Patient goals, motivations, and attitudes in a patient-driven variant reclassification study

Ginger J. Tsai, Lauren Thomas Garrett, Sukh Makhnoon, Deborah J. Bowen, Wylie Burke, Brian H. Shirts

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Family studies to reclassify clinically ascertained variants of uncertain significance (VUS) can impact risk assessment, medical management, and psychological outcomes for patients and their families. There are limited avenues for patients and their families to actively participate in VUS reclassification, and access to family studies at most commercial laboratories is restricted by multiple factors. To explore patient attitudes about participation in family studies for VUS reclassification, we conducted semistructured pre- and post-participation telephone interviews with 38 participants in a family-based VUS reclassification study that utilized a patient-driven approach for family ascertainment and recruitment. Participants had VUS from multigene panel testing performed at multiple clinical laboratories for cancer or other disease risk. Inductive thematic analysis of transcribed interviews highlighted four major themes: (a) Participants’ study goals were driven by the desire to resolve uncertainty related to the VUS, (b) Participants had mixed reactions to the VUS reclassification outcomes of the study, (c) Personal, public, and familial knowledge increased through study participation and (d) Participants used study participation to actively cope with the uncertainty of a VUS. As personalized genomic medicine becomes more prevalent, clinicians, clinical laboratories, and researchers could consider creating more opportunities for active partnership with patients and families, who are motivated to contribute data to familial VUS studies.

Original languageEnglish (US)
Pages (from-to)558-569
Number of pages12
JournalJournal of Genetic Counseling
Volume28
Issue number3
DOIs
StatePublished - Jun 2019
Externally publishedYes

Keywords

  • family studies
  • genetic research
  • health behavior
  • patient participation
  • patient-driven
  • qualitative research
  • thematic analysis
  • variant classification
  • variant of uncertain significance
  • variant reclassification

ASJC Scopus subject areas

  • Genetics(clinical)

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