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遗传测试解释中的陷阱和挑战:遗传专业人员对结果解释经验的探索。

Pitfalls and challenges in genetic test interpretation: An exploration of genetic professionals experience with interpretation of results.

机构信息

Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.

出版信息

Clin Genet. 2021 May;99(5):638-649. doi: 10.1111/cge.13917.

Abstract

The interpretation of genetic testing results is subject to error. This observational study illustrates examples of pitfalls and challenges in interpretation of genetic testing results as reported by genetics professionals. We surveyed genetics professionals to describe interpretation challenges, the types of variants that were involved, and the reported clinical impact of misconception of a test result. Case studies were then collected from a select group to further explore potential causes of misunderstanding. A total of 83% of survey respondents were aware of at least one instance of genetic test misinterpretation. Both professionals with and without formal training in genetics were challenged by test reports, and variants of unknown significance were most frequently involved. Case submissions revealed that interpretation pitfalls extend beyond variant classification analyses. Inferred challenges in case submissions include lack of genetic counseling, unclear wording of reports, and suboptimal communication among providers. Respondents and case submitters noted that incorrect interpretation can trigger unnecessary follow-up tests and improperly alter clinical management. Further research is needed to validate and quantify large-scale data regarding challenges of genetic results interpretation.

摘要

遗传检测结果的解读存在误差。本观察性研究通过遗传学专家报告的实例说明了遗传检测结果解读中存在的陷阱和挑战。我们调查了遗传学专家,以描述解读挑战、涉及的变异类型,以及对检测结果误解的报告临床影响。然后从一组精选的案例中收集了案例研究,以进一步探讨误解的潜在原因。调查的受访者中有 83%至少了解一次遗传检测结果的错误解读。具有和不具有遗传学正式培训的专业人员都面临着检测报告的挑战,且最常涉及意义不明的变异。案例提交表明,解读陷阱不仅限于变异分类分析。案例提交中推断出的挑战包括缺乏遗传咨询、报告措辞不清晰,以及提供者之间沟通不畅。受访者和案例提交者指出,不正确的解读可能会引发不必要的后续检测,并不当改变临床管理。需要进一步的研究来验证和量化遗传结果解读挑战的大规模数据。

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