Patel Ria, Friedrich Bettina, Sanderson Saskia C, Ellard Holly, Lewis Celine
UCL Medical School, University College London, London, UK.
Population, Policy and Practice, UCL GOS Institute of Child Health, London, UK.
J Med Genet. 2025 Mar 20;62(4):289-297. doi: 10.1136/jmg-2024-110458.
Whole genome sequencing (WGS) for paediatric rare disease diagnosis is now available as a first-line test for certain clinical indications in the Genomic Medicine Service in England. The aim of this study was to assess decisional conflict regarding WGS at the time of consent as well as parental knowledge, attitudes and satisfaction.
We conducted a multisite quantitative survey including validated measures. Surveys were sent out across seven National Health Service Trusts in England to parents of children offered WGS, within 4 weeks of their appointment.
374/1366 survey responses were included in the final dataset. Parents were highly satisfied with their WGS appointment (mean=24.47/28), had low decisional conflict (mean=20.09/100) and felt they had received enough information and support to make an informed decision (83.9%). Parents had positive attitudes towards WGS (mean=18.17/20), and those who had discussed WGS with a genetic counsellor or genomic associate had significantly more positive attitudes than those seen by genetic consultants (p<0.001). Most parents (84.3%) strongly agreed (27.2%) or agreed (67.1%) that they had a clear understanding of what a genomic test is. Parents whose child's condition was reported as more serious (p=0.0011) felt less conflicted about their decision.
The parents in this study had low decisional conflict and most felt they had made an informed decision. Further research after parents receive WGS results to assess whether any, and if so who, regrets their decision, is important.
全基因组测序(WGS)用于儿科罕见病诊断,目前在英国基因组医学服务中作为某些临床指征的一线检测方法。本研究的目的是评估同意进行WGS时的决策冲突以及家长的知识、态度和满意度。
我们进行了一项多中心定量调查,包括经过验证的测量方法。在英格兰的7个国民保健服务信托机构中,向接受WGS检测儿童的家长在预约后4周内发送调查问卷。
最终数据集中纳入了374/1366份调查问卷回复。家长对WGS预约高度满意(平均=24.47/28),决策冲突较低(平均=20.09/100),并认为他们已获得足够的信息和支持以做出明智的决定(83.9%)。家长对WGS持积极态度(平均=18.17/20),并且那些与遗传咨询师或基因组学助理讨论过WGS的家长比那些由遗传顾问接待的家长态度明显更积极(p<0.001)。大多数家长(84.3%)强烈同意(27.2%)或同意(67.1%)他们对基因检测是什么有清晰的理解。孩子病情报告为更严重的家长(p=0.0011)对自己的决定感到冲突较少。
本研究中的家长决策冲突较低,大多数人认为他们做出了明智的决定。在家长收到WGS结果后进行进一步研究,以评估是否有人以及如果有是谁对自己的决定感到后悔,这很重要。