Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland,
Department of Ophthalmology, University of Basel, Basel, Switzerland,
Ophthalmic Res. 2024;67(1):448-457. doi: 10.1159/000540607. Epub 2024 Jul 30.
The purpose of this project was to explore the current standards of clinical care genetic testing and counseling for patients with inherited retinal diseases (IRDs) from the perspective of leading experts in selected European countries. Also, to gather opinions on current bottlenecks and future solutions to improve patient care.
On the initiative of the European Vision Institute, a survey questionnaire with 41 questions was designed and sent to experts in the field from ten European countries. Each participant was asked to answer with reference to the situation in their own country.
Sixteen questionnaires were collected by November 2023. IRD genetic tests are performed in clinical care settings for 80% or more of tested patients in 9 countries, and the costs of genetic tests in clinical care are covered by the public health service to the extent of 90% or more in 8 countries. The median proportion of patients who are genetically tested, the median rate of genetically solved patients among those who are tested, and the median proportion of patients receiving counseling are 51-70%, 61-80%, and 61-80%, respectively. Improving the education of healthcare professionals who facilitate patient referrals to specialized centers, improving access of patients to more thorough genotyping, and increasing the number of available counselors were the most advocated solutions.
There is a significant proportion of IRD patients who are not genetically tested, whose genetic testing is inconclusive, or who do not receive counseling. Educational programs, greater availability of state-of-the-art genotyping and genetic counselors could improve healthcare for IRD patients.
本项目旨在从选定的欧洲国家的领先专家的角度探讨遗传性视网膜疾病(IRDs)患者的临床护理遗传检测和咨询的当前标准。此外,还收集了有关当前瓶颈和未来解决方案的意见,以改善患者护理。
在欧洲视觉研究所的倡议下,设计了一份包含 41 个问题的调查问卷,并分发给来自十个欧洲国家的该领域的专家。要求每位参与者根据自己国家的情况回答问题。
截至 2023 年 11 月,共收集了 16 份问卷。在 9 个国家中,超过 80%的接受测试的患者在临床护理环境中进行了 IRD 基因检测,而在 8 个国家中,临床护理基因检测费用的 90%或以上由公共卫生服务承担。接受基因检测的患者的中位数比例、接受基因检测的患者中基因检测结果明确的患者的中位数比例以及接受咨询的患者的中位数比例分别为 51-70%、61-80%和 61-80%。改善促进患者转介至专门中心的医疗保健专业人员的教育、改善患者获得更全面基因分型的机会以及增加可用顾问的数量是最提倡的解决方案。
有相当一部分 IRD 患者未接受基因检测,其基因检测结果不确定,或未接受咨询。教育计划、更广泛地提供最先进的基因分型和遗传咨询师可以改善 IRD 患者的医疗保健。