Behavioural changes, sharing behaviour and psychological responses after receiving direct-to-consumer genetic test results: a systematic review and meta-analysis

Abstract It has been hypothesised that direct-to-consumer genetic tests (DTC-GTs) could stimulate health behaviour change. However, genetic testing may also lead to anxiety and distress or unnecessarily burden the health care system. The aim is to review and meta-analyse the effects of DTC-GT on (1) behaviour change, (2) psychological response and (3) medical consumption. A systematic literature search was performed in three databases, using “direct-to-consumer genetic testing” as a key search term. Random effects meta-analyses were performed when at least two comparable outcomes were available. After selection, 19 articles were included involving 11 unique studies. Seven studies involved actual consumers who paid the retail price, whereas four included participants who received free genetic testing as part of a research trial (non-actual consumers). In meta-analysis, 23% had a positive lifestyle change. More specifically, improved dietary and exercise practices were both reported by 12%, whereas 19% quit smoking. Seven percent of participants had subsequent preventive checks. Thirty-three percent shared their results with any health care professional and 50% with family and/or friends. Sub-analyses show that behaviour change was more prevalent among non-actual consumers, whereas sharing was more prevalent among actual consumers. Results on psychological responses showed that anxiety, distress and worry were low or absent and that the effect faded with time. DTC-GT has potential to be effective as a health intervention, but the right audience needs to be addressed with tailored follow-up. Research is needed to identify consumers who do and do not change behaviour or experience adverse psychological responses.

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A Meta-Analysis of Line Bisection and Landmark Task Performance in Older Adults

Neuropsychology Review ◽

10.1007/s11065-021-09505-4 ◽

2021 ◽

Author(s):

Gemma Learmonth ◽

Marietta Papadatou-Pastou

Keyword(s):

Meta Analysis ◽

Line Length ◽

Line Bisection ◽

Group Level ◽

Bisection Task ◽

Leftward Bias ◽

State Dependent ◽

The Right ◽

Meta Analyses ◽

Line Bisection Task

AbstractYoung adults exhibit a small asymmetry of visuospatial attention that favours the left side of space relative to the right (pseudoneglect). However, it remains unclear whether this leftward bias is maintained, eliminated or shifted rightward in older age. Here we present two meta-analyses that aimed to identify whether adults aged ≥50 years old display a group-level spatial attention bias, as indexed by the line bisection and the landmark tasks. A total of 69 datasets from 65 studies, involving 1654 participants, were analysed. In the meta-analysis of the line bisection task (n = 63), no bias was identified for studies where the mean age was ≥50, but there was a clear leftward bias in a subset where all individual participants were aged ≥50. There was no moderating effect of the participant’s age or sex, line length, line position, nor the presence of left or right cues. There was a small publication bias in favour of reporting rightward biases. Of note, biases were slightly more leftward in studies where participants had been recruited as part of a stand-alone older group, compared to studies where participants were recruited as controls for a clinical study. Similarly, no spatial bias was observed in the meta-analysis of the landmark task, although the number of studies included was small (n = 6). Overall, these results indicate that over 50s maintain a group-level leftward bias on the line bisection task, but more studies are needed to determine whether this bias can be modulated by stimulus- or state-dependent factors.

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Health care providers and direct-to-consumer access and advertising of genetic testing in the United States

Genome Medicine ◽

10.1186/gm297 ◽

2011 ◽

Vol 3 (12) ◽

pp. 81 ◽

Cited By ~ 8

Author(s):

Melanie F Myers

Keyword(s):

United States ◽

Health Care ◽

Genetic Testing ◽

Health Care Providers ◽

The United States ◽

Care Providers ◽

Direct To Consumer ◽

Consumer Access

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Direct-to-Consumer Genetic Testing

Journal of Information Technology Research ◽

10.4018/jitr.2012010103 ◽

2012 ◽

Vol 5 (1) ◽

pp. 35-67 ◽

Cited By ~ 1

Author(s):

