Grant: Travel Awards - Institute Community Support

Background: The volume and complexity of incidental results (IR) from genome sequencing (GS) makes engaging in pre-test shared decision-making with patients infeasible. Novel e-health tools such, as decision aids (DAs), are needed to fill this care gap. We created an interactive, online DA (www.genomicsadviser.com) to guide patients' selection of IR. Aim: To evaluate the effectiveness of the DA compared to traditional genetic counseling. Methods: We are conducting a RCT of adult cancer patients who received negative results from past genetic testing for colorectal or breast cancer, and for whom GS may be clinically useful. Patients in the intervention arm use the DA to select the IR they would hypothetically like to learn, then speak briefly with a genetic counselor (GC) about their selections. Patients in the control arm speak with a GC to select IR. The primary outcome is decisional conflict, assessed within two weeks of randomization. Secondary outcomes are knowledge, preparation for decision-making, and satisfaction with decisions. Results: We have recruited 112 of 128 participants and the last patient follow-up is expected in December 2017. Our analysis will compare the responses between the DA and GC groups. Further we will explore whether both groups felt equally prepared and satisfied with their decisions. We will also examine the DA's efficacy in educating patients on GS and IR. Conclusion: If validated, our DA could serve as an effective tool for the selection IR and reduce in-clinic time and health care costs.