Quality of life drives patients’ preferences for secondary findings from genomic sequencing Journal Article


Authors: Mighton, C.; Carlsson, L.; Clausen, M.; Casalino, S.; Shickh, S.; McCuaig, L.; Joshi, E.; Panchal, S.; Semotiuk, K.; Ott, K.; Elser, C.; Eisen, A.; Kim, R. H.; Lerner-Ellis, J.; Carroll, J. C.; Glogowski, E.; Schrader, K.; Bombard, Y.; on behalf of the Incidental Genomics Study Team
Contributors: Hamilton, J. G.; Offit, K.; Robson, M.
Article Title: Quality of life drives patients’ preferences for secondary findings from genomic sequencing
Abstract: There is growing impetus to include measures of personal utility, the nonmedical value of information, in addition to clinical utility in health technology assessment (HTA) of genomic tests such as genomic sequencing (GS). However, personal utility and clinical utility are challenging to define and measure. This study aimed to explore what drives patients’ preferences for hypothetically learning medically actionable and non-medically actionable secondary findings (SF), capturing clinical and personal utility; this may inform development of measures to evaluate patient outcomes following return of SF. Semi-structured interviews were conducted with adults with a personal or family cancer history participating in a trial of a decision aid for selection of SF from genomic sequencing (GS) (www.GenomicsADvISER.com). Interviews were analyzed thematically using constant comparison. Preserving health-related and non-health-related quality of life was an overarching motivator for both learning and not learning SF. Some participants perceived that learning SF would help them “have a good quality of life” through informing actions to maintain physical health or leading to psychological benefits such as emotional preparation for disease. Other participants preferred not to learn SF because results “could ruin your quality of life,” such as by causing negative psychological impacts. Measuring health-related and non-health-related quality of life may capture outcomes related to clinical and personal utility of GS and SF, which have previously been challenging to measure. Without appropriate measures, generating and synthesizing evidence to evaluate genomic technologies such as GS will continue to be a challenge, and will undervalue potential benefits of GS and SF. © 2020, The Author(s), under exclusive licence to European Society of Human Genetics.
Keywords: adult; clinical article; treatment outcome; sequence analysis; quality of life; diagnosis; health; diseases; perception; semi structured interview; patient preference; randomized controlled trial (topic); emotional stability; human; male; female; priority journal; article; psychological well-being; secondary finding
Journal Title: European Journal of Human Genetics
Volume: 28
Issue: 9
ISSN: 1018-4813
Publisher: Nature Publishing Group  
Date Published: 2020-09-01
Start Page: 1178
End Page: 1186
Language: English
DOI: 10.1038/s41431-020-0640-x
PUBMED: 32424322
PROVIDER: scopus
PMCID: PMC7609335
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Kenneth Offit
    789 Offit
  2. Mark E Robson
    676 Robson
  3. Jada Gabrielle Hamilton
    111 Hamilton