Abstract
The purpose of this pilot study was to evaluate the feasibility, technical performance, and effectiveness of prenatal genetic counseling in advanced maternal age (AMA) patients through the use of interactive video-conferencing (IVC). Eight volunteers were asked to complete a genetic history questionnaire prior to the IVC consultation. Participants received information regarding the risk of fetal aneuploidy and testing options to evaluate these risks. Counseling was provided by board certified genetic counselors. The counselor and the participants were located in separate rooms within the institution, having contact only through IVC. At each site, PC computers were networked to simulate an Internet-like connection. Additional hardware included Intel's ProShare Video System 500 with video cameras and headsets. Microsoft's NetMeeting was used for real-time video-conferencing and also for sharing custom-designed visual aid tools. Following each IVC consultation, participants were given questionnaires to assess: 1) the genetic and medical information gained during the consultation, and 2) the patient/couple's opinion regarding the efficacy of IVC generic counseling. A protocol was developed to optimize the physical context of the system, by altering camera placement to approximate direct eye contact, and verbally orienting the patient to the unique features of the IVC equipment. All participants indicated that they believed that the counselor was able to address their needs in the IVC session. Similarly, 7/8 patients “agreed” or “strongly agreed” that they were satisfied with the consultation via IVC; 8/8 participants felt that they were “well informed” about risks and options after the consultation; all agreed that the graphic visual aids used on the IVC monitor by the counselor aided in their understanding of their genetic risks. In regard to the equipment, 3/8 indicated that the IVC made them feel uncomfortable, while 5/8 participants agreed that “it did not take long” to feel comfortable with the system. Finally, when asked if they would prefer have genetic counseling at home through IVC over standard “face-to-face” counseling, 7/8 marked “agree” or “strongly agree". These results suggest that the use of IVC for genetic counseling is a feasible alternative to traditional face-to-face consultations. To further evaluate these findings, a prospective trial in AMA patients is underway in our institution.
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Flore, L., Risinger, S., Britt, D. et al. Prenatal genetic counseling by telemedicme: a feasibility study. Genet Med 2, 101 (2000). https://doi.org/10.1097/00125817-200001000-00181
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DOI: https://doi.org/10.1097/00125817-200001000-00181