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Fam Cancer. 2018 Jan;17(1):31-41. doi: 10.1007/s10689-017-0014-x.

Use of the BOADICEA Web Application in clinical practice: appraisals by clinicians from various countries.

Author information

1
Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d'Ulm, 75005, Paris Cedex 05, France. anne.bredart@curie.fr.
2
University Paris Descartes, 71 avenue Edouard Vaillant, 92774, Boulogne-Billancourt, France. anne.bredart@curie.fr.
3
Université de Lorraine, Inter-Psy, 3 Place Godefroy de Bouillon, 54015, Nancy Cedex, France.
4
Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Worts Causeway, Cambridge, CB1 8RN, UK.
5
Institut Curie, Cancer Genetic Clinic, 26 rue d'Ulm, 75005, Paris Cedex 05, France.
6
Department of Medical Genetics, University of Cambridge, Level 6 Addenbrooke's Treatment Centre Cambridge Biomedical Campus, Box 238, Cambridge, CB2 0QQ, UK.
7
Department of Clinical Genetics, Laboratory Medicine, Office for Medical Services and Department of Clinical Genetics, Lund University, Universitetssjukhuset, 221 85, Lund, Sweden.
8
Institut Curie, Supportive Care Department, Psycho-oncology Unit, 26 rue d'Ulm, 75005, Paris Cedex 05, France.
9
CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay, 16 Avenue Paul Vaillant-Couturier, 94807, Villejuif Cedex, France.
10
University Paris Descartes, 71 avenue Edouard Vaillant, 92774, Boulogne-Billancourt, France.
11
Familial Breast and Ovarian Cancer Centre, Cologne University Hospital and Faculty of Medicine, Kerpener Str. 34 I, 50931, Cologne, Germany.
12
Department of Human Genetics, Department of Pathology, Leiden University Medical Centre, S4-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.

Abstract

The 'BOADICEA' Web Application (BWA) used to assess breast cancer risk, is currently being further developed, to integrate additional genetic and non-genetic factors. We surveyed clinicians' perceived acceptability of the existing BWA v3. An online survey was conducted through the BOADICEA website, and the British, Dutch, French and Swedish genetics societies. Cross-sectional data from 443 participants who provided at least 50% responses were analysed. Respondents varied in age and, clinical seniority, but mainly comprised women (77%) and genetics professionals (82%). Some expressed negative opinions about the scientific validity of BOADICEA (9%) and BWA v3 risk presentations (7-9%). Data entry time (62%), clinical utility (22%) and ease of communicating BWA v3 risks (13-17%) received additional negative appraisals. In multivariate analyses, controlling for gender and country, data entry time was perceived as longer by genetic counsellors than clinical geneticists (p < 0.05). Respondents who (1) considered hormonal BC risk factors as more important (p < 0.01), and (2) communicated numerical risk estimates more frequently (p < 0.001), judged BWA v3 of lower clinical utility. Respondents who carried out less frequent clinical activity (p < 0.01) and respondents with '11 to 15 years' seniority (p < 0.01) had less favourable opinions of BWA v3 risk presentations. Seniority of '6 to 10 years' (p < 0.05) and more frequent numerical risk communication (p < 0.05) were associated with higher fear of communicating the BWA v3 risks to patients. The level of genetics training did not affect opinions. Further development of BWA should consider technological, genetics service delivery and training initiatives.

KEYWORDS:

Appraisal; Breast cancer; Clinical practice; Risk prediction model; Survey; Tool

PMID:
28623477
PMCID:
PMC5770489
DOI:
10.1007/s10689-017-0014-x
[Indexed for MEDLINE]
Free PMC Article

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