A5090965905- BRCA gene mutations in cancer
- Ethics in Clinical Research
- Genomics and Rare Diseases
- Prenatal Screening and Diagnostics
- Childhood Cancer Survivors' Quality of Life
- Family Support in Illness
- Health Policy Implementation Science
- Cancer Genomics and Diagnostics
- Peripheral Artery Disease Management
- Cerebrovascular and Carotid Artery Diseases
- Coronary Interventions and Diagnostics
- Health Sciences Research and Education
- Traumatic Ocular and Foreign Body Injuries
- Child and Adolescent Psychosocial and Emotional Development
- DNA Repair Mechanisms
- Ocular Infections and Treatments
- Community Health and Development
- Mobile Health and mHealth Applications
- CRISPR and Genetic Engineering
- Genomic variations and chromosomal abnormalities
- Public Health Policies and Education
- Nutrition, Genetics, and Disease
- Intraocular Surgery and Lenses
- Telemedicine and Telehealth Implementation
University of Pennsylvania
2013-2024
Sechenov University
2023
Temple University Health System
2018
Fox Chase Cancer Center
2008-2018
University of Chicago
2009
Videoconferencing has been used to expand medical services low-access populations and could increase access genetic at community sites where in-person visits with providers are not available.To evaluate the feasibility of, patient feedback cognitive affective responses remote two-way videoconferencing (RVC) telegenetic multiple sociodemographically diverse practices without providers.Patients 3 in 2 US states outside host center completed RVC pretest (visit 1, V1) post-test 2, V2) counseling...
Germline genetic testing is standard practice in oncology. Outcomes of telephone disclosure a wide range cancer test results, including multigene panel (MGPT) are unknown. Patients undergoing were recruited to multicenter, randomized, noninferiority trial (NCT01736345) comparing (TD) results with usual care, in-person (IPD) after tiered-binned pretest counseling. Primary outcomes included change knowledge, state anxiety, and general anxiety. Secondary cancer-specific distress, depression,...
BRCA1/2 test disclosure has, historically, been conducted in-person by genetics professionals. Given increasing demand for, and access to, genetic testing, interest in telephone Internet services, including of results, has increased. Semi-structured interviews with counselors were to determine in, experiences results. Descriptive data are summarized response proportions. One hundred ninety-four completed self-administered surveys via the web. Although 98% had provided results telephone, 77%...
Abstract Background While there is increasing interest in sharing genetic research results with participants, how best to communicate the risks, benefits and limitations of remains unclear. Methods Participants who received answered open closed‐ended questions about their experiences receiving advantages disadvantages a web‐based alternative counseling. Results 107 BRCA1/2 negative women personal or family history breast cancer consented receive 82% completed survey items experience. Most...
<sec> <title>BACKGROUND</title> Germline BRCA1/2 testing has become a standard evidence-based practice, with established risk reduction and cancer screening guidelines for genetic carriers. With FDA approval PARP inhibitors in patients advanced breast, ovarian, pancreatic prostate cancer, there is an additional therapeutic rationale all germline mutations. Yet, many at-risk do not have access to services, leaving carriers unidentified. </sec> <title>OBJECTIVE</title> The eREACH study (A...
10502 Background: With FDA approval of targeted therapies in patients with germline BRCA1/2 -related advanced cancers there is a need to evaluate efficient and effective delivery models for cancer genetic testing. Methods: eREACH 4 arm non-inferiority study where traditional standard-of-care pre-test (visit 1) post-test 2) counseling delivered by counselor (GC) are replaced patient-centered eHealth (digital) intervention or metastatic cancer. GC visits were offered telehealth the home. Arms...
Background: Dissemination of genetic testing for disease susceptibility, one application “personalized medicine”, holds the potential to empower patients and providers through informed risk reduction prevention recommendations. Genetic has become a standard practice in cancer high-risk populations. Heightened consumer awareness “cancer genes” genes other diseases (eg, cardiovascular Alzheimer’s disease), as well burgeoning availability increasingly complex genomic tests (ie, multi-gene,...
Understanding the outcomes of returning individual genetic research results to participants is critical because some variants are found be associated with health and have become available for clinical testing.BRCA1/2-negative women early-onset breast cancer, multiple primary cancers, or a family history cancer who participated in gene discovery registry were offered opportunity learn their 24 susceptibility genes counselor after predisclosure counseling. Outcomes included uptake results,...
Abstract Purpose To examine the benefit of telehealth over current delivery options in oncology practices without genetic counselors. Methods Participants meeting cancer testing guidelines were recruited to this multi‐center, randomized trial comparing uptake services with remote (telephone or videoconference) usual care six predominantly community The primary outcome was composite counseling testing. Secondary outcomes compare telephone versus videoconference services. Results 147...
