Using chatbots to screen for heritable cancer syndromes in patients undergoing routine colonoscopy

2020 ◽  
pp. jmedgenet-2020-107294
Author(s):  
Brandie Heald ◽  
Emma Keel ◽  
Jessica Marquard ◽  
Carol A Burke ◽  
Matthew F Kalady ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Genetic Counselling ◽  
Assessment Tool ◽  
Cleveland Clinic ◽  
Cancer Risk Assessment ◽  
Patient Portal ◽  
Exact Test ◽  
Colon Cancer Risk ◽  
Genetic Test Results ◽  
The Subject

BackgroundHereditary colorectal cancer (HCRC) syndromes account for 10% of colorectal cancers but remain underdiagnosed. This feasibility project tested the utility of an artificial intelligence-based chatbot deployed to patients scheduled for colonoscopy to identify HCRC risk factors, educate participants about HCRC and obtain consent to genetic testing as an extension of genetic counselling of appropriate subjects. Genetic counsellor (GC) and genetic counselling assistant (GCA) time spent per subject was also measured.MethodsPatients scheduled for colonoscopy at Cleveland Clinic were invited via electronic medical record patient portal or letter prior to colonoscopy with a link to a chatbot administering the Colon Cancer Risk Assessment Tool (CCRAT) to screen for HCRC syndromes. Those with ≥1 positive response to a CCRAT question received chatbot-deployed genetic education and the option to receive genetic testing. An order for a 55-gene pan-cancer panel was placed for those consenting, and the subject had blood drawn on the day of colonoscopy. Results were disclosed by a GC or GCA by telephone. Subject demographics, progression through the chat, responses to CCRAT, personal and family history, genetic test results and communication with the subject were recorded. Descriptive statistics and two-tailed unpaired t-test and Fisher’s exact test were used.Results506/4254 (11.9%) initiated and 487 (96.2%) completed the chat with the chatbot. 215 (44.1%) answered ‘yes’ to ≥1 CCRAT question and all completed pretest education. 129/181 (71.3%) subjects who consented completed testing, and 12 (9.3%) were found to have a germline pathogenic variant. Per subject, the GC spent a mean of 14.3 (SD 7.3) and the GCA a mean of 19.2 (SD 9.8) minutes.ConclusionThe use of a chatbot in this setting was a novel and feasible method, with the potential of increasing genetic screening and testing in individuals at risk of HCRC syndromes.

Genetic counselling

2018 ◽  
Author(s):  
Jodie Ingles ◽  
Charlotte Burns ◽  
Laura Yeates
Keyword(s):  
Genetic Testing ◽  
Genetic Counselling ◽  
Psychosocial Care ◽  
Clinical Psychologist ◽  
Master's Level ◽  
Large Panels ◽  
Sequencing Technologies ◽  
Whole Exome ◽  
Genetic Test Results ◽  
Post Test

Cardiac genetic counselling is an emerging but important subspecialty. The qualifications of cardiac genetic counsellors depend on the country of practice, but at a minimum they are Master’s-level trained health professionals with expertise in genetics, and are integral members of the multidisciplinary inherited cardiovascular disease clinic. Though the framework is diverse in different countries, key roles include investigation and confirmation of family history details, discussion of inheritance risks and facilitation of cardiac genetic testing, communication with at-risk relatives, and increasingly, curation of genetic test results. The use of next-generation sequencing technologies has seen a recent shift in the uptake of genetic testing, due to greater availability and lowered costs. As these gene tests become more comprehensive, including large panels of genes and even whole exome or whole genome sequencing, the need for cardiac genetic counsellors to provide informed consent, appropriate pre- and post-test genetic counselling, and ongoing curation of the variants identified is evident. Finally, given the improved understanding of the psychological implications of living with a cardiovascular genetic disease, cardiac genetic counsellors are integral in delivering psychosocial care and identifying patients requiring intervention with a clinical psychologist.

