GenetiKit: a randomized controlled trial to enhance delivery of genetics services by family physicians

Carroll, June C.; Wilson, Brenda J.; Allanson, Judith; Grimshaw, Jeremy; Blaine, Sean M.; Meschino, Wendy S.; Permaul, Joanne A.; Graham, Ian D.

doi:10.1093/fampra/cmr040

Cited by 44 publications

(67 citation statements)

References 31 publications

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“…These findings contribute to studies demonstrating the value of educational interventions in hereditary cancer (Blazer et al 2004;Carroll et al 2009Carroll et al , 2011Houwink et al 2013Houwink et al , 2014aSchroy et al 2005;Watson et al 2001). Watson showed improved referral decisions for patients with a FH of breast/ovarian cancer, using mailed information including a laminated summary card with simple referral guidelines, a booklet with more detailed information, and two patient leaflets (Watson et al 2001).…”

Section: Discussionmentioning

confidence: 54%

“…It may be possible to adapt this tool to other topics where genetics plays a role, such as cardiovascular diseases, diabetes, and other hereditary cancers. A previous study of family physicians using a similar tool for hereditary breast cancer was shown to be useful in identifying those at increased risk and making appropriate genetics referrals on vignettes (Carroll et al 2011).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of an educational intervention on family physicians’ risk assessment and management of colorectal cancer

et al. 2014

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We developed a point-of-care tool indicating risk categories for colorectal cancer (CRC) based on family history (FH) and management recommendations tailored to risk. The study objective was to determine if this CRC Risk Triage/ Management Too would enable family physicians (FPs) to appropriately triage and make screening and genetics referral recommendations for patients with CRC FH. Baseline questionnaires were mailed to a random sample of FPs in Ontario and Newfoundland, Canada. Participants were asked to use the tool for 3 months and then complete a follow-up questionnaire. The primary outcomes were correct responses to questions regarding CRC risk category, screening method, starting age, frequency, and decision to refer to genetics, for eight clinical vignettes. The study was completed by 75/121 (62 %) participating FPs. Most (77 %) agreed they routinely recommended fecal occult blood testing for average risk patients age ≥50. This did not change significantly following the intervention. There was a significant increase in confidence in CRC risk assessment (52 % pre; 88 % post; p<0.001), correct management recommendations for patients with CRC FH (51 % pre; 84 % post; p<0.001), and improvement in total mean scores on outcome measures for all vignettes. Most demonstrates the value of point-of-care tools and illustrates a process for development, evaluation, and dissemination of tools needed by FPs if potential impacts of genomic advances are to be achieved.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Efficacy of an educational intervention on family physicians’ risk assessment and management of colorectal cancer

et al. 2014

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“…Previous research has indicated that patients expected primary care physicians to have sufficient knowledge of genetics to recognize familial risk and make appropriate healthcare decisions, such as onward referral to specialists (Carroll et al 2011;Miller et al 2010;Vries et al 2005). Participants in the present study indicated a similar expectation that health care professionals across the board will be engaged in the implementation of many types of PM applications, especially in the preventive medicine context.…”

Section: Discussionmentioning

confidence: 73%

Public attitudes towards genomic risk profiling as a component of routine population screening

