TY - JOUR
T1 - Specialist physicians’ referral behavior regarding preimplantation genetic testing for single-gene disorders
T2 - Is there room to grow?
AU - Capelouto, Sarah
AU - Evans, Melanie
AU - Shannon, Jennifer
AU - Jetelina, Katelyn
AU - Bukulmez, Orhan
AU - Carr, Bruce
N1 - Funding Information:
The authors thank Samir Babayev, M.D. for his aid in conceptualizing this original research project. Next, the authors thank the administrators from the University of Texas Southwestern Medical Center Departments of Internal Medicine, Obstetrics and Gynecology, and Pediatrics for allowing us to recruit physicians for our study by attending grand rounds presentations and disseminating our online REDCap survey via e-mail. Lastly, the authors thank the Division of Reproductive Endocrinology and Infertility at the University of Texas Southwestern Medical Center for their support in the development and execution of our study. There were no funding sources used for this research project.
Publisher Copyright:
© 2021 The Authors
PY - 2021/6
Y1 - 2021/6
N2 - Objective: To assess whether primary care specialists’ demographics, specialty, and knowledge of preimplantation genetic testing for monogenic disorders (PGT-M) influence their practice patterns. Design: Cross-sectional survey study. Setting: Academic medical center. Patient(s): Not applicable. Intervention(s): None. Main Outcome Measure(s): Objective PGT-M knowledge, subjective comfort with PGT-related topics, PGT care practices (discussions/referrals), and PGT-M implementation barriers. Result(s): Our survey had 145 respondents: 65 obstetrician/gynecologists, 36 internists, and 44 pediatricians. Overall, 88% believed that patients at a risk of passing on genetic disorders should be provided PGT-M information. However, few discussed PGT-M with their patients (24%) or referred them for testing (23%). Over half (63%) believed that the lack of physician knowledge was a barrier to PGT use. In terms of subjective comfort with PGT, only 1 in 5 physicians felt familiar enough with the topic to answer patient questions. There were higher odds of discussing (odds ratio, 3.21; 95% confidence interval, 1.75–5.87) or referring for PGT (odds ratio, 2.52; 95% confidence interval, 1.41–4.51) for each additional 0.5 correct answers to PGT knowledge-related questions. The odds of referring patients for PGT-M were the highest among obstetrician/gynecologists compared with those among the internists and pediatricians. Conclusion(s): Physician specialty and PGT knowledge were associated with PGT-M care delivery practices. Although most specialists believed in equipping at-risk patients with PGT-M information, <1 in 4 discussed or referred patients for PGT. The low levels of PGT-related care among providers may be owed to inadequate knowledge of and comfort with the topic. An opportunity to promote greater understanding of PGT-M among primary care specialists exists and can in turn improve the use of referrals to PGT-M services.
AB - Objective: To assess whether primary care specialists’ demographics, specialty, and knowledge of preimplantation genetic testing for monogenic disorders (PGT-M) influence their practice patterns. Design: Cross-sectional survey study. Setting: Academic medical center. Patient(s): Not applicable. Intervention(s): None. Main Outcome Measure(s): Objective PGT-M knowledge, subjective comfort with PGT-related topics, PGT care practices (discussions/referrals), and PGT-M implementation barriers. Result(s): Our survey had 145 respondents: 65 obstetrician/gynecologists, 36 internists, and 44 pediatricians. Overall, 88% believed that patients at a risk of passing on genetic disorders should be provided PGT-M information. However, few discussed PGT-M with their patients (24%) or referred them for testing (23%). Over half (63%) believed that the lack of physician knowledge was a barrier to PGT use. In terms of subjective comfort with PGT, only 1 in 5 physicians felt familiar enough with the topic to answer patient questions. There were higher odds of discussing (odds ratio, 3.21; 95% confidence interval, 1.75–5.87) or referring for PGT (odds ratio, 2.52; 95% confidence interval, 1.41–4.51) for each additional 0.5 correct answers to PGT knowledge-related questions. The odds of referring patients for PGT-M were the highest among obstetrician/gynecologists compared with those among the internists and pediatricians. Conclusion(s): Physician specialty and PGT knowledge were associated with PGT-M care delivery practices. Although most specialists believed in equipping at-risk patients with PGT-M information, <1 in 4 discussed or referred patients for PGT. The low levels of PGT-related care among providers may be owed to inadequate knowledge of and comfort with the topic. An opportunity to promote greater understanding of PGT-M among primary care specialists exists and can in turn improve the use of referrals to PGT-M services.
KW - Preimplantation genetic testing
KW - monogenic disease
KW - obstetrician/gynecologist
KW - primary care specialist
KW - survey
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U2 - 10.1016/j.xfre.2021.03.002
DO - 10.1016/j.xfre.2021.03.002
M3 - Article
C2 - 34278357
AN - SCOPUS:85117611775
SN - 2666-3341
VL - 2
SP - 215
EP - 223
JO - F and S Reports
JF - F and S Reports
IS - 2
ER -