Bachelor of Medicine and Bachelor of Surgery Program, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
Hum Genomics. 2021 Aug 18;15(1):54. doi: 10.1186/s40246-021-00353-0.
The global development and advancement of genomic medicine in the recent decade has accelerated the implementation of personalized medicine (PM) and pharmacogenomics (PGx) into clinical practice, while catalyzing the emergence of genetic testing (GT) with relevant ethical, legal, and social implications (ELSI).
The perception of university undergraduates with regards to PM and PGx was investigated, and 80% of undergraduates valued PM as a promising healthcare model with 66% indicating awareness of personal genome testing companies. When asked about the curriculum design towards PM and PGx, compared to undergraduates in non-medically related curriculum, those studying in medically related curriculum had an adjusted 7.2 odds of perceiving that their curriculum was well-designed for learning PGx (95% CI 3.6-14.6) and a 3.7 odds of perceiving that PGx was important in their study (95% CI 2.0-6.8). Despite this, only 16% of medically related curriculum undergraduates would consider embarking on future education on PM. When asked about their perceptions on GT, 60% rated their genetic knowledge as "School Biology" level or below while 76% would consider undergoing a genetic test. As for ELSI, 75% of undergraduates perceived that they were aware of ethical issues of GT in general, particularly on "Patient Privacy" (80%) and "Data Confidentiality" (68%). Undergraduates were also asked about their perceived reaction upon receiving an unfavorable result from GT, and over half of the participants perceived that they would feel "helpless or pessimistic" (56%), "inadequate or different" (59%), and "disadvantaged at job seeking" (59%), while older undergraduates had an adjusted 2.0 odds of holding the latter opinion (95% CI 1.1-3.5), compared to younger undergraduates.
Hong Kong undergraduates showed a high awareness of PM but insufficient genetic knowledge and low interest in pursuing a career towards PM. They were generally aware of ethical issues of GT and especially concerned about patient privacy and data confidentiality. There was a predominance of pessimistic views towards unfavorable testing results. This study calls for the attention to evaluate education and talent development on genomics, and update existing legal frameworks on genetic testing in Hong Kong.
近十年来,全球基因组医学的发展和进步加速了个性化医学(PM)和药物基因组学(PGx)在临床实践中的应用,并催生了具有相关伦理、法律和社会影响(ELSI)的基因检测(GT)。
调查了大学生对 PM 和 PGx 的看法,80%的大学生认为 PM 是一种很有前途的医疗模式,66%的大学生知道个人基因组检测公司。当被问及 PM 和 PGx 的课程设计时,与非医学课程的大学生相比,医学课程的大学生对他们的课程设计有利于学习 PGx 的感知调整后有 7.2 倍的优势(95%CI 3.6-14.6),认为 PGx 对他们的学习很重要的感知有 3.7 倍的优势(95%CI 2.0-6.8)。尽管如此,只有 16%的医学课程大学生会考虑在 PM 方面接受未来教育。当被问及他们对 GT 的看法时,60%的大学生将他们的遗传知识评为“学校生物学”水平或以下,而 76%的大学生会考虑进行基因测试。至于 ELSI,75%的大学生普遍认为他们了解 GT 的伦理问题,特别是“患者隐私”(80%)和“数据保密性”(68%)。大学生还被问及他们对 GT 不利结果的反应,超过一半的参与者认为他们会感到“无助或悲观”(56%)、“不充分或不同”(59%)和“在求职中处于不利地位”(59%),而年龄较大的大学生对后一种观点的调整后几率为 2.0(95%CI 1.1-3.5),与年轻的大学生相比。
香港大学生对 PM 的认识较高,但遗传知识不足,对从事 PM 相关职业的兴趣较低。他们普遍了解 GT 的伦理问题,特别关注患者隐私和数据保密性。对不利检测结果持悲观态度。这项研究呼吁关注对基因组学的教育和人才培养,并更新香港现有的遗传检测法律框架。