Nicholls

Wilson

Craigie

et al. 2013

Genome

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Abstract:Including low penetrance genomic variants in population-based screening might enable personalization of screening intensity and follow up. The application of genomics in this way requires formal evaluation. Even if clinically beneficial, uptake would still depend on the attitudes of target populations. We developed a deliberative workshop on two hypothetical applications (in colorectal cancer and newborn screening) in which we applied stepped, neutrally-framed, information sets. Data were collected using nonparticipant observation, free-text comments by individual participants, and a structured survey. Qualitative data were transcribed and analyzed using thematic content analysis. Eight workshops were conducted with 170 individuals (120 colorectal cancer screening and 50 newborn screening for type 1 diabetes). The use of information sets promoted informed deliberation. In both contexts, attitudes appeared to be heavily informed by assessments of the likely validity of the test results and its personal and health care utility. Perceived benefits included the potential for early intervention, prevention, and closer monitoring while concerns related to costs, education needs regarding the probabilistic nature of risk, the potential for worry, and control of access to personal genomic information. Differences between the colorectal cancer and newborn screening groups appeared to reflect different assessments of potential personal utility, particularly regarding prevention.Key words: personalized medicine, screening, public health, evaluation, utility.Résumé : L'inclusion de variants génomiques à faible pénétrance dans des dépistages à l'échelle de populations pourrait permettre une personnalisation de l'intensité du dépistage et de son suivi. Un tel recours à la génomique doit cependant faire l'objet d'une évaluation formelle. Même si bénéfique au plan clinique, l'adoption d'une telle approche dépendrait des attitudes au sein des populations ciblées. Les auteurs ont mis au point un atelier de discussion pour deux applications hypothétiques (dépistage pour le cancer colorectal et chez les nouveau-nés) où ils ont fait appel à des ensembles d'information gradués et neutres. Les données ont été obtenues auprès d'observateurs non-participants, des commentaires écrits produits par les participants individuels et au moyen d'un sondage structuré. Des données qualitatives ont été transcrites et analysées par analyse du contenu thématique. Huit ateliers ont été tenus impliquant un total de 170 individus (120 pour le dépistage du cancer colorectal et 50 pour le dépistage du diabète de type 1 chez les nouveau-nés). L'emploi d'ensembles d'information a favorisé les échanges informés. Dans les deux cas, les attitudes ont semblé fortement influencées par la vraisemblable validité des résultats des tests ainsi que leur utilité en matière de soins. Les bénéfices perçus incluaient la possibilité d'une intervention précoce, la prévention et un suivi plus serré tandis que les inquiétudes concernaient les coûts, la nécessité d'...

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“…Our results add to the evidence that this approach was successful. 13,14,32 In Medicine's Future, knowledge and confidence in practice skills related to risk assessment, development of a genetic testing strategy, interpretation of results, and application of results to patient care all improved significantly. These improvements were sustained over the 10-month duration of the course and, for some skills, for 6 months following the course.…”

Section: Discussionmentioning

confidence: 99%

“…5,7 Many groups have developed continuing education programs designed to address these topics. [13][14][15][16] Historically, though, much continuing medical education (CME) has been passive and didactic. 17 Programs that are grounded in evidence-based principles of adult learning and medical education have a greater impact on physician performance than programs that do not incorporate such principles.…”

Section: Education Reportmentioning

confidence: 99%

What works in genomics education: outcomes of an evidenced-based instructional model for community-based physicians

Reed

Taber

Nissen

et al. 2016

Genetics in Medicine

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Purpose: Education of practicing health professionals is likely to be one factor that will speed appropriate integration of genomics into routine clinical practice. Yet many health professionals, including physicians, find it difficult to keep up with the rapid pace of clinical genomic advances and are often uncomfortable using genomic information in practice. Methods:Having identified the genomics educational needs of physicians in a Silicon Valley-area community hospital, we developed, implemented, and evaluated an educational course entitled Medicine's Future: Genomics for Practicing Doctors. The course structure and approach were based on best practices in adult learning, including interactivity, casebased learning, skill-focused objectives, and sequential monthly modules.Results: Approximately 20-30 physicians attended each module. They demonstrated significant gains in genomics knowledge and confidence in practice skills that were sustained throughout and following the course. Six months following the course, the majority of participants reported that they had changed their practice to incorporate skills learned during the course. Conclusion:We believe the adult-learning principles underlying the development and delivery of Medicine's Future were responsible for participants' outcomes. These principles form a model for the development and delivery of other genomics educational programs for health professionals. Genet Med advance online publication 19 November 2015

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GenetiKit: a randomized controlled trial to enhance delivery of genetics services by family physicians

Abstract: This study demonstrated that a complex educational intervention was able to significantly improve practice intent for clinical genetics scenarios found in primary care, as well as confidence in genetics skills.

Cited by 44 publications

References 31 publications

Efficacy of an educational intervention on family physicians’ risk assessment and management of colorectal cancer

Efficacy of an educational intervention on family physicians’ risk assessment and management of colorectal cancer

Public attitudes towards genomic risk profiling as a component of routine population screening

What works in genomics education: outcomes of an evidenced-based instructional model for community-based physicians

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