Physician Communication and Patient Understanding of Molecular Testing Terminology

Abstract

Background. The use of molecular testing in oncology is rapidly expanding. The aim of this study is to determine how oncologists describe molecular testing and whether patients understand the terminology being used. Materials and Methods. Sixty conversations between oncologists and patients about molecular testing were observed and technical terms used were noted by the researcher. Patients were interviewed post-conversation to assess their understanding of the noted technical terms. A patient understanding score was calculated for each participant. Comparisons of the terms were conducted using chisquare tests, Fisher's exact tests, or ANOVA where appropriate.Results. Sixty-one unique technical terms were used by oncologists, to describe 7 topics. 'Mutation' was a challenging term for patients to understand with 48.8% (21/43 mentions) of participants correctly defining the term. 'Genetic testing' was understood a little over half the time (53.3%; 8/15). 'Gene' was well understood (66.7%; 26/39) as was 'DNA' (80%; 12/15). There was no correlation between the terms being defined by the oncologist in the conversation, and the likelihood of the patient providing a correct definition. White participants were significantly more likely to understand both 'mutation' and 'genetic testing' than nonwhite participants. 42%(n=25) of participants had an understanding score below 50%, and a higher family income was significantly correlated with a higher score. Conclusion.Our results show that oncologists use variable terminology to describe molecular testing, which is often not understood. Since oncologists' defining the terms did not correlate with understanding, it is imperative to develop new, improved methods to explain molecular testing. The Oncologist 2021;9999:• • Implications for Practice: The use of molecular testing is expanding in oncology, yet little is known about how effectively clinicians are communicating information about molecular testing and whether patients understand the terminology used. Our results indicate that patients do not understand some of the terminology used by their clinicians, and that clinicians tend to use highly variable terminology to describe molecular testing. These results highlight the need to develop and implement effective methods to explain molecular testing terminology to patients to ensure that patients have the tools to make autonomous and informed decisions about their treatment.

Biomarker Testing Disparities in Metastatic Colorectal Cancer

“…While we could not assess linguistic abilities due to insufficient information in the NCDB and, although Hispanic ethnicity was not associated with a lack of testing, we contend that patients’ understanding of medical terminology and the purpose of testing were below physicians’ expectations. This disparity is exemplified in an analysis reporting that almost half of the patients could not describe specific terms related to biomarker testing immediately after an explanation by their oncologists . False perceptions toward biomarker testing can be attributed to lower health literacy levels and limited efforts by clinicians to explain comprehensively the importance of testing, both of which can be deterrents for patients with lower educational levels.…”

“…This disparity is exemplified in an analysis reporting that almost half of the patients could not describe specific terms related to biomarker testing immediately after an explanation by their oncologists. 26 False perceptions toward biomarker testing can be attributed to lower health literacy levels and limited efforts by clinicians to explain comprehensively the importance of testing, both of which can be deterrents for patients with lower educational levels.…”

Challenges in Improving Genomic Literacy: Results from National and Regional Surveys of Genomic Knowledge, Attitudes, Concerns, and Behaviors

“…Those with genetic disorders are likely to have a different relationship with their providers. [33][34][35] Indeed, more of the variance in behavior in the national sample was accounted for when the analysis included having a genetic disorder or disease related gene. These findings suggest that interventions to improve genomic knowledge will increase the public's engagement in positive genomic health behaviors.…”

Artificial Intelligence and Precision Medicine: A New Frontier for the Treatment of Brain Tumors

“…A study found that immunotherapy and targeted therapy based on PM can treat brain metastases [ 57 ]. Genomic and molecular profiling of tumors reveals the function of tumor-derived genetic markers [ 58 , 59 ]. A study relating tumor biology with circulating tumor DNA (tDNA) levels was conducted and showed that patients with solid tumors had genomic alterations detected by plasma tDNA assay.…”