Telephone disclosure of cancer genetic test results is noninferior to in‐person disclosure. However, how patients who prefer communication differ from those agree telephone unclear but important when considering delivery models for medicine. Patients undergoing testing were recruited a multicenter, randomized, noninferiority trial (NCT01736345) comparing results. We evaluated preferences disclosure, factors associated with this preference and outcomes compared agreed randomization. Among...
Abstract Background . As familial cancer genetic services moves into community practice increased numbers of trained health professionals are needed to counsel individuals seeking risk information. Nurses have been targeted provide assessment and counseling. To help prepare nurses for this role, a 5‐day training in counseling followed by long‐distance mentorship support continued skill development the work environment was conducted Fox Chase Cancer Center, Philadelphia, PA. Methods Four...
Purpose Multigene panels (MGPs) are increasingly being used despite questions regarding their clinical utility and no standard approach to genetic counseling. How frequently providers use MGP testing how patient-reported outcomes (PROs) differ from targeted (eg, BRCA1/2 only) unknown. Methods We evaluated of PROs in participants undergoing cancer the multicenter Communication Genetic Test Results by Telephone study (ClinicalTrials.gov identifier: NCT01736345), a randomized telephone versus...
Although multigene panel testing (MGPT) is increasingly utilized in clinical practice, there remain limited data on patient-reported outcomes. BRCA 1/2 negative patients were contacted and offered MGPT. Patients completed pre- posttest counseling, surveys assessing cognitive, affective behavioral outcomes at baseline, postdisclosure 6 12 months. Of 317 eligible BRCA1/2 who discussed the study with research staff, 249 (79%) enrolled. Decliners more likely to be older, non-White, recruited by...
We developed a web-based education intervention as an alternative to predisclosure with genetic counselor (GC) reduce participant burden and provider costs return of research results.
The use of multigene panels has significantly increased the likelihood that genetic testing will leave patients with uncertainties regarding test interpretation, implications, and recommendations, which change over time. Effective longitudinal care models are needed to provide updated information obtain patient family history updates. To bridge this gap, we aimed develop a patient- provider-informed digital health portal (GHP), MyCancerGene, improve understanding responses testing. We used...
Abstract #1098 Disclosure of BRCA1/2 test results has historically been conducted in person by a certified genetic counselor (GC) and/or other health care professional. Due to increasing demand for and access testing, there interest providing counseling services, including disclosure results, telephone internet. The practice among counselors not described. We semi-structured interviews with GCs determine current prevalence of, future in, (TD) results. Surveys were self-administered completed...
Abstract #2098 Background: Disclosure of BRCA1/2 test results has historically been conducted in person by a health care professional. Due to increasing consumer demand for, and access testing, as well the prevalence acceptance telemedicine, there interest among those who provide testing delivering risk assessment genetic counseling services, including disclosure results, telephone internet. Consumers' opinions regarding, receiving their via have not described. Method: Conducted...
To evaluate the impact of fractional flow reserve (FFR) assessment on choice myocardial revascularization strategy in patients with ischemic heart disease and multivessel coronary artery to compare long-term outcomes complete functional or anatomical revascularization.
<sec> <title>BACKGROUND</title> The use of multigene panels in clinical practice has created an increasing likelihood that cancer genetic testing will leave many patients with uncertainties regarding test interpretation, implications and recommendations, which change over time. We lack effective longitudinal care models to provide updated information results or medical recommendations obtain personal history updates. </sec> <title>OBJECTIVE</title> To bridge this gap medicine, we developed a...
Research participants report interest in receiving genetic research results. How best to return results remains unclear. In this randomized pilot study, we sought assess the feasibility of returning actionable through a two-step process including patient-centered digital intervention as compared with counselor (GC) Penn Medicine biobank. Step 1, an result and procedural controls (no result) were invited pre-disclosure education provided options for opting out 2, those who had not opted...
1510 Background: BRCA1/2 test results have historically been disclosed in person (IPD) by a certified genetic counselor (GC). Greater consumer demand and access to testing, greater prevalence acceptance of telemedicine, interested providers conducting testing disclosing telephone (TD) internet. GC experiences opinions about TD not well described. Methods: To determine experience, interest we conducted semi-structured interviews with 194 recruited via NSGC Cancer Special Interest Group 30...
1502 Background: Genetic testing for cancer predisposition traditionally includes in-person pre- and post-test genetic counseling. Outcomes of telephone delivery a range test results, including multi-gene panel testing, are unknown. Methods: 984 patients at 5 centers undergoing (after pre-test counseling) enrolled. 819 were randomly assigned to (IPD; n=418) or disclosure (TD; n=401) results. 17% (n=165) declined randomization given preference IPD. Primary outcomes knowledge, state anxiety...