Richard A. Stein

Keyword(s):

Health Care ◽

Genetic Testing ◽

Health Care Providers ◽

Double Helix ◽

Health Care Facilities ◽

Past Century ◽

Care Providers ◽

Genetic Tests ◽

Direct To Consumer ◽

Dna Double Helix

Genetics has fascinated societies since ancient times, and references to traits or behaviors that appear to be shared or different among related individuals have permeated legends, literature, and popular culture. Biomedical advances from the past century, and particularly the discovery of the DNA double helix, the increasing numbers of links that were established between mutations and medical conditions or phenotypes, and technological advances that facilitated the sequencing of the human genome, catalyzed the development of genetic testing. Genetic tests were initially performed in health care facilities, interpreted by health care providers, and included the availability of counseling. Recent years have seen an increased availability of genetic tests that are offered by companies directly to consumers, a phenomenon that became known as direct-to-consumer genetic testing. Tests offered in this setting range from the ones that are also provided in health care establishments to tests known as ‘recreational genomics,’ and consumers directly receive the test results. In addition, testing in this context often does not involve the availability of counseling and, when this is provided, it frequently occurs on-line or over the phone. As a field situated at the interface between biotechnology, biomedical research, and social sciences, direct-to-consumer genetic testing opens multiple challenges that can be appropriately addressed only by developing a complex, inter-disciplinary framework.

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A meta-analysis of line bisection and landmark task performance in older adults

10.31234/osf.io/em8bh ◽

2021 ◽

Author(s):

Gemma Learmonth ◽

Marietta Papadatou-Pastou

Keyword(s):

Meta Analysis ◽

Line Length ◽

Line Bisection ◽

Group Level ◽

Bisection Task ◽

Leftward Bias ◽

State Dependent ◽

The Right ◽

Meta Analyses ◽

Line Bisection Task

Young adults exhibit a small asymmetry of visuospatial attention that favours the left side of space relative to the right (pseudoneglect). However, it remains unclear whether this leftward bias is maintained, eliminated or shifted rightward in older age. Here we present two meta-analyses that aimed to identify whether adults aged ≥50 years old display a group-level spatial attention bias, as indexed by the line bisection and the landmark tasks. A total of 69 datasets from 65 studies, involving 1654 participants, were analysed. In the meta-analysis of the line bisection task (n = 63), no bias was identified for studies where the mean age was ≥50, but there was a clear leftward bias in a subset where all individual participants were aged ≥50. There was no moderating effect of the participant’s age or sex, line length, line position, nor the presence of left or right cues. There was a small publication bias in favour of reporting rightward biases. Of note, biases were slightly more leftward in studies where participants had been recruited as part of a stand-alone older group, compared to studies where participants were recruited as controls for a clinical study. Similarly, no spatial bias was observed in the meta-analysis of the landmark task, although the number of studies included was small (n = 6). Overall, these results indicate that over 50s maintain a group-level leftward bias on the line bisection task, but more studies are needed to determine whether this bias can be modulated by stimulus- and/or state-dependent factors.

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Functional localization and categorization of intentional decisions in humans: a meta-analysis of brain imaging studies

10.1101/2020.11.27.401208 ◽

2020 ◽

Author(s):

Ruoguang Si ◽

James B Rowe ◽

Jiaxiang Zhang

Keyword(s):

