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Genet Med. 2019 Feb;21(2):311-318. doi: 10.1038/s41436-018-0047-z. Epub 2018 Jul 5.

Physicians' perspectives on receiving unsolicited genomic results.

Author information

1
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
2
Boston Children's Hospital, Boston, Massachusetts, USA.
3
Harvard Medical School, Boston, Massachusetts, USA.
4
Geisinger, Danville, Pennsylvania, USA.
5
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
6
University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA.
7
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
8
University of Louisville School of Medicine, Louisville, Kentucky, USA.
9
Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA.
10
Vanderbilt University Medical Center, Nashville, Tennessee, USA. ellen.clayton@vanderbilt.edu.
11
Vanderbilt University School of Law, Nashville, Tennessee, USA. ellen.clayton@vanderbilt.edu.

Abstract

PURPOSE:

Physicians increasingly receive genomic test results they did not order, which we term "unsolicited genomic results" (UGRs). We asked physicians how they think such results will affect them and their patients.

METHODS:

Semistructured interviews were conducted with adult and pediatric primary care and subspecialty physicians at four sites affiliated with a large-scale return-of-results project led by the Electronic Medical Records and Genomics (eMERGE) Network. Twenty-five physicians addressed UGRs and (1) perceived need for actionability, (2) impact on patients, (3) health care workflow, (4) return of results process, and (5) responsibility for results.

RESULTS:

Physicians prioritize actionability of UGRs and the need for clear, evidence-based "paths" for action coupled with clinical decision support (CDS). They identified potential harms to patients including anxiety, false reassurance, and clinical disutility. Clinicians worried about anticipated workflow issues including responding to UGRs and unreimbursed time. They disagreed about who was responsible for responding to UGRs.

CONCLUSION:

The prospect of receiving UGRs for otherwise healthy patients raises important concerns for physicians. Their responses informed development of an in-depth survey for physicians following return of UGRs. Strategic workflow integration of UGRs will likely be necessary to empower physicians to serve their patients effectively.

KEYWORDS:

Attitudes; Ethics; Physicians; Return of research results; Unsolicited genomic results

PMID:
29904163
PMCID:
PMC6294706
DOI:
10.1038/s41436-018-0047-z
[Indexed for MEDLINE]
Free PMC Article

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