Obstet Gynecol. 2021 Jan 1;137(1):e1-e6. doi: 10.1097/AOG.0000000000004200.
With the increased emphasis on patient-driven health care and readily available access to patients as consumers through the internet and media, many genetic testing companies are marketing directly to consumers. Direct-to-consumer genetic testing may result in unique concerns and considerations, because of limited knowledge about available genetic tests among patients and health care professionals, challenges in interpretation of genetic test results, and lack of oversight of some companies, as well as issues of privacy and confidentiality. It is important to note that tests from different companies that evaluate the same condition or genes can vary greatly in scope and technical quality. When undergoing direct-to-consumer genetic testing, the consumer should be apprised of risk from screening or susceptibility test results that can neither prove nor eliminate disease potential but may be distressing for consumers. Because of these considerations and the fact that the interpretation of test results often requires specific training and medical knowledge, direct-to-consumer genetic testing ideally should be performed after counseling to review the test's potential benefits, risks, and limitations. Confirmatory genetic testing should be performed under the supervision of an appropriate obstetrician-gynecologist or other health care professional who is skilled in interpretation of genetic testing and risk assessment for the diseases of interest. This Committee Opinion has been updated to include information on counseling for patients who present with direct-to-consumer genetic test results, clinical vignettes, and an overview of currently available testing options as well as those potentially available in the near future.
随着患者驱动的医疗保健的重视程度不断提高,以及通过互联网和媒体使患者作为消费者更容易获得医疗服务,许多基因检测公司开始直接向消费者营销。直接面向消费者的基因检测可能会带来独特的问题和考虑因素,因为患者和医疗保健专业人员对可用的基因检测了解有限,基因检测结果的解释存在挑战,以及一些公司缺乏监管,同时还存在隐私和保密问题。值得注意的是,评估同一病症或基因的不同公司的测试在范围和技术质量上可能有很大差异。当进行直接面向消费者的基因检测时,应告知消费者筛查或易感性测试结果的风险,这些结果既不能证明也不能排除疾病的可能性,但可能会给消费者带来困扰。由于这些考虑因素以及测试结果的解释通常需要特定的培训和医学知识,因此,在进行直接面向消费者的基因检测之前,理想情况下应进行咨询,以审查测试的潜在益处、风险和局限性。确认性基因检测应由熟练解读基因检测和相关疾病风险评估的适当妇产科医生或其他医疗保健专业人员在监督下进行。本委员会意见已更新,包括针对呈现直接面向消费者的基因检测结果的患者的咨询信息、临床案例以及当前可用的检测选项概述,以及近期内可能提供的检测选项。