title: 'Someday it will be the norm': physician perspectives on the utility of genome sequencing for patient care in the MedSeq Project.
abstract: OBJECTIVE
  To describe practicing physicians' perceived clinical utility of genome sequencing.
  
  
  METHODS
  We conducted a mixed-methods analysis of data from 18 primary care physicians and cardiologists in a study of the clinical integration of whole-genome sequencing. Physicians underwent brief genomics continuing medical education before completing surveys and semi-structured interviews.
  
  
  RESULTS
  Physicians described sequencing as currently lacking clinical utility because of its uncertain interpretation and limited impact on clinical decision-making, but they expressed the idea that its clinical integration was inevitable. Potential clinical uses for sequencing included complementing other clinical information, risk stratification, motivating patient behavior change and pharmacogenetics.
  
  
  CONCLUSIONS
  Physicians given genomics continuing medical education use the language of both evidence-based and personalized medicine in describing the utility of genome-wide testing in patient care.
authors: Section of General Internal Medicine, VA Boston Healthcare System, Boston, MA 02130, USA ; Division of General Medicine & Primary Care, Department of Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA ; Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
authors: Jason L
authors: JL
authors: Vassy
authors: Department of Medicine, Harvard Medical School, Boston, MA 02115, USA ; Division of Genetics, Brigham & Women's Hospital, Boston, MA 02115, USA.
authors: Kurt D
authors: KD
authors: Christensen
authors: School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA 01003, USA.
authors: Melody J
authors: MJ
authors: Slashinski
authors: Department of Medicine, Harvard Medical School, Boston, MA 02115, USA ; Division of Genetics, Brigham & Women's Hospital, Boston, MA 02115, USA.
authors: Denise M
authors: DM
authors: Lautenbach
authors: Department of Medicine, Harvard Medical School, Boston, MA 02115, USA ; General Medicine Division, Massachusetts General Hospital, Boston, MA 02114, USA.
authors: Sridharan
authors: S
authors: Raghavan
authors: Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX 77030, USA.
authors: Jill Oliver
authors: JO
authors: Robinson
authors: Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX 77030, USA.
authors: Jennifer
authors: J
authors: Blumenthal-Barby
authors: Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX 77030, USA.
authors: Lindsay Zausmer
authors: LZ
authors: Feuerman
authors: Division of General Medicine & Primary Care, Department of Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA ; Department of Medicine, Harvard Medical School, Boston, MA 02115, USA ; General Medicine Division, Massachusetts General Hospital, Boston, MA 02114, USA.
authors: Lisa Soleymani
authors: LS
authors: Lehmann
authors: Geisinger Health System, Danville, PA 17822 4910, USA.
authors: Michael F
authors: MF
authors: Murray
authors: Department of Medicine, Harvard Medical School, Boston, MA 02115, USA ; Division of Genetics, Brigham & Women's Hospital, Boston, MA 02115, USA.
authors: Robert C
authors: RC
authors: Green
authors: Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX 77030, USA.
authors: Amy L
authors: AL
authors: McGuire
keywords: genomics; high-throughput nucleotide sequencing; pharmacogenetics; physician’s practice patterns; qualitative research
references: Clin Pharmacol Ther. 2012 Mar;91(3):450-8
references: 22278335
references: Fam Med. 2013 Apr;45(4):257-62
references: 23553089
references: J Health Psychol. 2008 May;13(4):481-94
references: 18420756
references: Health Aff (Millwood). 2013 Feb;32(2):223-31
references: 23381514
references: JAMA. 2008 Mar 19;299(11):1320-34
references: 18349093
references: Per Med. 2012 Sep 1;9(7):683-692
references: 23795206
references: Can Fam Physician. 2003 Jan;49:45-52
references: 12602842
references: Nat Biotechnol. 2012 Nov;30(11):1027-9
references: 23138290
references: Nature. 2014 Jan 16;505(7483):286-7
references: 24436984
references: Technol Eval Cent Assess Program Exec Summ. 2013 Aug;28(3):1-4
references: 24066368
references: J Genet Couns. 2012 Feb;21(1):113-26
references: 21769569
references: N Engl J Med. 2009 May 7;360(19):1925-7
references: 19420360
references: JAMA. 2014 Mar 12;311(10):1035-45
references: 24618965
references: Diabetologia. 2009 Nov;52(11):2299-2305
references: 19727660
references: Genet Med. 2007 Dec;9(12):842-9
references: 18091434
references: Ann Intern Med. 2012 Oct 2;157(7):461-70
references: 23027317
references: Sci Transl Med. 2011 Jun 15;3(87):87re3
references: 21677200
references: Trials. 2014 Mar 20;15:85
references: 24645908
references: J Genet Couns. 2013 Feb;22(1):90-100
references: 22585186
references: Genet Med. 2013 Jan;15(1):45-54
references: 22878507
references: Am J Med Genet A. 2013 Apr;161A(4):758-63
references: 23444119
references: Science. 2011 Feb 18;331(6019):861-2
references: 21330519
references: N Engl J Med. 2014 May 1;370(18):1763
references: 24785218
references: J Gen Intern Med. 2011 Aug;26(8):834-40
references: 21311998
references: N Engl J Med. 2012 Jun 14;366(24):2267-75
references: 22693998
references: Genet Med. 2009 Jan;11(1):3-14
references: 18813139
references: Genet Med. 2013 Jan;15(1):14-24
references: 22955111
references: Public Health Genomics. 2010;13(2):106-15
references: 19556749
references: Diabetes Care. 2013 Jan;36(1):13-9
references: 22933432
references: Cochrane Database Syst Rev. 2010 Oct 06;(10):CD007275
references: 20927756
references: Ann Intern Med. 2014 Apr 1;160(7):507-8
references: 24514942
references: Nature. 2011 Feb 10;470(7333):204-13
references: 21307933
references: Cell. 2012 Mar 16;148(6):1293-307
references: 22424236
references: Genet Med. 2014 Mar;16(3):225-7
references: 24232411
references: Genet Med. 2011 Mar;13(3):255-62
references: 21173700
references: Genet Med. 2013 Jun;15(6):437-43
references: 23412608
references: Annu Rev Public Health. 2010;31:89-103
references: 20070198
references: N Engl J Med. 2013 Oct 17;369(16):1502-11
references: 24088041
references: Eur J Hum Genet. 2010 Dec;18(12):1271-3
references: 20736974
references: Genet Med. 2003 May-Jun;5(3):172-5
references: 12792425
references: Genet Med. 2003 May-Jun;5(3):166-71
references: 12792424
references: N Engl J Med. 2014 Jun 19;370(25):2418-25
references: 24941179