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NCGENES: North Carolina Clinical Genomic Evaluation by NextGen Exome Sequencing

Not Applicable
Completed
Conditions
Cancer
Cardiovascular Disease
Congenital Abnormalities
Neurologic Dysfunction
Hearing Loss
Interventions
Behavioral: Experimental
Registration Number
NCT01969370
Lead Sponsor
University of North Carolina, Chapel Hill
Brief Summary

This study is part of a larger consortium project investigating the validity and best use of next-generation sequencing (in particular, whole exome sequencing, or WES) in clinical care. This sub-project is investigating benefits and harms of providing WES diagnostic and different types of incidental findings to adult patients and parents of pediatric patients who undergo WES because they have symptoms suggesting genetic disease.

Detailed Description

This study is part of a larger consortium project investigating the validity and best use of next-generation sequencing (in particular, whole exome sequencing, or WES) in clinical care. Participants are patients who were either seen in the University of North Carolina Cancer and Adult Genetics Clinic or referred to the study by their physician. They will be approached by their physician or a genetic counselor for recruitment. Once enrolled, a clinical geneticist or genetic counselor will obtain consent and collect blood samples to be analyzed using WES. Results may include information related to a diagnosis and incidental information. Medically actionable incidental findings will be CLIA (Clinical Laboratory Improvement Amendments)-certified and returned to participants in a routine genetic counseling session, along with diagnostic findings. Eligible adult participants will be randomized to have the opportunity to choose to get certain types of non-medically actionable incidental findings, as well. Their decisions will be investigated, as will psychosocial and behavioral responses to sequencing and receiving sequencing information. This is a longitudinal, mixed methods study (i.e., multiple assessments pre- and post-return of results, with both quantitative and qualitative methods used to gather data). Because only the quantitative component of the study uses randomization, only measures and procedures associated with that component are described here.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
645
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ExperimentalExperimentalOption to request non-medically actionable incidental information (after receiving education about them)
Primary Outcome Measures
NameTimeMethod
Extent of test-specific distress 2 weeks after return of results2 weeks after return of diagnostic results; for adult patient participants who are eligible and who request them, 2 weeks after return of non-medically actionable incidental results

Measured with an adapted version of the multidimensional impact of testing scale (MICRA)

Secondary Outcome Measures
NameTimeMethod
Extent of information seeking2 weeks after consent (T1) and change from T1 to 2 weeks after return of diagnostic results

Participants will answer questions about the extent to which they sought information about whole exome sequencing and results it produces. Questions also ask about sources of that information (e.g., the Internet, doctors) to provide descriptive data about how participants get information.

Extent of health-related Quality of Life 2 weeks after consentAll participants: 2 wks after consent (T1)

Measured with the Medical Outcomes Study Short Form-12

Extent of communication of test results with other people2 weeks after return of diagnostic results

Motivations of communications will also be assessed and examined for descriptive analyses.

Change in test-specific distress at 3 and 6 months after return of resultsAdult patient participants: change from 2 weeks after return of diagnostic results to 3 months and 6 months after return of diagnostic results

Measure is an adapted version of the multidimensional impact of testing scale MICRA)

Extent of Decision Regret 2 weeks after consentAll participants: 2 wks after consent (T1)
Extent of Healthcare Utilization 2 weeks after return of resultsAll participants: 22 wks after return of diagnostic (dx) results
Extent of Decision Regret 2 weeks after return of resultsAll participants: 2 wks after return of diagnostic (dx) results and, for eligible adults who request them, return of incidental results

Also administered 2 wks after return of non-medically actionable incidental results for eligible adult patient participants who request them.

Change in decision regretFor all participants: Change from post-consent to post-return of results; Additional for adults: change at 3 and 6 months after return of dx results
Extent of Healthcare Utilization 2 weeks after consentAll participants: 2 wks after consent (T1)
Change in Healthcare UtilizationAll participants: Change in utilization from post-consent to post-return of results; Additional for adult patients: Change at 3 and 6 months after return of dx results
Enactment of health-related lifestyle behaviors 2 weeks after consentAdult participants: 2 wks after consent (T1)

Behaviors include those related to diet, physical activity, smoking, drinking, and substance use.

Change in enactment of health-related lifestyle behaviorsAdult participants: Change in behaviors from 2 wks after consent (T1) to 2 wks, 3 months, and 6 months after return of dx results

Behaviors include those related to diet, physical activity, smoking, drinking, and substance use.

Change in extent of psychological distressAll participants: Change from 2 wks after consent (T1) to 2 wks after return of diagnostic (dx) results; Additional for adult patients: Change at 3 and 6 months after return of dx results

Symptoms of depression and anxiety measured with the Hospital Anxiety and Depression Scale

Enactment of health-related lifestyle behaviors 2 weeks after return of resultsAdult participants: 2 wks after return of diagnostic (dx) results

Behaviors include those related to diet, physical activity, smoking, drinking, and substance use.

Extent of psychological distress 2 weeks after consentAll participants: 2 wks after consent

Symptoms of depression and anxiety measured with the Hospital Anxiety and Depression Scale

Extent of psychological distress 2 weeks after return of resultsAll participants: 2 wks after return of diagnostic (dx) results

Symptoms of depression and anxiety measured with the Hospital Anxiety and Depression Scale

Extent of health-related Quality of Life 2 weeks after return of resultsAll participants: 2 wks after return of diagnostic results

Measured with the Medical Outcomes Study Short Form-12

Change in extent of health-related Quality of LifeAll participants: Change from 2 wks after consent to 2 weeks after return of diagnostic results

Measured with the Medical Outcomes Study Short Form-12

Trial Locations

Locations (1)

University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

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