Genetic counselling

ESC CardioMed ◽  
2018 ◽  
pp. 662-665
Author(s):  
Laura Yeates ◽  
Charlotte Burns ◽  
Jodie Ingles
Keyword(s):  
Genetic Testing ◽  
Genetic Counselling ◽  
Psychosocial Care ◽  
Clinical Psychologist ◽  
Master's Level ◽  
Large Panels ◽  
Sequencing Technologies ◽  
Whole Exome ◽  
Genetic Test Results ◽  
Post Test

Cardiac genetic counselling is an important subspecialty. The qualifications of cardiac genetic counsellors depend on the country of practice, but at a minimum they are Master’s-level trained health professionals with expertise in genetics, and are integral members of the multidisciplinary inherited cardiovascular disease clinic. Though the framework is diverse in different countries, key roles include investigation and confirmation of family history details, discussion of inheritance risks and facilitation of cardiac genetic testing, communication with at-risk relatives, and increasingly, curation of genetic test results. The increasing use of next-generation sequencing technologies has seen a shift in the uptake of genetic testing, due to greater availability and lowered costs. As these gene tests become more comprehensive, including large panels of genes and increasingly whole exome or whole genome sequencing, the need for cardiac genetic counsellors to provide informed consent, appropriate pre- and post-test genetic counselling, and ongoing curation of the variants identified is evident. Finally, given the improved understanding of the psychological implications of living with a cardiovascular genetic disease, cardiac genetic counsellors are integral in delivering psychosocial care and identifying patients requiring intervention with a clinical psychologist.

scholarly journals Development and Validation of a Colon Cancer Risk Assessment Tool for Patients Undergoing Colonoscopy

2009 ◽  
Vol 104 (6) ◽  
pp. 1508-1518 ◽  
Author(s):  
Fay Kastrinos ◽  
John I Allen ◽  
David H Stockwell ◽  
Elena M Stoffel ◽  
Earl F Cook ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Colon Cancer ◽  
Cancer Risk ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Cancer Risk Assessment ◽  
Colon Cancer Risk ◽  
Development And Validation

Construction of an Achievement Test in General Science for Class IX Based on NCERT Syllabus

2018 ◽  
Vol 6 (26) ◽  
Author(s):  
Sailendra Bhuyan ◽  
Punita Borpuzari Deori
Keyword(s):  
Assessment Tool ◽  
Subject Area ◽  
Achievement Test ◽  
General Science ◽  
School Students ◽  
The People ◽  
The Subject ◽  
The Government ◽  
Time Changes ◽  
Teaching Learning

Achievement test is of very important assessment tool to evaluate the student’s current level of knowledge and skill acquired from classroom instruction. This test is designed to evaluate the student’s level of achievement in a particular subject for a particular class prescribed under the board or the university. In other words, to assess how much the pupils have achieved the educational objectives in teaching learning process at the end of the course and if achieved then to what extent, it has been achieved. Achievement tests are proved to be very helpful in various ways to the people who are involved in the field of education such as the teachers, the administrators, the planners, to the parents as well as for the students. The teacher very carefully develops and conduct achievement test in the class which enable the teacher to get an overall idea of the progress or the level of achievement of his students in the subject area. The teacher can determine the pupil’s strength and weakness in the subject area. So, based on this the teacher can take necessary remedial instructional strategies for the betterment of the pupil’s progress. In the same time, it also provides feedback for the teaching efficiency of the teacher.As with the time changes there have been many educational reforms taken place and in between syllabus had also been changed under different Boards of Studies. In order to maintain uniform standard of education the Government has formulated a policy to implement NCERT syllabus common to all School Boards throughout the country and accordingly the State Board of Secondary Education, Assam (SEBA) follow NCERT syllabus and to evaluate students’ achievement in terms of the policy formulated by the Board. Till now, no any standardized achievement test has been conducted for the secondary school students of Assam. Therefore, the investigators felt to construct and standardize an achievement test in the subject General Science which will definitely help in educational research.

scholarly journals Solutions for Unexpected Challenges Encountered when Integrating Research Genomics Results into the EHR

