Improving Decision Making about Genetic Testing in the Clinic: An Overview of Effective Knowledge Translation Interventions

PLoS One. 2016 Mar 3;11(3):e0150123. doi: 10.1371/journal.pone.0150123. eCollection 2016.

Abstract

Background: Knowledge translation (KT) interventions are attempts to change behavior in keeping with scientific evidence. While genetic tests are increasingly available to healthcare consumers in the clinic, evidence about their benefits is unclear and decisions about genetic testing are thus difficult for all parties.

Objective: We sought to identify KT interventions that involved decisions about genetic testing in the clinical context and to assess their effectiveness for improving decision making in terms of behavior change, increased knowledge and wellbeing.

Methods: We searched for trials assessing KT interventions in the context of genetic testing up to March 2014 in all systematic reviews (n = 153) published by two Cochrane review groups: Effective Practice and Organisation of Care (EPOC) and Consumers and Communication.

Results: We retrieved 2473 unique trials of which we retained only 28 (1%). Two EPOC reviews yielded two trials of KT interventions: audit and feedback (n = 1) and educational outreach (n = 1). Both targeted health professionals and the KT intervention they assessed was found to be effective. Four Consumers and Communication reviews yielded 26 trials: decision aids (n = 15), communication of DNA-based disease risk estimates (n = 7), personalized risk communication (n = 3) and mobile phone messaging (n = 1). Among these, 25 trials targeted only health consumers or patients and the KT interventions were found to be effective in four trials, partly effective in seven, and ineffective in four. Lastly, only one trial targeted both physicians and patients and was found to be effective.

Conclusions: More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Communication
  • Decision Making*
  • Decision Support Systems, Clinical*
  • Decision Support Techniques
  • Genetic Predisposition to Disease
  • Genetic Testing / methods*
  • Humans
  • Outcome Assessment, Health Care
  • Patient Education as Topic
  • Professional-Patient Relations
  • Research Design
  • Translational Medical Research*

Grant support

This study was supported by the APOGEE-Net/CanGèneTest Research and Knowledge Network on Genetic and Genomics Health Services and Policy. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.