Motivating factors for physician ordering of factor V Leiden genetic tests.
BACKGROUND
The factor V Leiden (FVL) genetic test is used by many physicians despite its uncertain clinical utility.


METHODS
We investigate whether self-reported motivations and behaviors concerning FVL genetic testing differ between 2 groups of primary care physicians defined by frequency of previous FVL test use. In January 2007, 112 physicians (60 frequent and 52 infrequent FVL test users) at Group Health, a large health care delivery system, were surveyed. Survey content areas included primary reasons and motivating factors for ordering the FVL test, the likelihood of ordering the FVL test for hypothetical patients, potential barriers to genetic testing, and practices and skills regarding FVL test ordering.


RESULTS
Responses between groups agreed concerning most clinical- and patient-related factors. Frequent-FVL physicians were more likely than infrequent-FVL physicians to report ordering the FVL test for hypothetical patients with mesenteric venous thrombosis (adjusted odds ratio, 4.57; 95% confidence interval, 1.55-13.53) or venous thrombosis after hospital discharge (adjusted odds ratio, 3.42; 95% confidence interval, 1.30-8.95). Frequent-FVL physicians were also less likely to identify several items on the survey as barriers to genetic testing and were more likely to report high confidence in interpreting and explaining FVL test results.


CONCLUSIONS
Generally, both physician groups reported similar motivating factors for ordering FVL tests, and reported behaviors were consistent with existing guidelines. More striking differences were observed for measures such as barriers to and confidence in using genetic tests. Although additional research is necessary to evaluate the impact of these results, they inform several knowledge-to-practice translation issues that are important for the successful integration of genetic testing into primary care.
Hindorff
Lucia A
LA
Department of Epidemiology, University of Washington, Seattle, USA. hindorffl@mail.nih.gov
Burke
Wylie
W
Laberge
Anne-Marie
AM
Rice
Kenneth M
KM
Lumley
Thomas
T
Leppig
Kathleen
K
Rosendaal
Frits R
FR
Larson
Eric B
EB
Psaty
Bruce M
BM
D000328:Adult; D001291:Attitude of Health Personnel; D016001:Confidence Intervals; D005165:Factor V / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology*; D005820:Genetic Testing / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D054556:Venous Thromboembolism / Q000235:genetics* / Q000517:prevention & control
D005165:Factor V