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.
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Acknowledgements
This research was supported by the Canadian Institutes of Health Research (CIHR) and the University of Toronto McLaughlin Centre. JGH, KO, and MER were supported by NCI P30 CA008748. We would like to thank Rohini Rau Murthy, Marina Corinnes, Melissa Salerno, Shari Gitlin, and Chelsea LeBlang for their contributions to the cognitive interviews. We are grateful to the following people for their feedback on the DA, video script and animation: Raymond Kim, Melyssa Aronson, June Carroll, Christian Storm, Jina Saikia, and Brian Lila. We thank Helios Design Labs for their work designing and programing the DA and our study participants for their time and valuable input.
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Bombard, Y., Clausen, M., Mighton, C. et al. The Genomics ADvISER: development and usability testing of a decision aid for the selection of incidental sequencing results. Eur J Hum Genet 26, 984–995 (2018). https://doi.org/10.1038/s41431-018-0144-0
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DOI: https://doi.org/10.1038/s41431-018-0144-0
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