Bogaert Brenda, Crevier Marie-Josée, Roth Cindy, Jox Ralf J, Barazzetti Gaia
Institut des humanités en médecine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Unité de consentement à la recherche, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
J Community Genet. 2024 Oct;15(5):529-538. doi: 10.1007/s12687-024-00734-7. Epub 2024 Sep 18.
This article elaborates research participant perspectives on the communication of individual research results from genomic analyses. While most analyses focus on how to communicate results from the perspectives of clinicians or researchers, there is insufficient data on user perspectives and how this information may be used, valued, and interpreted by patients and their families. The concept of personal utility, which considers factors related to quality of life, including on how information may impact the person's future decisions, has been shown to be particularly relevant to understand research participant perspectives and to move beyond clinical and analytic utility factors such as mortality and morbidity. This article draws from qualitative research of research participants awaiting genomic results in the case of sudden cardiac death. Our results show perspectives of personal utility in communication of genomic results, including cognitive, behavioral, and affective outcomes. Cognitive outcomes include gain of information, improved knowledge of etiology and inheritance characteristics, and curiosity for what might be found. Behavioral outcomes include being able to plan life decisions, while affective outcomes include various coping strategies used. We will also discuss the value of knowing negative results and incidental findings from the research participant's perspective. This contribution gives suggestions on best practices to guide genome analysis returns, including incorporating participant wishes on individualized communication at the consent stage; developing relational autonomy approaches; and engaging them throughout the research trajectory.
本文阐述了研究参与者对于基因组分析中个体研究结果传达的观点。虽然大多数分析是从临床医生或研究人员的角度关注如何传达结果,但关于用户观点以及患者及其家属如何使用、重视和解读这些信息的数据却不足。个人效用的概念,即考虑与生活质量相关的因素,包括信息如何影响个人未来决策,已被证明对于理解研究参与者的观点以及超越诸如死亡率和发病率等临床和分析效用因素尤为相关。本文取材于对等待心脏性猝死基因组结果的研究参与者的定性研究。我们的结果显示了基因组结果传达中个人效用的观点,包括认知、行为和情感结果。认知结果包括信息获取、对病因和遗传特征的了解增加以及对可能发现的事物的好奇。行为结果包括能够规划生活决策,而情感结果包括所采用的各种应对策略。我们还将从研究参与者的角度讨论知晓阴性结果和偶然发现的价值。本论文对指导基因组分析结果反馈的最佳实践提出了建议,包括在同意阶段纳入参与者对个性化沟通的意愿;制定关系自主性方法;以及在整个研究过程中让他们参与进来。