Evidence map›Paper›PMID 42410102›Full record

ArticleEuropean journal of human genetics : EJHG2026

A changed landscape: five-year retrospective on the paradigm shift in genetic testing practices for ALS in Canada.

Maya Binet, Gordon Jewett, Ari Breiner, Marvin Chum, Angela Genge, Kerri Schellenberg, Christen Shoesmith, Gerald Pfeffer, Kristiana Salmon

Abstract read
In one paragraph

Article in European journal of human genetics : EJHG, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Genomics cycle: discover, diagnose, interpret, act.European journal of human genetics : EJHG · 2026
    Article
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

9 authors.

Maya BinetDepartment of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Gordon JewettDepartment of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.ORCID http://orcid.org/0000-0002-8268-5677
Ari BreinerThe Ottawa Hospital, Ottawa, ON, Canada.
Marvin ChumDivision of Neurology, Department of Medicine, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada.
Angela GengeDepartment of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, ON, Canada.
Kerri SchellenbergUniversity of Saskatchewan, Saskatoon, Canada.
Christen ShoesmithDepartment of Clinical Neurological Sciences, Western University, London, ON, Canada.
Gerald PfefferDepartment of Clinical Neurosciences, Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Kristiana SalmonDepartment of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montreal, ON, Canada. Kristiana.salmon@mcgill.ca.ORCID http://orcid.org/0000-0002-0013-5568

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Offering genetic testing is increasingly recommended for all individuals with amyotrophic lateral sclerosis (ALS), particularly following the development of gene-targeted therapies, such as tofersen for SOD1-ALS. Historically, testing was routinely offered to those with familial ALS (fALS), but inconsistently to those with sporadic ALS (sALS). We evaluated changes in genetic testing and counseling practices among Canadian ALS physicians over a five-year period spanning pivotal clinical trial results and regulatory approval of tofersen. Members of the Canadian ALS Research Network were surveyed in 2020, 2022, and 2025 about genetic testing practices for symptomatic and asymptomatic individuals, gene panel composition, access to genetic counseling, and perceived drivers of change. Clinics offering genetic testing for sALS increased from 33% of clinics in 2020 and 57% in 2022 to 100% of respondents in 2025. Genetic testing for patients with a family history (fALS) was near-universal across all timepoints. Broader use of multi-gene panel testing increased over time, coinciding with sponsored testing availability. 61% of respondents reported that Health Canada approval of tofersen directly influenced their practice. Predictive testing offerings increased from 37% in 2020 to 61% in 2025. Genetic testing practices in Canada shifted substantially during late-stage clinical development and following regulatory approval of a gene-targeted therapy (tofersen). Proactive planning during the clinical trial phase facilitated rapid, nationwide adoption. This study captures a key turning point in ALS care, illustrating how therapeutic breakthroughs can redefine national clinical standards.

Indexed as

Amyotrophic Lateral SclerosisGenetic TestingCanadaGenetic CounselingHumansRetrospective Studies

Identifiers

PMID42410102
PMCPMC13634039

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.