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ACTIVE NOT RECRUITING
NCT03597165
NA

Incidental Genomics

Sponsor: Unity Health Toronto

View on ClinicalTrials.gov

Summary

Health care providers (HCP) are increasingly using genomic sequencing (GS) to diagnose diseases and target treatment for patients. However, GS may incidentally reveal inherited risks for thousands of current and future diseases. Guidelines recommend HCP inform patients of incidental GS results. GS is a relatively new technology, raising many questions about its adoption in clinical care, including: What are the psychological harms, health outcomes, clinical utility and economic costs of receiving primary and incidental GS results? We will use a randomized controlled trial (RCT) to evaluate whether patients receiving incidental GS results will report higher levels of distress and more risk reducing behaviors compared to patients receiving GS for their primary indication alone. We will explore the personal utility of GS via in-depth interviews with a subset of patients. Clinical utility for cancer and incidental results will be evaluated through diagnostic yield, clinical actions triggered by GS results and in-depth interviews with a subset of patients and providers. The economic impact will be evaluated in two ways: (a) health service use will be assessed retrospectively using billing records from the Institute of Clinical Evaluative Sciences (ICES); and, (b) participants' personal costs incurred as a result of GS will be assessed via surveys. Participants will be adult cancer patients who have received negative single gene or panel test results and who have been determined by their health care provider to be a candidate for GS.

Official title: The Health Outcomes, Utility, and Costs of Returning Incidental Genomic Findings

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

289

Start Date

2018-07-25

Completion Date

2027-10-01

Last Updated

2023-12-06

Healthy Volunteers

No

Conditions

Interventions

OTHER

Incidental Genomic Sequencing Results

Patient will receive GS results related to their primary indication (cancer), as well as the option to learn incidental GS results. Incidental results will be categorized into five "bins" based on Berg et al.'s framework (medically actionable and pharmacogenetic, common disease SNPs, Mendelian conditions, early-onset brain diseases, and carrier status). In pre-test counseling, patients will have the option to select which bins of incidental results they would like to learn, if any.

OTHER

GS Results for Primary Indications only

Patients will receive GS results related to the primary indication (cancer) only.

Locations (3)

Mount Sinai Hospital

Toronto, Ontario, Canada

Princess Margret Cancer Centre

Toronto, Ontario, Canada

Sunnybrook Hospital

Toronto, Ontario, Canada