title: Lay perceptions of predictive testing for diabetes based on DNA test results versus family history assessment: a focus group study.
abstract: BACKGROUND
  This study assessed lay perceptions of issues related to predictive genetic testing for multifactorial diseases. These perceived issues may differ from the "classic" issues, e.g. autonomy, discrimination, and psychological harm that are considered important in predictive testing for monogenic disorders. In this study, type 2 diabetes was used as an example, and perceptions with regard to predictive testing based on DNA test results and family history assessment were compared.
  
  
  METHODS
  Eight focus group interviews were held with 45 individuals aged 35-70 years with (n = 3) and without (n = 1) a family history of diabetes, mixed groups of these two (n = 2), and diabetes patients (n = 2). All interviews were transcribed and analysed using Atlas-ti.
  
  
  RESULTS
  Most participants believed in the ability of a predictive test to identify people at risk for diabetes and to motivate preventive behaviour. Different reasons underlying motivation were considered when comparing DNA test results and a family history risk assessment. A perceived drawback of DNA testing was that diabetes was considered not severe enough for this type of risk assessment. In addition, diabetes family history assessment was not considered useful by some participants, since there are also other risk factors involved, not everyone has a diabetes family history or knows their family history, and it might have a negative influence on family relations. Respect for autonomy of individuals was emphasized more with regard to DNA testing than family history assessment. Other issues such as psychological harm, discrimination, and privacy were only briefly mentioned for both tests.
  
  
  CONCLUSIONS
  The results suggest that most participants believe a predictive genetic test could be used in the prevention of multifactorial disorders, such as diabetes, but indicate points to consider before both these tests are applied. These considerations differ with regard to the method of assessment (DNA test or obtaining family history) and also differ from monogenic disorders.
authors: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. l.henneman@vumc.nl
authors: Miranda
authors: M
authors: Wijdenes-Pijl
authors: Wybo J
authors: WJ
authors: Dondorp
authors: Danielle Rm
authors: DR
authors: Timmermans
authors: Martina C
authors: MC
authors: Cornel
authors: Lidewij
authors: L
authors: Henneman
mesh_terms: D000328:Adult; D000368:Aged; D004247:DNA; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D017144:Focus Groups; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011237:Predictive Value of Tests; D011639:Public Opinion
chemical_list: D004247:DNA