluated. We surveyed patients at the National Institute of Allergy and Infectious Diseases (NIAID) to evaluate decisional conflict regarding enrolling in a study that returns SF. Responses were collected using a cross-sectional survey after informed consent but before return of SF. Sixty-six adults of 116 eligible participants responded. No participant explicitly declined because they did not want to possibly receive a SF. Sixty-five of 66 (98%) participants thought it was appropriate to return SFs in research; one participant was unsure. Decisional conflict regarding enrolling in a study returning SF was low overall with 68% of participants reporting a score of less than 10 on a 100-point decisional conflict scale, implying that they felt informed, clear on what they wanted, and supported. Lower genetic literacy was weakly associated with higher decisional conflict (Spearman's rho = -0.297, p = .015). Six participants reported confusion related to the choices about SFs. Our data suggest that participants in our study feel it is appropriate to receive SF and have little decisional conflict about potentially receiving such information; however, some participants may need further education and counseling.
正在制定和评估管理临床研究中二级基因组发现(SF)的最适当策略。我们在国家过敏和传染病研究所(NIAID)调查了患者,以评估他们对参与一项返回 SF 的研究的决策冲突。在获得知情同意后但在返回 SF 之前,使用横断面调查收集了回复。在 116 名符合条件的参与者中,有 66 名成年人做出了回应。没有参与者明确拒绝,因为他们不想可能收到 SF。66 名参与者中有 65 名(98%)认为在研究中返回 SF 是合适的;一名参与者不确定。总体而言,参与者对参与返回 SF 的研究的决策冲突较低,68%的参与者在 100 分决策冲突量表上的得分低于 10,这意味着他们感到知情、清楚自己想要什么并得到支持。遗传素养较低与决策冲突较高呈弱相关(Spearman's rho = -0.297,p =.015)。有 6 名参与者报告与 SF 相关的选择存在困惑。我们的数据表明,我们研究中的参与者认为收到 SF 是合适的,并且对可能收到此类信息的决策冲突很小;然而,一些参与者可能需要进一步的教育和咨询。