Scheuner Maren T, Sales Paloma, Hoggatt Katherine, Zhang Ning, Whooley Mary A, Kelley Michael J
Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA; Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Pediatrics, University of California San Francisco, San Francisco, CA.
Medicine Service, Hematology-Oncology Section, San Francisco VA Health Care System, San Francisco, CA.
Genet Med. 2023 Jan;25(1):103-114. doi: 10.1016/j.gim.2022.09.012. Epub 2022 Oct 28.
Genetic tests have become widely available. We sought to understand the use of genetic tests in the practice of frontline clinicians within the United States Department of Veterans Affairs (VA).
We administered a web-based survey to clinicians at 20 VA facilities. Physicians, nurse practitioners, physician assistants, and pharmacists were eligible. We excluded genetics providers and clinicians not seeing patients. We used multiple logistic regression to evaluate the associations between clinician characteristics and experience with genetics.
The response rate was 11.3% (1207/10,680) and of these, 909 respondents were eligible. Only 20.8% of the respondents reported feeling prepared to use genetic tests and 13.0% of the respondents were currently ordering genetic tests; although, it was usually only 1 or 2 a year. Delivery of genetic tests without involving genetics providers was preferred by only 7.9% of the respondents. Characteristics positively associated with currently ordering genetic tests included practice in clinical and research settings, believing improving genetics knowledge could alter their practice, feeling prepared to use genetic tests, and referral of at least 1 patient to genetics in the past year.
Most VA clinicians don't feel prepared to use genetic tests. Those with genetic testing experience are more likely to consult genetics providers. The demand for genetics providers should increase as frontline clinicians use genetic tests in their practice.
基因检测已广泛应用。我们试图了解美国退伍军人事务部（VA）一线临床医生在实践中对基因检测的使用情况。
我们对20个VA机构的临床医生进行了一项基于网络的调查。医生、执业护士、医师助理和药剂师均符合条件。我们排除了基因检测提供者和不看诊患者的临床医生。我们使用多元逻辑回归来评估临床医生特征与基因检测经验之间的关联。
回复率为11.3%（1207/10680），其中909名受访者符合条件。只有20.8%的受访者表示准备好使用基因检测，13.0%的受访者目前正在订购基因检测；不过，通常每年只有1或2次。只有7.9%的受访者倾向于在不涉及基因检测提供者的情况下进行基因检测。与目前订购基因检测呈正相关的特征包括在临床和研究环境中的实践、认为提高基因知识可以改变其实践、准备好使用基因检测以及在过去一年中至少将1名患者转诊至基因检测。
大多数VA临床医生认为自己没有准备好使用基因检测。有基因检测经验的人更有可能咨询基因检测提供者。随着一线临床医生在实践中使用基因检测，对基因检测提供者的需求应该会增加。
