Evidence map›Paper›PMID 24940102›Full record

ArticleCurrent oncology (Toronto, Ont.)2014

Access to personalized medicine: factors influencing the use and value of gene expression profiling in breast cancer treatment.

Y Bombard, L Rozmovits, M Trudeau, N B Leighl, K Deal, D A Marshall

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Current oncology (Toronto, Ont.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.

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  10. Liquid biopsies to guide therapeutic decisions in rheumatoid arthritis.Translational research : the journal of laboratory and clinical medicine · 2018
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  12. Barriers to information provision regarding breast cancer and its treatment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 2 countries.

Y BombardUniversity of Toronto, Toronto, ON. ; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON.
L RozmovitsIndependent qualitative researcher.
M TrudeauUniversity of Toronto, Toronto, ON. ; Sunnybrook Health Sciences Centre, Toronto, ON.
N B LeighlUniversity of Toronto, Toronto, ON. ; Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON.
K DealMcMaster University, DeGroote School of Business, Hamilton, ON.
D A MarshallMcMaster University, Department of Clinical Epidemiology and Biostatistics, and St. Joseph's Healthcare, Hamilton, ON; and Department of Community Health Sciences, University of Calgary, Calgary, AB.
McMaster University · CAHealth Sciences Centre · CAHigher Institute for Qualitative Studies · EGSt. Michael's Hospital · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

unlabelledGenomic information is increasingly being used to personalize health care. One example is gene expression profiling (gep) tests, which estimate recurrence risk to inform chemotherapy decisions in breast cancer. Recently, gep tests were publicly funded in Ontario. We explored the perceived utility of gep tests, focusing on the factors influencing their use and value in treatment decision-making by patients and oncologists.

methodsWe conducted interviews with oncologists (n = 14) and interviews and a focus group with early-stage breast cancer patients (n = 28) who underwent gep testing. Both groups were recruited through oncology clinics in Ontario. Data were analyzed using the content analysis and constant comparison techniques.

resultsNarratives from patients and oncologists provided insights into various factors facilitating and restricting access to gep. First, oncologists are positioned as gatekeepers of gep, providing access in medically appropriate cases. However, varying perceptions of appropriateness led to perceived inequities in access and negative impacts on the doctor-patient relationship. Second, media attention facilitated patient awareness of gep, but also complicated gatekeeping. Third, the dedicated administration attached to gep was burdensome and led to long waits for results and also to increased patient anxiety and delayed treatment. Collectively, because of barriers to access, those factors inadvertently heightened the perceived value of gep for patients relative to other prognostic indicators.

conclusionsOur study delineates the factors facilitating and restricting access to gep, and highlights the roles of media and organization of services in the perceived value and utilization of gep. The results identify a need for administrative changes and practice guidelines to support streamlined and standardized use of gep tests.

Indexed as

accessbreast cancerdecision-makingGene expression profilinggenomicshealth care providerspatient perceptionspersonalized medicineperspectivesrisk recurrence

Identifiers

PMID24940102
PMCPMC4059806
OpenAlexW2111465038

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.