Prefrontal Cortex ◽

Brain Imaging ◽

Free Choice ◽

Meta Analysis ◽

Motor Intention ◽

Specific Category ◽

Dorsolateral Prefrontal ◽

Imaging Research ◽

The Right ◽

Meta Analyses

AbstractBrain-imaging research on intentional decision-making often employs a “free-choice” paradigm, in which participants choose among options with identical values or outcomes. Although the medial prefrontal cortex has commonly been associated with choices, there is no consensus on the wider network that underlies diverse intentional decisions and behaviours. Our systematic literature search identified 39 fMRI/PET experiments using various free-choice paradigms, with appropriate control conditions using external instructions. An Activation-Likelihood-Estimate (ALE) meta-analysis showed that, compared with external instructions, intentional decisions consistently activate the medial and dorsolateral prefrontal cortex, the right insula and the inferior parietal lobule. We then categorized the studies into four different types according to their experimental designs: reactive motor intention, perceptual intention, inhibitory intention and cognitive intention. We conducted conjunction and contrast meta-analyses to identify consistent and selective brain activations within each specific category of intentional decision. Finally, we used meta-analytic decoding to probe cognitive processes underlying free choices. Our findings suggest that the neurocognitive process underlying intentional decision incorporates anatomically separated components subserving distinct cognitive and computational roles.

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The contribution of NintendoWii Fitseries in the field of health: a systematic review and meta-analysis

PeerJ ◽

10.7717/peerj.3600 ◽

2017 ◽

Vol 5 ◽

pp. e3600 ◽

Cited By ~ 12

Author(s):

Julien Tripette ◽

Haruka Murakami ◽

Katie Rose Ryan ◽

Yuji Ohta ◽

Motohiko Miyachi

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Balance Training ◽

Confidence Score ◽

Search Term ◽

Training Experience ◽

Wii Fit ◽

Health Related ◽

Health Journal ◽

Meta Analyses

BackgroundWii Fitwas originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples ofWii Fitbeing utilized in clinical settings. This article aims to identify the contribution ofWii Fitin the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which theWii Fitseries has been tested, (2) clarifying the effect ofWii Fitin those identified health-related domains and (3) quantifying this effect.MethodA systematic literature review was undertaken. The MEDLINE database andGames for Health Journalpublished content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements fromWii Fitactivities for at least one relevant health indicator. The effect ofWii Fitinterventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG).FindingsA total of 115 articles highlighted that theWii Fithas been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N= 55). This systematic review highlights several potential benefits ofWii Fitinterventions and these positive observations are supported by meta-analyses data (N= 25). For example, the BBC and the TUG respond to a similar extend toWii Fitinterventions compared with traditional training.ConclusionWii Fithas the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.

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Direct to consumer genetic testing and the libertarian right to test

Journal of Medical Ethics ◽

10.1136/medethics-2016-103778 ◽

2017 ◽

Vol 44 (11) ◽

pp. 787-789 ◽

Cited By ~ 3

Author(s):

Wendy Elizabeth Bonython ◽

Bruce Baer Arnold

Keyword(s):

Genetic Testing ◽

Physical Properties ◽

Prima Facie ◽

Genetic Privacy ◽

Physical Body ◽

Direct To Consumer ◽

Rights And Interests ◽

Privacy Violation ◽

The Right ◽

Regulatory Intervention

Loi recently proposed a libertarian right to direct to consumer genetic testing (DTCGT)— independent of autonomy or utility—reflecting Cohen’s work on self-ownership and Hohfeld’s model of jural relations. Cohen’s model of libertarianism dealt principally with self-ownership of the physical body. Although Loi adequately accounts for the physical properties of DNA, DNA is also an informational substrate, highly conserved within families. Information about the genome of relatives of the person undergoing testing may be extrapolated without requiring direct engagement with their personal physical copy of the genome, triggering rights and interests of relatives that may differ from the rights and interests of others, that is, individual consumers, testing providers and regulators. Loi argued that regulatory interference with exercise of the right required justification, whereas prima facie exercise of the right did not. Justification of regulatory interference could include ‘conflict with other people’s rights’, ‘aggressive’ use of the genome and ‘harming others’. Harms potentially experienced by relatives as a result of the individual’s exercise of a right to test include breach of genetic privacy, violation of their right to determine when, and if, they undertake genetic testing and discrimination. Such harms may justify regulatory intervention, in the event they are recognised; motives driving ‘aggressive’ use of the genome may also be relevant. Each of the above criteria requires clarification, as potential redundancies and tensions exist between them, with different implications affecting different groups of rights holders.

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