Table 3 Factors that impact participant actions when their interpretation differs from a laboratory report.
Theme | Illustrative quotes |
|---|---|
Trust in laboratory | “We trust our analysts enough that if they’re hesitant, we usually stop short of saying…just flat-out saying, ‘This is diagnostic,’ if it’s not, or, ‘This is nondiagnostic,’ if the lab feels it is.” –Pediatric GC |
“I’m very much in the camp of, ‘You picked this lab. Trust this lab. You know, this is what they said about it, and so therefore, you go with it.’” –Cancer GC | |
View of role | “Just because the lab thinks this is the most important one doesn’t mean that we’re going to clinically think it’s the most important one. And I think that’s an important part of what we do is because we’re streamlined looking at one way, they’re streamlined looking at another way, and we have to mold those two together.” –Pediatric + Cardiology GC |
“I think the expectation is the provider is supposed to go in and decide for themselves.” –Medical geneticist | |
Confidence in expertise | “I feel like [the laboratory’s] expertise is at a level that I will never be able to get to. There’s just no time, you can’t be an expert at everything. So I still fall back on what the lab calls it, but I verify and make sure that there’s nothing that I find that might be worth discussing with the lab.” –Cardiology GC |
Practice setting | “Because I’m alone in cardiology, I don’t have a lot of backup from a clinical geneticist or anybody else to really help me with sort of sifting through these results. That’s another reason why I’m personally more cautious, because I don’t want to be responsible for giving the ordering provider the wrong information, or them conveying that to the families.” –Cardiology GC |
Specialty | “With cancer, we always try and default back to family history, and so we try to, even if we don’t agree with the results, like, for example, a VUS and something, where, like I said, we’re supposed to treat it like we don’t worry about it. Sometimes, it’s helpful for patients to, kind of, put that in the light of, but, based on your family history, we might want to do this anyway.” –Cancer GC |
“I think families are looking for does this explain the phenotype? Like, is this something that you think is meaningful? Are there other medical issues we need to watch out for that we weren’t otherwise aware of?” –Pediatric GC |
