Moultrie Rebecca R, Andrews Sara M, Williams Kristi M, Kutsa Oksana, Hudnell Tarneisha, Brailsford Jennifer, Aguilar Sienna, Savage Sarah, Biesecker Barbara B, Hunter Jessica Ezzell
RTI International, Research Triangle Park, North Carolina, USA.
University of Florida College of Medicine, Jacksonville, Florida, USA.
J Genet Couns. 2025 Aug;34(4):e70081. doi: 10.1002/jgc4.70081.
The three CDC Tier 1 conditions (Hereditary Breast and Ovarian Cancer, Lynch Syndrome, and Familial Hypercholesterolemia) are estimated to affect 2 million people in the United States. Population-based genomic screening holds promise in identifying individuals who may not know their risk. This novel study explored primary care clinician and patient attitudes toward population screening generally and in the context of a research study and the potential for chatbot technology to support informed decision-making in the primary care context, perspectives vital to inform scalable, patient-centered approaches to facilitate population screening. We conducted semistructured interviews with primary care patients (N = 20) and primary care clinicians (N = 9) from primary care clinics at a patient-diverse academic medical center. The interviews focused on receptivity to population-level screening, information needs, and the potential for chatbot technology as a mechanism to support patient informed decision-aking about testing. Patient and clinician participants also reviewed a brief demonstration of the chatbot technology and shared their views. Interviews were recorded and transcribed. We used rapid qualitative analysis methodology to analyze interview data. Patients and clinicians acknowledged the benefits of population genomic screening and found the chatbot technology to be easy to navigate. Patients endorsed the utility of screening but raised concerns about data privacy and the desire for more information about the conditions and screening process. Clinicians gave insights into information that could be integrated to further support patients in informed decision-making. Overall, chatbot technology as a facilitator of population screening is a promising approach. The results of this study can improve future efforts to ensure that chatbots and similar technology incorporate vital information to facilitate informed decisions.
据估计，美国有200万人受到美国疾病控制与预防中心（CDC）的三类一级疾病（遗传性乳腺癌和卵巢癌、林奇综合征和家族性高胆固醇血症）影响。基于人群的基因组筛查有望识别出那些可能不知道自身风险的个体。这项新研究探讨了初级保健临床医生和患者对一般人群筛查的态度，以及在一项研究背景下的态度，还探讨了聊天机器人技术在初级保健环境中支持明智决策的潜力，这些观点对于为促进人群筛查制定可扩展的、以患者为中心的方法至关重要。我们对一家患者多样化的学术医疗中心的初级保健诊所的初级保健患者（N = 20）和初级保健临床医生（N = 9）进行了半结构化访谈。访谈重点关注对人群层面筛查的接受度、信息需求，以及聊天机器人技术作为支持患者关于检测的明智决策的一种机制的潜力。患者和临床医生参与者还观看了聊天机器人技术的简短演示并分享了他们的看法。访谈进行了录音和转录。我们使用快速定性分析方法来分析访谈数据。患者和临床医生认可人群基因组筛查的益处，并发现聊天机器人技术易于操作。患者认可筛查的效用，但对数据隐私以及对获取更多关于疾病和筛查过程信息的渴望表示担忧。临床医生提供了关于可整合哪些信息以进一步支持患者进行明智决策的见解。总体而言，聊天机器人技术作为人群筛查的促进手段是一种很有前景的方法。这项研究的结果可以改进未来的工作，以确保聊天机器人和类似技术纳入重要信息以促进明智决策。
