InHealth-Funded Researchers Present Preliminary Findings on Patient Preferences and Genomic Diagnostics

What if you could undergo a diagnostic test that uses your genetic information to determine what drug therapies will work best for you? How accurate would such a test have to be for you to pay for it out of pocket? What if the results of the test were available to your insurance company?

As the emergence of genomic diagnostic tests gradually makes personalized medicine a reality for both doctors and patients, these and many similar questions are revealing issues of fundamental importance in today’s healthcare arena.

To address these questions, a team of researchers from the University of Houston is conducting a study that explores the decisions and trade-offs many breast and colon cancer patients face when deciding whether to undergo genomic testing––which holds the potential to enable doctors to tailor drug therapies to the individual’s specific case. Leading the study is Amalia M. Issa, PhD, MPH, associate professor in the College of Pharmacy and founding director of the university’s initiative in personalized medicine and targeted therapeutics.

Preliminary findings from the InHealth-funded study, titled “Assessing the Clinical Adoption and Value of Genomic Diagnostics for Personalized Medicine,” will be featured as poster presentations at the annual meetings of the American College of Clinical Pharmacology (September) and the Association for Molecular Pathology (November). Findings will also be published in a forthcoming issue of the Journal of Molecular Diagnostics. Although preliminary, the findings are attracting the attention of clinicians, health policy experts, and the diagnostics industry.

For the study, researchers are surveying breast and colorectal patients about what factors are most influential in their choice to undergo genomic testing. The conjoint analysis instrument mimics real-world decision making by having patients make trade-offs between sets of conditions that may vary in terms of cost, accuracy, privacy, side effects, and other factors. For instance, when a study participant chooses to pay $1000 out of pocket for a diagnostic test that is 70% accurate but makes the results available to the participant’s insurance company, rather than paying $500 out of pocket for a test that offers 40% accuracy but private results, the participant indicates that accuracy is more important than cost or privacy. Using this model, researchers are able to quantify and measure patient preferences to discern how they might make similar decisions in a real-life situation––indicating what barriers are preventing patients from utilizing this technology. 

“Of the many factors affecting a patient’s decision to undergo genomic testing, early findings suggest that clinical validity is the issue that stands out as most important,” says Issa. “Because the test results may help optimize therapies and eliminate trial and error during treatment, many patients are indicating a willingness to spend time and money to achieve accurate test results.”

Preliminary results are based on pilot studies designed to develop and test the conjoint analysis instrument in focus groups. Findings from the full study are expected next year.

The study is expected to provide insight into patient preferences and their willingness to adopt, pay for, and use genomic diagnostics. “Findings could have an impact on policy and clinical practice guidelines by providing evidence-based guidance to policymakers, regulatory agencies, and pharmaceutical and diagnostic companies,” says Issa. “The study results will help physicians and others understand how these technologies can best be introduced and implemented to personalize medicine for cancer patients.”