Evaluation of a virtual, nurse practitioner–led, pre-counselling seminar for mainstream germline genetic testing using a patient-reported outcomes measure (PROM).
Notice bibliographique
Résumé
290 Background: Ovarian cancer (OC) is a common, often fatal disease where 1/4 of cases are due to hereditary syndromes. Genetic screening of OC patients provides access to targeted treatments and screening recommendations. Patients are currently referred to a virtual, group, pre-counseling seminar, delivered by a Nurse Practitioner, where consent for germline genetic testing is obtained and results are delivered later by a Genetic Counsellor (GC). Previously, we found group pre-counseling to be an effective method to decrease wait times from diagnosis to test results. The purpose of this study was to evaluate the patient seminar experience using the previously validated, Genetic Counselling Outcome Scale (GCOS-24). BC Cancer- Victoria is a satellite of BC Cancer, providing tertiary cancer care to a population of ̃1.2 million. Methods: We completed a REB approved, prospective study recruiting patients referred to the group pre-counseling consenting seminar. The GCOS-24 was delivered electronically both pre (1) and post (2) attendance at the seminar, and 4 weeks post genetic counselling visit (3). Inclusion criteria included OC patients referred for germline BRCA testing between Jan 1, 2021, to Feb 28, 2022, > 18 years old who attended the group consenting seminar. Patients who could not communicate in English were excluded. Data was stored electronically via REDCap, a secure web-based platform. Results: Thirty-eight patients attended the seminar and 28 consented to participate and completed the first questionnaire. Twenty-five patients completed the second questionnaire and 21 completed the third. The average age was 67, with 80% high grade serous, 11% low grade, 6% clear cell and 3% endometrioid OC subtypes. Forty- nine percent of participants were from Victoria area, and 11% were 225+ km away. The average GCOS-24 score for pre seminar participants was 111, post seminar 121 and post GC’s appointment 124. Twelve (52%) patients scored minimum clinically important difference (MCID) increase between questionnaires 1 and 2, and 14 (67%) patients scored MCID increase between questionnaires 1 and 3. The questions reflecting the most improvement in average scores between questionnaires 1 and 3 were exploring knowledge and emotions. Conclusions: Virtual group pre-counseling sessions for OC patients are feasible and allow germline genetic testing access to a geographically diverse group of eligible patients. Mean GCO-24 score almost reached MCID between pre seminar and post seminar visit and did reach MCID between pre counselling and post GC visit. There was a general trend to improved scores as patients moved from counselling naïve to pre-counseling to completed GC appointment. Virtual pre-counseling seminars should be considered as high impact, resource light method of improving access to germline genetic counselling for OC patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».