Physician knowledge, use, and perceptions of genetic biomarker testing for the management of patients with newly diagnosed advanced ovarian cancer: an international physician survey
Bibliographic record
Abstract
To explore physician-reported knowledge, use, and perceptions of genetic testing for advanced ovarian cancer management. Gynecology/oncology specialists (n = 390) in the US, Europe, Canada, Japan, and Australia completed an online survey spanning March 2021 to April 2022. Physician-reported breast cancer gene mutation (BRCAm) testing rates increased over the 2 years before the survey; most patients underwent testing in the preceding 6 months. Homologous recombination deficiency (HRD) genomic instability testing rates and physicians’ confidence interpreting results remained relatively low. Genetic testing was driven by the associated treatment implications of the findings. Poor performance status, inadequate tissue, and patients’ willingness to undergo testing were reported barriers to testing. Findings indicate that there is a need to improve both access to and information about HRD testing. Why did we perform this research? Testing for breast cancer gene mutations (BRCAm) is strongly recommended to guide treatment decisions for patients with ovarian cancer (OC), with screening for homologous recombination deficiency (HRD) genomic instability (when cells cannot accurately repair breaks in DNA strands) also recommended. However, not all eligible women are tested, indicating that a greater understanding of physicians’ testing practices is needed. What did we do? Physicians (n = 390) in the US, Europe, Canada, Japan, and Australia completed an online survey that evaluated their knowledge, use, and perceptions of genetic testing for advanced OC management. What were the results? Across all countries, physicians reported increasing BRCAm testing rates over the 2 years before the survey, with most patients with advanced OC now receiving these tests. HRD testing rates were relatively low, and few physicians reported complete confidence in interpreting these test results. Physicians most commonly reported that genetic testing was conducted because the results could guide treatment decisions. The main reasons for not conducting tests were patients being too unwell, tissue samples being inadequate, or patients being unwilling to undergo testing. Across countries, most physicians agreed genetic counseling should be offered to patients with OC; however, in some countries, there was insufficient access to these services. What are the implications? Our findings indicate that physicians’ understanding of the wider implications of genetic testing, including HRD testing, and patients’ access to genetic counseling may require improvement to ensure patients with advanced OC receive optimal care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".