Feasibility and acceptability of an electronic decision aid for genetic testing in ovarian and pancreatic cancer patients.

Background and aims: Germline genetic testing is recommended for all patients with ovarian or pancreatic cancer, and alternative service delivery models are needed to meet this demand. We evaluated an electronic decision aid (DA) that can be administered during a visit with an oncology provider. The DA centered around the decision to pursue genetic testing and selection of a specific multi-gene panel. Methods: An electronic DA had previously been developed by a multi-disciplinary team. Patients were enrolled at two academic medical centers. We surveyed participants with ovarian or pancreatic cancer who completed the DA about their experience and knowledge gained. Oncology providers were also surveyed. Results: Ninety-two patients were enrolled. The DA took 13.7 min to complete. There was a 20% increase in knowledge scores after using the DA. Ninety-five percent opted to pursue genetic testing; 20% chose the smallest cancer-specific gene panel, 31% chose the mid-size multi-cancer panel, and 49% chose the largest panel that included limited evidence genes. Nearly all participants (93%) indicated the DA helped their decision-making, and 95% would recommend the DA to friends interested in genetic testing. Ninety-one percent of providers felt patients were well-informed about genetic testing options and 93% indicated the DA did not extend appointment times. Conclusions: Use of a DA for genetic testing is feasible and acceptable. Patients and providers expressed high levels of satisfaction. The wide range of multi-gene panels selected highlights the importance of offering choice. Studies to formally compare the performance of the DA with traditional genetic counseling are warranted.