Genetic variants with discordant classifications: An assessment of genetic counselor attitudes and practices.
Discordant variant classifications (DVCs) can impact patient care and pose challenges for clinicians. A survey‐based study was conducted to examine genetic counselor (GC) attitudes and practices related to DVCs. Most GCs (202/229, 88%) in the study provide direct patient care across clinical special...
| Publicado en: | Journal of Genetic Counseling Vol. 32; no. 1; pp. 100 - 111 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161757549&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161757549 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10597700 41A jtl: Journal of Genetic Counseling issn: 10597700 maglogo: N pubinfo: dt: Feb2023 vid: 32 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 161757549 161757549 161757549 10.1002/jgc4.1626 161757549 ppf: 100 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Genetic variants with discordant classifications: An assessment of genetic counselor attitudes and practices. aug: au: Lahiri, Sayoni Reys, Brian Wunder, Julia Pirzadeh‐Miller, Sara affil: Cancer Genetics Program, UT Southwestern Medical Center, Dallas Texas,, USA sug: subj: Genetic Counselors Psychosocial Factors Psychotherapist Attitudes Medical Practice Mutation Classification Polymorphism, Single Nucleotide Classification Human Descriptive Statistics Patient Care Genetic Screening Genetic Counselors Ethical Issues Family History Patient History Taking Funding Source ab: Discordant variant classifications (DVCs) can impact patient care and pose challenges for clinicians. A survey‐based study was conducted to examine genetic counselor (GC) attitudes and practices related to DVCs. Most GCs (202/229, 88%) in the study provide direct patient care across clinical specialties; review patients' genetic test results to determine if reported genetic variants have DVCs (176/202, 88%); and inform patients of known DVCs that impact medical management (165/202, 82%). DVC review, which takes 41 min (range: 5–240) on average per week, is typically prompted by the identification of a variant of uncertain significance (VUS) (160/176, 90%) and is primarily conducted using public databases (176/176, 100%). While most GCs felt it would not be ethical to knowingly provide different medical management recommendations to patients with the same genetic variant (152/229, 66%), they also stated they would rely on the variant classification on the test report (141/229, 61%) and/or the patient's personal/family history (188/229, 82%) to determine which classification to follow if a DVC is identified. Both factors are patient‐specific and, inherently, could lead to differing recommendations. When posed with a hypothetical scenario in which two patients have the same genetic variant, but test reports show a DVC (pathogenic vs VUS), most GCs (179/229, 78.2%) stated they would make the same recommendation for both patients regardless of management guidelines. One‐third (52/179, 29.1%) cited patient‐specific factors, such as personal/family history, would impact their recommendations. Disagreements about whether the pathogenic or VUS classification should be used to make medical management recommendations were noted. Differing practices and opinions on how to manage patients with DVCs, as well as the fact that most GCs (209/229, 91.3%) have consulted with colleagues on this matter, highlight the need for more professional guidance to ensure equitable patient care. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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