Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Am J Med Genet A. 2021 Dec;185(12):3634-3643. doi: 10.1002/ajmg.a.62411. Epub 2021 Jun 29.
Decisions about genetic testing have traditionally been based on clinical utility and cost, but personal utility is increasingly recognized when assessing the value of testing. Whole exome sequencing (WES) was offered to a population cohort of 106 infants diagnosed with congenital hearing loss. Parents could choose to receive results relating to hearing loss only or also learn additional information about childhood-onset conditions (medically nonactionable and/or actionable). This study aimed to quantify the personal utility of WES for parents after a diagnosis of hearing loss in their child. Parents completed surveys pretest (63/106), after hearing loss results (52/106) and after receiving additional information (47/72). Open-ended responses from all three surveys (N = 67) were analyzed using inductive content analysis. Answers to questions regarding the value of sequencing to parents were analyzed and collated. Parents placed high value on diagnostic WES for hearing loss but had different perspectives on the personal utility of additional information. Diagnostic results provided certainty while the choice to learn additional information about childhood-onset disorders was associated with empowerment. WES also represented an opportunity to promote their child's best interests. Results provide insights into the utility of WES for the indication of congenital deafness and for genomic newborn screening broadly.
传统上,基因检测的决策一直基于临床效用和成本,但在评估检测的价值时,个人效用越来越受到重视。对 106 名被诊断为先天性听力损失的婴儿进行了全外显子组测序(WES)检测。父母可以选择仅获得与听力损失相关的结果,或者还可以了解有关儿童期发病情况的其他信息(医学上无作为和/或有作为)。本研究旨在定量评估 WES 在孩子听力损失后对父母的个人效用。父母在测试前(63/106)、听力损失结果后(52/106)和收到额外信息后(47/72)完成了调查。使用归纳内容分析对所有三个调查的开放式回答(N=67)进行了分析。分析并整理了关于测序对父母价值的问题的答案。父母非常重视 WES 对听力损失的诊断价值,但对额外信息的个人效用有不同的看法。诊断结果提供了确定性,而选择了解儿童期发病障碍的额外信息则与赋权有关。WES 还代表了促进孩子最佳利益的机会。结果提供了对 WES 用于先天性耳聋和广义基因组新生儿筛查的效用的见解。