title: Stakeholder perspectives on decision-analytic modeling frameworks to assess genetic services policy.
abstract: OBJECTIVE
  Genetic services policymakers and insurers often make coverage decisions in the absence of complete evidence of clinical utility and under budget constraints. We evaluated genetic services stakeholder opinions on the potential usefulness of decision-analytic modeling to inform coverage decisions, and asked them to identify genetic tests for decision-analytic modeling studies.
  
  
  METHODS
  We presented an overview of decision-analytic modeling to members of the Western States Genetic Services Collaborative Reimbursement Work Group and state Medicaid representatives and conducted directed content analysis and an anonymous survey to gauge their attitudes toward decision-analytic modeling. Participants also identified and prioritized genetic services for prospective decision-analytic evaluation.
  
  
  RESULTS
  Participants expressed dissatisfaction with current processes for evaluating insurance coverage of genetic services. Some participants expressed uncertainty about their comprehension of decision-analytic modeling techniques. All stakeholders reported openness to using decision-analytic modeling for genetic services assessments. Participants were most interested in application of decision-analytic concepts to multiple-disorder testing platforms, such as next-generation sequencing and chromosomal microarray.
  
  
  CONCLUSIONS
  Decision-analytic modeling approaches may provide a useful decision tool to genetic services stakeholders and Medicaid decision-makers.
authors: Center for Genomics and Healthcare Equality, University of Washington, Seattle, Washington, USA.
authors: Gregory F
authors: GF
authors: Guzauskas
authors: Louis P
authors: LP
authors: Garrison
authors: Jacquie
authors: J
authors: Stock
authors: Sylvia
authors: S
authors: Au
authors: Debra Lochner
authors: DL
authors: Doyle
authors: David L
authors: DL
authors: Veenstra
mesh_terms: D003657:Decision Making; D003661:Decision Support Techniques; D033142:Genetic Services / Q000331:legislation & jurisprudence; D005820:Genetic Testing; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage; D011795:Surveys and Questionnaires