ACI Open ◽  
2020 ◽  
Vol 04 (02) ◽  
pp. e132-e135
Author(s):  
Luke V. Rasmussen ◽  
Christin Hoell ◽  
Maureen E. Smith ◽  
Rex Chisholm ◽  
Justin Starren ◽  
...  
Keyword(s):  
Genetic Research ◽  
Lessons Learned ◽  
Return Of Results ◽  
Patient Portal ◽  
Test Results ◽  
Research Results ◽  
Genetic Test Results ◽  
Future Return ◽  
New Research ◽  
Genetic Results

Abstract Background While there have been published reports detailing technical challenges of incorporating genetic test results into the electronic health record (EHR) with proposed solutions, less has been published about unanticipated sociotechnological or practical communication challenges involved in this process. Objectives This study was aimed to describe unanticipated issues that arose returning genetic research results through the EHR as part of the National Human Genome Research Institute (NHGRI)-funded electronic Medical Records and Genomics (eMERGE) 3 consortium, and provide lessons learned for future implementations Methods We sequenced 3,000 participants on a 109-gene panel and returned genetic results initially in person and/or by letter, with a later release directly into the EHR and patient portal. Results When results were returned through the EHR, multiple participants expressed confusion and contacted the health system, resulting in our institution temporarily freezing our return of research results. Discussion We determined the likely causes of this issue to be (1) the delay between enrollment and results return, (2) inability to personalize mass e-mail messages announcing new research test results in the EHR, (3) limited space for description of test results in the EHR, and (4) the requirement to list an ordering physician for research results in the EHR. For future return of results, we propose sending preparatory e-mails to participants, including screenshots of how they can expect to see their results presented in the EHR portal. Conclusion We hope our lessons learned can provide helpful guidance to other sites implementing research genetic results into the EHR and can encourage EHR developers to incorporate greater flexibility in the future.

scholarly journals The formation of patient trust and its transference to online health services: the case of a Dutch online patient portal for rehabilitation care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lex van Velsen ◽  
Ina Flierman ◽  
Monique Tabak
Keyword(s):  
Health Services ◽  
Structural Equation ◽  
Assessment Tool ◽  
Measurement Model ◽  
Care Team ◽  
Care Organization ◽  
Patient Portal ◽  
Patient Trust ◽  
Related Factors ◽  
Ehealth Service

Abstract Background Trust is widely recognized as a crucial factor in successful physician–patient communication and patient engagement in treatment. However, with the rise of eHealth technologies, such as online patient portals, the role of trust and the factors that influence it need to be reconsidered. In this study, we aim to identify the factors that contribute to trust in an eHealth service and we aim to identify the consequences of trust in an eHealth service in terms of use. Methods The Patient Trust Assessment Tool was provided to new outpatients of a rehabilitation center in the Netherlands, that were expected to use the center’s online patient portal. Via this tool, we assessed five trust-related factors. This data was supplemented by questions about demographics (age, gender, rehabilitation treatment) and data about use (number of sessions, total time spent in sessions), derived from data logs. Data was analyzed via Partial Least Squares Structural Equation Modelling. Results In total, 93 patients participated in the study. Out of these participants, 61 used the portal at least once. The measurement model was considered good. Trust in the organization was found to affect trust in the care team (β = .63), trust in the care team affected trust in the treatment (β = .60). Both, trust in the care team and trust in the treatment influenced trust in the technology (β = .42 and .30, respectively). Trust in the technology affected the holistic concept trust in the service (β = .78). This holistic trust in the service finally, did not affect use. Conclusions This study shows that the formation of this trust is not unidimensional, but consists of different, separate factors (trust in the care organization, trust in the care team and trust in the treatment). Trust transfer does take place from offline to online health services. However, trust in the service does not directly affect the use of the eHealth technology.

A brief assessment of concerns associated with genetic testing for cancer: The multidimensional impact of cancer risk assessment (MICRA) questionnaire.

2002 ◽  
Vol 21 (6) ◽  
pp. 564-572 ◽  
Author(s):  
David Cella ◽  
Chanita Hughes ◽  
Amy Peterman ◽  
Chih-Hung Chang ◽  
Beth N. Peshkin ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Genetic Testing ◽  
Cancer Risk ◽  
Cancer Risk Assessment ◽  
Brief Assessment
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