Population Whole Exome Screening: Primary Care Provider Attitudes About Preparedness, Information Avoidance, and Nudging

Abstract

Compared to clinicians previously surveyed, primary care providers employed in a health system known for clinical genomics were more likely to have ordered or referred a patient for genetic testing, but had only modestly more genetics training and reported similarly low levels of comfort answering patient questions about genetic risk. Most supported population genomic screening, reported willingness to get screened themselves, and judged a hypothetical patient's decision to be screened favorably relative to a similar patient's decision to decline screening. Stakeholder perceptions of the ethical appropriateness of nudging at-risk patients to discuss testing with counselors were mixed.

Keywords: Ethics; Genetics; Genomics; Information avoidance; Nudge; Personalized medicine; Population screening; Whole exome sequencing.