A QUALITATIVE SYSTEMATIC REVIEW OF DECISIONS ABOUT CANCER GENETIC TESTING (CGT) FOR HEREDITARY BREAST CANCER (HBC): WILL THE REAL UPTAKE RATE PLEASE STAND UP?

2.50
Hdl Handle:
http://hdl.handle.net/10755/165302
Category:
Abstract
Type:
Presentation
Title:
A QUALITATIVE SYSTEMATIC REVIEW OF DECISIONS ABOUT CANCER GENETIC TESTING (CGT) FOR HEREDITARY BREAST CANCER (HBC): WILL THE REAL UPTAKE RATE PLEASE STAND UP?
Author(s):
Ropka, Mary; Phillips, Elayne; Wenzel, Jennifer; Philbrick, John
Author Details:
Mary Ropka, PhD, RN, FAAN, UVA School of Medicine and School of Nursing, Charlottesville, Virginia, USA; Elayne Phillips, PhD; Jennifer Wenzel, MS; John Philbrick, MD
Abstract:
Building on recent progress of the Human Genome Project, risk assessment and counseling is increasingly incorporated into cancer nursing practice. Individuals and families dealing with hereditary cancer risk face complex decisions, including whether to obtain CGT. Synthesis of research regarding CGT decisions is important to guide development, testing, and dissemination of evidence-based decision support interventions. Our review of 40 papers addressing HBC CGT revealed large variability in CGT uptake (20% to 96%). The purpose of this analysis was to explain that variability. Aims included examining role of: methods of measuring uptake; HBC personal history (PH) and family history (FH); and research methodology. Ottawa Decision Support Framework (knowledge, expectations, values, support, skills) guides assessment of decision making needs and subsequent tailoring of CGT decision support interventions. Design: Qualitative Systematic Review. Sample: Using MEDLINE, CINAHL, and PSYCHINFO, we identified 40 primary research reports in English, 1990-2002, meeting these criteria: cancer-related; adults; breast CGT decisions; and peer-reviewed. Procedure: Data Abstracted: Breast cancer PH and FH; CGT uptake percent, “real” (blood draw, R), or “hypothetical” (intent or interest, H) and how measured; study design; sampling strategy; recruitment, setting. Quality Review: Two independent reviewers systematically applied 14 criteria adapted from established quality review guidelines to accommodate diverse designs. Descriptive statistics. Study heterogeneity precluded statistical meta-analysis. In 40 studies, 58 rates (40 H-CGT, 18 R-CGT) were reported in 56 patient cohorts. Mean H-CGT and R-CGT rates were similar (70% vs 73%). FH patients had higher H-CGT rates (74% FH vs. 53% other), while PH patients had higher R-CGT rates (82% PH vs. 50% other). Other factors contributing to uptake variability were: study design differences (26 correlational, 5 randomized controlled trials, 9 other); patient assembly (30 convenience, 4 consecutive series, 6 other); sampling frame (hospital/clinic/registry 27, community 7, both 5); and methods measuring H-CGT rates (40 different questions). Our review shows that study methodology, in addition to patient and cancer characteristics, must be evaluated as part of interpreting CGT research. Only then can results be used to guide clinical care and future research.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
30th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Orlando, Florida, USA
Sponsors:
Funding Sources: National Cancer Institute K07 Award.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleA QUALITATIVE SYSTEMATIC REVIEW OF DECISIONS ABOUT CANCER GENETIC TESTING (CGT) FOR HEREDITARY BREAST CANCER (HBC): WILL THE REAL UPTAKE RATE PLEASE STAND UP?en_GB
dc.contributor.authorRopka, Maryen_US
dc.contributor.authorPhillips, Elayneen_US
dc.contributor.authorWenzel, Jenniferen_US
dc.contributor.authorPhilbrick, Johnen_US
dc.author.detailsMary Ropka, PhD, RN, FAAN, UVA School of Medicine and School of Nursing, Charlottesville, Virginia, USA; Elayne Phillips, PhD; Jennifer Wenzel, MS; John Philbrick, MDen_US
dc.identifier.urihttp://hdl.handle.net/10755/165302-
dc.description.abstractBuilding on recent progress of the Human Genome Project, risk assessment and counseling is increasingly incorporated into cancer nursing practice. Individuals and families dealing with hereditary cancer risk face complex decisions, including whether to obtain CGT. Synthesis of research regarding CGT decisions is important to guide development, testing, and dissemination of evidence-based decision support interventions. Our review of 40 papers addressing HBC CGT revealed large variability in CGT uptake (20% to 96%). The purpose of this analysis was to explain that variability. Aims included examining role of: methods of measuring uptake; HBC personal history (PH) and family history (FH); and research methodology. Ottawa Decision Support Framework (knowledge, expectations, values, support, skills) guides assessment of decision making needs and subsequent tailoring of CGT decision support interventions. Design: Qualitative Systematic Review. Sample: Using MEDLINE, CINAHL, and PSYCHINFO, we identified 40 primary research reports in English, 1990-2002, meeting these criteria: cancer-related; adults; breast CGT decisions; and peer-reviewed. Procedure: Data Abstracted: Breast cancer PH and FH; CGT uptake percent, “real” (blood draw, R), or “hypothetical” (intent or interest, H) and how measured; study design; sampling strategy; recruitment, setting. Quality Review: Two independent reviewers systematically applied 14 criteria adapted from established quality review guidelines to accommodate diverse designs. Descriptive statistics. Study heterogeneity precluded statistical meta-analysis. In 40 studies, 58 rates (40 H-CGT, 18 R-CGT) were reported in 56 patient cohorts. Mean H-CGT and R-CGT rates were similar (70% vs 73%). FH patients had higher H-CGT rates (74% FH vs. 53% other), while PH patients had higher R-CGT rates (82% PH vs. 50% other). Other factors contributing to uptake variability were: study design differences (26 correlational, 5 randomized controlled trials, 9 other); patient assembly (30 convenience, 4 consecutive series, 6 other); sampling frame (hospital/clinic/registry 27, community 7, both 5); and methods measuring H-CGT rates (40 different questions). Our review shows that study methodology, in addition to patient and cancer characteristics, must be evaluated as part of interpreting CGT research. Only then can results be used to guide clinical care and future research.en_GB
dc.date.available2011-10-27T12:16:06Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:16:06Z-
dc.conference.date2005en_US
dc.conference.name30th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.description.sponsorshipFunding Sources: National Cancer Institute K07 Award.-
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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