Jiang Sharon, Liberti Lawrence, Lebo David
School of Pharmacy, Temple University, Philadelphia, PA, USA.
Regulatory Affairs Department, 23andMe, Inc., Sunnyvale, CA, USA.
Ther Innov Regul Sci. 2023 Nov;57(6):1190-1198. doi: 10.1007/s43441-023-00567-5. Epub 2023 Aug 17.
Emerged in the early 2000s, direct-to-consumer (DTC) genetic testing has helped consumers access and understand their genetic information without the involvement of a healthcare provider. Unlike traditional clinical-based testing, in which a healthcare provider is responsible for ordering, testing, interpreting, and communicating the results, DTC testing provides valuable insights directly to individuals about their genetic information. It empowers consumers and their families to be proactive about their health and lifestyle. The online testing format has become increasingly popular due to its accessibility and affordability. However, it raises concerns about the accuracy and reliability of the results, data security and how to ensure privacy for consumers and regulators. A hybrid model combining elements from both DTC and clinical-based genetic testing has surfaced in the market recently. In the US, current health-related DTC genetic tests are not recognized for diagnostic purposes; instead, these tests are intended to provide genetic information that is associated with certain conditions, which may encourage consumers to take the opportunity to discuss the results and their implications with a healthcare provider. This DTC genetic testing review focuses on the fundamental concepts, applications, benefits, limitations, risks, and consumer concerns, as well as the state of the DTC framework compared with the clinical-based and hybrid models. Additionally, the regulatory oversight, data protection, and healthcare professional perspective on DTC genetic testing in the US will be discussed, including current policies and regulations.
直接面向消费者(DTC)的基因检测始于21世纪初,它帮助消费者在无需医疗保健提供者参与的情况下获取和了解自己的基因信息。与传统的基于临床的检测不同,在传统检测中医疗保健提供者负责订购、检测、解读和传达检测结果,而DTC检测直接向个人提供有关其基因信息的宝贵见解。它使消费者及其家人能够积极主动地关注自身健康和生活方式。由于其易获取性和可承受性,在线检测形式越来越受欢迎。然而,它引发了人们对检测结果的准确性和可靠性、数据安全以及如何确保消费者和监管机构隐私的担忧。一种结合了DTC和基于临床的基因检测要素的混合模式最近在市场上出现。在美国,目前与健康相关的DTC基因检测不被认可用于诊断目的;相反,这些检测旨在提供与某些病症相关的基因信息,这可能会促使消费者有机会与医疗保健提供者讨论检测结果及其影响。本DTC基因检测综述重点关注基本概念、应用、益处、局限性、风险和消费者关切,以及与基于临床的模式和混合模式相比DTC模式的状况。此外,还将讨论美国对DTC基因检测的监管监督、数据保护以及医疗保健专业人员的观点,包括当前的政策和法规。