A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients

Myers, Ronald E.; Wolf, Thomas; Shwae, Phillip; Hegarty, Sarah; Peiper, Stephen C.

doi:10.1186/s12885-016-2812-1

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…The development of easily accessible online genomic knowledge banks provides resources to aid data interpretation and clinical decision-making. Treating oncologists frequently cite perceived low levels of genetic knowledge or limited confidence in their ability to interpret genomic reports as reasons for lower utilization of genetic testing [151]. Several large institutions have created teams to centralize genomic interpretation and provide decision support.…”

Section: Clinician Educationmentioning

confidence: 99%

Molecular profiling for precision cancer therapies

et al. 2020

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The number of druggable tumor-specific molecular aberrations has grown substantially in the past decade, with a significant survival benefit obtained from biomarker matching therapies in several cancer types. Molecular pathology has therefore become fundamental not only to inform on tumor diagnosis and prognosis but also to drive therapeutic decisions in daily practice. The introduction of next-generation sequencing technologies and the rising number of large-scale tumor molecular profiling programs across institutions worldwide have revolutionized the field of precision oncology. As comprehensive genomic analyses become increasingly available in both clinical and research settings, healthcare professionals are faced with the complex tasks of result interpretation and translation. This review summarizes the current and upcoming approaches to implement precision cancer medicine, highlighting the challenges and potential solutions to facilitate the interpretation and to maximize the clinical utility of molecular profiling results. We describe novel molecular characterization strategies beyond tumor DNA sequencing, such as transcriptomics, immunophenotyping, epigenetic profiling, and single-cell analyses. We also review current and potential applications of liquid biopsies to evaluate blood-based biomarkers, such as circulating tumor cells and circulating nucleic acids. Last, lessons learned from the existing limitations of genotype-derived therapies provide insights into ways to expand precision medicine beyond genomics.

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Section: Clinician Educationmentioning

confidence: 99%

Molecular profiling for precision cancer therapies

et al. 2020

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“…Views regarding the perceived relevance of genetics to conditions seen in clinical practice and utility of genetic testing varied across and within the specialties studied in the literature (Wilkins-Haug et al, 2000a; Hoop et al, 2008a; Hoop et al, 2008b; Harris et al, 2013; Myers et al, 2016; Amara et al, 2018; Diamonstein et al, 2018; Loss et al, 2018). For example, genetics was considered highly relevant and useful in obstetrics and pediatrics (Diamonstein et al, 2018) but less so in psychiatry (Hoop et al, 2008b) and general internal medicine (Diamonstein et al, 2018).…”

Section: Genetics Genomics and Medical Specialists: A Complex Relatmentioning

confidence: 99%

“…Although the value of genetic testing was often recognized, a number of concerns, primarily relating to test access and implications for patients, were often raised across studies (Freedman et al, 2003; Finn et al, 2005; Harris et al, 2013; Salm et al, 2014; Myers et al, 2016). Perceptions of genomics, which largely emanate from the oncology field to date, are proving to be similarly mixed, with perceived benefits often tempered by a host of concerns, some old, some new.…”

Section: Genetics Genomics and Medical Specialists: A Complex Relatmentioning

confidence: 99%

Preparing Medical Specialists to Practice Genomic Medicine: Education an Essential Part of a Broader Strategy

et al. 2019

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Developing a competent workforce will be crucial to realizing the promise of genomic medicine. The preparedness of medical specialists without specific genetic qualifications to play a role in this workforce has long been questioned, prompting widespread calls for education across the spectrum of medical training. Adult learning theory indicates that for education to be effective, a perceived need to learn must first be established. Medical specialists have to perceive genomic medicine as relevant to their clinical practice. Here, we review what is currently known about medical specialists’ perceptions of genomics, compare these findings to those from the genetics era, and identify areas for future research. Previous studies reveal that medical specialists’ views on the clinical utility of genomic medicine are mixed and are often tempered by several concerns. Specialists generally perceive their confidence and understanding to be lacking; subsequently, they welcome additional educational support, although specific needs are rarely detailed. Similar findings from the genetics era suggest that these challenges are not necessarily new but on a different scale and relevant to more specialties as genomic applications expand. While existing strategies developed for genetic education and training may be suitable for genomic education and training, investigating the educational needs of a wider range of specialties is critically necessary to determine if tailored approaches are needed and, if so, to facilitate these. Other interventions are also required to address some of the additional challenges identified in this review, and we encourage readers to see education as part of a broader implementation strategy.

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“…The JDCG is a decision aid that can facilitate shared decision-making (SDM) about a wide range of health care decisions. [24][25][26][27][28] This tool, which is based on the Analytic Hierarchy Processing framework, is designed to help patients identify decision factors (reasons/goals) that would make them favor one health care option over another. [29][30][31][32][33][34] A copy of the JDCG is provided (included as Supplementary material: Data S2).…”

Section: Methodsmentioning

confidence: 99%

“…During the session, the research coordinator first reviewed the mailed materials that described the trial and then conducted a semi‐structured interview session using an online software application, the Jefferson Decision Counseling Guide© (or JDCG). The JDCG is a decision aid that can facilitate shared decision‐making (SDM) about a wide range of health care decisions 24–28 . This tool, which is based on the Analytic Hierarchy Processing framework, is designed to help patients identify decision factors (reasons/goals) that would make them favor one health care option over another 29–34 .…”

Section: Methodsmentioning

confidence: 99%

Primary care patient interest in joining a planned multi‐cancer early detection clinical trial

Myers,

Hallman,

Shimada

et al. 2024

Cancer Medicine

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IntroductionClinical trials are being conducted and are being planned to assess the safety and efficacy of multi‐cancer early detection (MCED) tests for use in cancer screening. This study aimed to determine the feasibility of primary care patient outreach in recruiting participants to a planned MCED clinical trial, assess patient interest in trial participation, and measure decisional conflict related to participation.MethodsThe research team used the electronic medical record of a large, urban health care system to identify primary care patients 50–80 years of age who were potentially eligible for a planned MCED trial. We mailed information about the planned MCED trial to identified patients and then contacted the patients by telephone to obtain consent and administer a baseline survey. Subsequently, we contacted consented patients to complete an interview to review the mailed information and elicit perceptions about trial participation. Finally, a research coordinator administered an endpoint telephone survey to assess patient interest in and decisional conflict related to joining the trial.ResultsWe randomly identified 1000 eligible patients and were able to make contact with 690 (69%) by telephone. Of the patients contacted, 217 (31%) completed the decision counseling session and 219 (32%) completed the endpoint survey. Among endpoint survey respondents, 177 (81%) expressed interest in joining the MCED trial and 162 (74%) reported low decisional conflict.ConclusionsMost patients were contacted and about a quarter of those contacted expressed interest in and low decisional conflict about joining the planned MCED trial. Research is needed to determine how to optimize patient outreach and engage patients in shared decision‐making about MCED trial participation.

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A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients

Cited by 6 publications

References 20 publications

Molecular profiling for precision cancer therapies

Molecular profiling for precision cancer therapies

Preparing Medical Specialists to Practice Genomic Medicine: Education an Essential Part of a Broader Strategy

Primary care patient interest in joining a planned multi‐cancer early detection clinical trial

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