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Eur J Hum Genet. 2018 Jul;26(7):984-995. doi: 10.1038/s41431-018-0144-0. Epub 2018 Apr 27.

The Genomics ADvISER: development and usability testing of a decision aid for the selection of incidental sequencing results.

Author information

1
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. yvonne.bombard@utoronto.ca.
2
Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada. yvonne.bombard@utoronto.ca.
3
Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada.
4
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
5
University Health Network, Toronto, ON, Canada.
6
GeneDx, Gaithersburg, MD, USA.
7
BC Cancer Agency, Vancouver, BC, Canada.
8
Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.
9
Department of Surgery, University of Toronto, Toronto, ON, Canada.
10
Cancer Care Ontario, Toronto, ON, Canada.
11
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
12
Mount Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.
13
Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.

Abstract

Guidelines recommend patients be informed of their incidental results (IR) when undergoing genomic sequencing (GS), yet there are limited tools to support patients' decisions about learning IR. The aim of this study is to develop and test the usability of a decision aid (DA) to guide patients' selection of IR, and to describe patients' preferences for learning IR following use of the DA. We developed and evaluated a DA using an iterative, mixed-methods process consisting of (1) prototype development, (2) feasibility testing, (3) cognitive interviews, (4) design and programming, and (5) usability testing. We created an interactive online DA called the Genomics ADvISER, a genomics decision AiD about Incidental SEquencing Results. The Genomics ADvISER begins with an educational whiteboard video, and then engages users in a values clarification exercise, knowledge quiz and final choice step, based on a 'binning' framework. Participants found the DA acceptable and intuitive to use. They were enthusiastic towards GS and IR; all selected multiple categories of IR. The Genomics ADvISER is a new patient-centered tool to support the clinical delivery of incidental GS results. The Genomics ADvISER fills critical care gaps, given the health care system's limited genomics expertise and capacity to convey the large volume of IR and their myriad of implications.

PMID:
29703952
PMCID:
PMC6018661
[Available on 2019-07-01]
DOI:
10.1038/s41431-018-0144-0

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