Interpretations of the Term “Actionable” when Discussing Genetic Test Results: What you Mean Is Not What I Heard

Michele C Gornick; Kerry A Ryan; Aaron M Scherer; J Scott Roberts; Raymond G De Vries; Wendy R Uhlmann

doi:10.1007/s10897-018-0289-6

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Interpretations of the Term “Actionable” when Discussing Genetic Test Results: What you Mean Is Not What I Heard

Journal article

Peer reviewed

Interpretations of the Term “Actionable” when Discussing Genetic Test Results: What you Mean Is Not What I Heard

Michele C Gornick, Kerry A Ryan, Aaron M Scherer, J Scott Roberts, Raymond G De Vries and Wendy R Uhlmann

Journal of genetic counseling, Vol.28(2), pp.334-342

04/2019

DOI: 10.1007/s10897-018-0289-6

PMID: 30194681

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https://hdl.handle.net/2027.42/149289View

Open Access

Abstract

In genomic medicine, the familiarity and inexactness of the term “actionable” can lead to multiple interpretations and mistaken beliefs about realistic treatment options. As part of a larger study focusing on public attitudes toward policies for the return of secondary genomic results, we looked at how members of the lay public interpret the term “medically actionable” in the context of genetic testing. We also surveyed a convenience sample of oncologists as part of a separate study and asked them to define the term “medically actionable.” After being provided with a definition of the term, 21 out of 60 (35%) layperson respondents wrote an additional action not specified in the provided definition (12 mentioned “cure” and 9 mentioned environment or behavioral change) and 17 (28%) indicated “something can be done” with no action specified. In contrast, 52 surveyed oncologists did not mention environment, behavioral change, or cure. Based on our findings, we propose that rather than using the term “actionable” alone, providers should also say “what they mean” to reduce miscommunication and confusion that could negatively impact medical decision‐making. Lastly, to guide clinicians during patient‐ provider discussion about genetic test results, we provide examples of phrasing to facilitate clearer communication and understanding of the term “actionable.”

Genomic results

Medically actionable

health literacy

Health provider‐patient communication

Details

Title: Subtitle: Interpretations of the Term “Actionable” when Discussing Genetic Test Results: What you Mean Is Not What I Heard
Creators: Michele C Gornick - University of Michigan Medical School
Kerry A Ryan - University of Michigan Medical School
Aaron M Scherer - University of Iowa Carver College of Medicine
J Scott Roberts - University of Michigan
Raymond G De Vries - University of Michigan Medical School
Wendy R Uhlmann - University of Michigan Medical School
Resource Type: Journal article
Publication Details: Journal of genetic counseling, Vol.28(2), pp.334-342
DOI: 10.1007/s10897-018-0289-6
PMID: 30194681
NLM abbreviation: J Genet Couns
ISSN: 1059-7700
eISSN: 1573-3599
Number of pages: 9
Grant note: DOI: 10.13039/100000051, name: National Human Genome Research Institute, award: 1UM1HG006508
Language: English
Date published: 04/2019
Academic Unit: General Internal Medicine; Internal Medicine
Record Identifier: 9984094367902771

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