title: Public perceptions of disease severity but not actionability correlate with interest in receiving genomic results: nonalignment with current trends in practice.
abstract: OBJECTIVE
  Frameworks highlighting disease actionability and severity are evolving to address the need to organize results from genome-wide analyses. This approach represents a paradigm shift from consultations focused on one or more genes to multiple genes for multiple disorders. Empirical input from the general population is lacking, yet seems essential for understanding how to maximize patient autonomy and satisfaction in the decision-making process.
  
  
  METHODS
  We conducted a cross-sectional online survey with a representative sample of 900 US adults and assessed the participants' perceptions and attitudes toward disease actionability and severity, ranking hypothetical scenarios for these properties, and explored correlations with interest in learning test results.
  
  
  RESULTS
  Most respondents (>85%) rated actionability and severity as useful concepts; 46.6% indicated actionability alone would be adequate for decision making. Over half of them (53.8%) reported being very/extremely confident in their ability to score for actionability and severity. The participants' scoring of medical scenarios varied significantly between individuals. Scores for severity but not actionability were correlated with interest in learning genetic results. Subsets of the respondents projected wanting all results (30%) or no results (16%). The use of expert-created lists was acceptable to 43%.
  
  
  CONCLUSIONS
  The respondents from the general population were confident in making their own decisions. The responses suggested different priorities than current expert-driven approaches. The emphasis on binning genes may be missing a complementary, simplifying approach of grouping patients based upon their all/none interest in genomic results. This study illuminates important differences between the general public and genetic experts.
authors: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C., USA.
authors: Kristi D
authors: KD
authors: Graves
authors: Pamela S
authors: PS
authors: Sinicrope
authors: Jennifer B
authors: JB
authors: McCormick
authors: Yingjun
authors: Y
authors: Zhou
authors: Susan T
authors: ST
authors: Vadaparampil
authors: Noralane M
authors: NM
authors: Lindor
mesh_terms: D022126:Access to Information / Q000523:psychology*; D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D005820:Genetic Testing / Q000941:ethics / Q000379:methods; D055106:Genome-Wide Association Study / Q000941:ethics / Q000379:methods; D023281:Genomics / Q000941:ethics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012938:Social Perception; D014342:Truth Disclosure / Q000941:ethics; D014481:United States