Saturday, April 20, 2024

Prioritizing Patient Values in Predictive Genetic Testing for Hereditary Cancers

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A recent study has focused on determining the relative importance and willingness to pay for specific attributes of genetic testing in hereditary cancer syndromes. Comprehending service user preferences is deemed essential for efficacious healthcare decision-making and economical resource allocation. This is particularly relevant in handling high-risk patients where predictive genetic testing can significantly modify health outcomes.

The research included an extensive search in Medline, Embase, PsycINFO, HMIC, Web of Science, and EconLit using discrete choice experiment (DCE) terms combined with terms linked to hereditary cancer syndromes, malignancy synonyms, and genetic testing. After independent screening by three reviewers, seven studies fulfilled the inclusion criteria, i.e., a DCE investigating patient or public preferences related to predictive genetic testing for hereditary cancer syndromes.

The study extracted data including study and respondent characteristics, DCE attributes and levels, data analysis and interpretation methods, and key study findings. The research covered colorectal, breast, and ovarian cancer syndromes. The results were summarized in a narrative synthesis, and the quality was assessed using the Lancsar and Louviere framework.

Genetic Testing

Strategic Priorities in Hereditary Cancer Genetic Testing

According to the review, test effectiveness and detection rates were consistently important to respondents, indicating these factors should be a priority for policymakers. Other factors such as accuracy, cost, and wait time, while significant, showed variation between studies. However, it was suggested that an overall reduction in cost may improve the uptake of genetic testing. It was also found that patients and the public would be willing to pay for improved detection and clinician over insurance provider involvement.

Considering the limitations, the review focused only on DCE design and testing for hereditary cancer syndromes rather than other complex diseases, and challenges also arose from heterogeneity in attributes and levels. Future studies are recommended to contextualize findings by considering the impact of sociodemographic characteristics, health system coverage, and insurance policies on preferences.

 

Orijinal Article DOI: 10.1177/0272989X241227425

Original title: Preferences for Genetic Testing to Predict the Risk of Developing Hereditary Cancer: A Systematic Review of Discrete Choice Experiments

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