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Key drivers of family-level utility of pediatric genomic sequencing: a qualitative analysis to support preference research

European Journal of Human Genetics (2022)Cite this article

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Abstract

Given that pediatric genomic sequencing (GS) may have implications for the health and well-being of both the child and family, a clearer understanding of the key drivers of the utility of GS from the family perspective is needed. The purpose of this study is to explore what is important to caregivers of pediatric patients regarding clinical GS, with a focus on family-level considerations. We conducted semi-structured interviews with caregivers (n = 41) of pediatric patients who had been recommended for or completed GS that explored the scope of factors caregivers considered when deciding whether to pursue GS for their child. We analyzed the qualitative data in multiple rounds of coding using thematic analysis. Caregivers raised important family-level considerations, in addition to those specifically for their child, which included wanting the best chance at good quality of life for the family, the ability to learn about family health, the impact on the caregiver’s well-being, privacy concerns among family members, and the cost of testing to the family. We developed a framework of key drivers of utility consisting of four domains that influenced caregivers’ decision making: underlying values, perceived benefits, perceived risks, and other pragmatic considerations regarding GS. These findings can inform measurement approaches that better capture the utility of pediatric GS for families and improve assessments of the value of clinical GS.

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Fig. 1: Framework of key drivers of family-lelve utility of genomic sequencing.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

Dr. Smith is supported by the National Human Genome Research Institute of the National Institutes of Health under Award Number K99HG011491. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA

    Hadley Stevens Smith, Amanda M. Gutierrez, Amy L. McGuire & Stacey Pereira

  2. Institute for Public Health Genetics, University of Washington School of Public Health, Seattle, WA, USA

    Emily S. Bonkowski

  3. School of Health Professions, Baylor College of Medicine, Houston, TX, USA

    Raymond Belanger Deloge

  4. Texas Children’s Cancer Center, Texas Children’s Hospital, Houston, TX, USA

    Alva M. Recinos

  5. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Alva M. Recinos

  6. Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA

    Tara A. Lavelle

  7. Comparative Health Outcomes, Policy & Economics (CHOICE) Institute, School of Pharmacy, University of Washington, Seattle, WA, USA

    David L. Veenstra

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  1. Hadley Stevens Smith
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  2. Emily S. Bonkowski
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  8. Amy L. McGuire
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HSS confirms that she had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors gave final approval of this version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Hadley Stevens Smith.

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The authors declare no competing interests.

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Approval to conduct this human subjects research was obtained by the Baylor College of Medicine Institutional Review Board. Verbal informed consent was obtained from all participants for being included in the study.

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Smith, H.S., Bonkowski, E.S., Deloge, R.B. et al. Key drivers of family-level utility of pediatric genomic sequencing: a qualitative analysis to support preference research. Eur J Hum Genet (2022). https://doi.org/10.1038/s41431-022-01245-0

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  • DOI: https://doi.org/10.1038/s41431-022-01245-0

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