Exploring the feasibility of delivering standardized genomic care using ophthalmology as an example

Genet Med. 2017 Sep;19(9):1032-1039. doi: 10.1038/gim.2017.9. Epub 2017 Mar 16.

Abstract

Purpose: Broadening access to genomic testing and counseling will be necessary to realize the benefits of personalized health care. This study aimed to assess the feasibility of delivering a standardized genomic care model for inherited retinal dystrophy (IRD) and of using selected measures to quantify its impact on patients.

Methods: A pre-/post- prospective cohort study recruited 98 patients affected by IRD to receive standardized multidisciplinary care. A checklist was used to assess the fidelity of the care process. Three patient-reported outcome measures-the Genetic Counselling Outcome Scale (GCOS-24), the ICEpop CAPability measure for Adults (ICECAP-A), and the EuroQol 5-dimension questionnaire (EQ-5D)-and a resource-use questionnaire were administered to investigate rates of missingness, ceiling effects, and changes over time.

Results: The care model was delivered consistently. Higher rates of missingness were found for the genetic-specific measure (GCOS-24). Considerable ceiling effects were observed for the generic measure (EQ-5D). The ICECAP-A yielded less missing data without significant ceiling effects. It was feasible to use telephone interviews for follow-up data collection.

Conclusion: The study highlighted challenges and solutions associated with efforts to standardize genomic care for IRD. The study identified appropriate methods for a future definitive study to assess the clinical effectiveness and cost-effectiveness of the care model.Genet Med advance online publication 02 March 2017.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Cohort Studies
  • Delivery of Health Care* / methods
  • Delivery of Health Care* / standards
  • Disease Management
  • Female
  • Genetic Counseling
  • Genetic Testing / methods
  • Genetic Testing / standards
  • Genomics* / methods
  • Humans
  • Male
  • Models, Theoretical
  • Ophthalmology* / methods
  • Ophthalmology* / standards
  • Patient Acceptance of Health Care
  • Patient Reported Outcome Measures
  • Retinal Dystrophies / diagnosis
  • Retinal Dystrophies / genetics
  • Standard of Care*