The effect of disease risk probability and disease type on interest in clinic-based versus direct-to-consumer genetic testing services
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The effect of disease-specific cognitions on interest in clinic-based and direct-to-consumer (DTC) genetic testing was assessed. Participants (N = 309) responded to an online hypothetical scenario and received genetic testing-related messages that varied by risk probability (25, 50, 75 %) and disease type (Alzheimer’s disease vs. Type 2 Diabetes). Post-manipulation interest increased for both testing types, but was greater for clinic-based testing. Interest was greater for Type 2 Diabetes than for Alzheimer’s disease, the latter perceived as more severe and likely, and less treatable and preventable. For DTC testing only, participants allocated to the high risk condition (75 %) had greater testing interest than those in the low (25 %) category. DTC testing is perceived as a viable, but less preferred, option compared with clinic-based testing. Particularly when considering DTC genetic testing, there is a need to emphasize subjective disease-related perceptions, including risk probability.
KeywordsDirect-to-consumer Genetic testing Risk probability Perceived manageability Perceived severity
Conflict of interest
Kerry Sherman, Laura-Kate Shaw, Katrina Champion, Fernanda Caldeira and Margaret McCaskill declare that they have no conflict of interest.
Human and animal rights and Informed Consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
- Barlow-Stewart, K. (2007). DNA genetic testing—Screening for genetic conditions and genetic susceptibility [Fact sheet]. In Centre for Genetics Education (Ed.), The Australasian genetics resource book. Retrieved 16th October, 2014 from http://www.nhmrc.gov.au/_files_nhmrc/file/your_health/egenetics/FS21-dna-genetic-testing.pdf
- Browne, J. L., Ventura, A., Mosely, K., & Speight, J. (2013). ‘I call it the blame and shame disease’: A qualitative study about perceptions of social stigma surrounding type 2 diabetes. British Medical Journal Open, 3. doi: 10.1136/bmjopen-2013-003384
- Cameron, L. D., Marteau, T. M., Brown, P. M., Klein, W. M., & Sherman, K. A. (2011). Communication strategies for enhancing understanding of the behavioral implications of genetic and biomarker tests for disease risk: The role of coherence. Journal of Behavioral Medicine, 35, 286–298. doi: 10.1007/s10865-011-9361-5 CrossRefPubMedGoogle Scholar
- de Bruin, W. B., Fischhoff, B., Millstein, S. G., & Halpern-Felsher, B. L. (2000). Verbal and numerical expressions of probability: “It’s a fifty–fifty chance”. Organizational Behavior and Human Decision Processes, 81, 115–131. doi: 10.1006/obhd.1999.2868
- Diabetes Australia. (2013). Type 2 diabetes. http://www.diabetesaustralia.com.au/Understanding-Diabetes/What-is-Diabetes/Type-2-Diabetes/#Preventing. Type 2 Diabetes.
- easyDNA. (2014). Genetic predisposition test. http://www.easydna.com.au/content/index.php?section_id=37
- Green, C. A., & Pope, C. R. (1999). Gender, psychosocial factors and the use of medical services: A longitudinal analysis. Social Science & Medicine, 48, 1363–1372. doi: 10.1016/S0277-9536(98)00440-7
- Hock, K. T., Christensen, K. D., Yashar, B. M., Roberts, J. S., Gollust, S. E., & Uhlmann, W. R. (2011). Direct-to-consumer genetic testing: An assessment of genetic counselors’ knowledge and beliefs. Genetics in Medicine, 13, 325–332. doi: 10.1097/GIM.0b013e3182011636 PubMedCentralCrossRefPubMedGoogle Scholar
- Javitt, G. (2008). Direct-to-consumer genetic testing: Empowering or endangering the public? [Issue brief]. Washington: Genetics and Public Policy Center. Retrieved 28th October, 2014 from http://www.dnapolicy.org/images/issuebriefpdfs/2006_DTC_Issue_Brief.pdf
- Kovess-Masfety, V., Boyd, A., van de Velde, S., de Graaf, R., Vilagut, G., Haro, J. M., & Alonso, J. (2014). Are there gender differences in service use for mental disorders across countries in the European Union? Results from the EU-World Mental Health survey. Journal of Epidemiology and Community Health, 68, 649–656. doi: 10.1136/jech-2013-202962 CrossRefPubMedGoogle Scholar
- Lab Tests Online. (2014). Sample report. Retrieved 21st October, 2014 from http://labtestsonline.org/assets/static-pages/Sample.html
- McBride, C. M., Alford, S. H., Reid, R. J., Larson, E. B., Baxevanis, A. D., & Brody, L. C. (2009). Characteristics of users of online personalized genomic risk assessments: Implications for physician-patient interactions. Genetics in Medicine, 11, 582–587. doi: 10.1097/GIM.0b013e3181b22c3a PubMedCentralCrossRefPubMedGoogle Scholar
- National Health and Medical Research Council. (2012). Direct-to-consumer DNA genetic testing: An information resource for consumers. Retrieved 5th November, 2014 from https://www.nhmrc.gov.au/guidelines-publications/ps4
- National Human Genome Research Institute. (2014). Regulation of genetic tests. http://www.genome.gov/10002335
- National Institutes of Health. (2013). Confused by genetic tests? NIH’s new online tool may help. Retrieved 17th October, 2014 from http://www.nih.gov/news/health/feb2012/od-29.htm
- The Cochrane Collaboration. (2010). Does communicating DNA‐based risk estimates motivate people to change their behaviour? Retrieved 3rd November, 2014 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014386/
- The Genetics and Public Policy Center. (2012). GPPC releases updated list of DTC genetic testing companies. Retrieved 28th October, 2014 from http://www.dnapolicy.org/news.release.php?action=detail&pressrelease_id=145
- Wilde, A., Meiser, B., Mitchell, P. B., & Schofield, P. R. (2010). Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: Preliminary findings. European Journal of Human Genetics, 18, 47–51. doi: 10.1038/ejhg.2009.138 PubMedCentralCrossRefPubMedGoogle Scholar