Genetic Counseling and Genomic Sequencing

2019 ◽  
pp. 125-142
Author(s):  
Barbara A. Bernhardt
2020 ◽  
pp. 307-318 ◽  
Author(s):  
Ilana B. Solomon ◽  
Sarah McGraw ◽  
Jenny Shen ◽  
Adem Albayrak ◽  
Gil Alterovitz ◽  
...  

PURPOSE Evidence-based somatic and germline sequencing has transformed cancer care and improves patient outcomes. However, patients’ low genetic literacy and misunderstanding of their own genomic results poses a threat to the realization of precision oncology. To optimize patient genomic comprehension, we developed a Web-based, patient-directed, genomic sequencing education and return-of-results tool, HOPE-Genomics. METHODS The HOPE-Genomics prototype included somatic and germline sequencing results, embedded multimedia genomic education, and interactive features (eg, request for genetic counseling). Between January and April 2018, we elicited feedback on tool usability and comprehensiveness through participant surveys, 4 focus groups of patients with cancer and their family members, and 3 provider focus groups (comprising 8 patients, 5 family members, and 19 providers). RESULTS We identified themes in patient/family tool-related responses, including the desire to view a patient-friendly report, a desire to receive multiple types of genomic information (eg, prognostic and uncertain), high acceptability of report content, and interest in tool-enabled access to genetic counseling. Major themes from the clinician focus groups included believing the tool could help patients formulate questions and facilitate patients’ communication of results to family members. However, there were diverse responses from all participants in terms of tool implementation (ie, timing and nature of report release). Some participants preferred report release before meeting with the provider, and others preferred it during the appointment. Additionally, some clinicians were concerned about providing prognostic and treatment information through the tool. CONCLUSION There was high acceptability and interest from patients, family members, and providers in a patient-directed genomics report. Future work will determine whether direct-to-patient reporting of genomic results improves patient knowledge, care engagement, and compliance with genomically guided interventions.


2021 ◽  
Vol 11 (5) ◽  
pp. 322
Author(s):  
Annika T. Beck ◽  
Erica J. Sutton ◽  
Carolyn P. Y. Chow ◽  
Susan H. Curtis ◽  
Iftikhar J. Kullo ◽  
...  

As genomic sequencing expands to screen larger numbers of individuals, offering genetic counseling to everyone may not be possible. One approach to managing this limitation is for a genetic counselor to communicate clinically actionable results in person or by telephone, but report other results by mail. We employed this approach in a large genomic implementation study. In this paper, we describe participants’ experiences receiving genomic screening results by mail. We conducted 50 semi-structured telephone interviews with individuals who received neutral genomic screening results by mail. Most participants were satisfied receiving neutral results by mail. Participants generally had a good understanding of results; however, a few participants had misunderstandings about their genomic screening results, including mistaken beliefs about their disease risk and the comprehensiveness of the test. No one reported plans to alter health behaviors, defer medical evaluations, or take other actions that might be considered medically problematic. Reporting neutral results by mail is unlikely to cause recipients distress or generate misunderstandings that may result in reduced vigilance in following recommended preventive health strategies. Nonetheless, some individuals may benefit from additional genetic counseling support to help situate their results in the context of personal concerns and illness experiences.


2020 ◽  
Vol 10 (4) ◽  
pp. 143
Author(s):  
Erica J. Sutton ◽  
Annika T. Beck ◽  
Kylie O. Gamm ◽  
Jennifer B. McCormick ◽  
Iftikhar J. Kullo ◽  
...  

As applications of genomic sequencing have expanded, offering genetic counseling support to all patients is arguably no longer practical. Additionally, whether individuals desire and value genetic counseling services for genomic screening is unclear. We offered elective genetic counseling to 5110 individuals prior to undergoing sequencing and 2310 participants who received neutral results to assess demand. A total of 0.2% of the study participants accessed genetic counseling services prior to sequencing, and 0.3% reached out after receiving neutral results. We later conducted 50 interviews with participants to understand why they did not access these services. Many interviewees did not recall the availability of genetic counseling and were unfamiliar with the profession. Interviewees described not needing counseling before sequencing because they understood the study and felt that they could cope with any result. Counseling was considered equally unnecessary after learning neutral results. Although the participants had questions about their results, they did not feel that speaking with a genetic counselor would be helpful. Genomic screening efforts that employ opt-in models of genetic counseling may need to clarify the potential value of genetic counseling support from the outset and feature genetic counseling services more prominently in program materials.


2014 ◽  
Vol 24 (2) ◽  
pp. 193-204 ◽  
Author(s):  
Cynthia M. Khan ◽  
Christine Rini ◽  
Barbara A. Bernhardt ◽  
J. Scott Roberts ◽  
Kurt D. Christensen ◽  
...  

2014 ◽  
Vol 24 (2) ◽  
pp. 372-372
Author(s):  
Cynthia M. Khan ◽  
Christine Rini ◽  
Barbara A. Bernhardt ◽  
J. Scott Roberts ◽  
Kurt D. Christensen ◽  
...  

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