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Use of the BOADICEA Web Application in clinical practice: appraisals by clinicians from various countries.

Accepted version
Peer-reviewed

Type

Article

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Authors

Kop, Jean-Luc 
Antoniou, Antonis C 
Cunningham, Alex P 
De Pauw, Antoine 

Abstract

The 'BOADICEA' Web Application (BWA) used to assess breast cancer risk, is currently being further developed, to integrate additional genetic and non-genetic factors. We surveyed clinicians' perceived acceptability of the existing BWA v3. An online survey was conducted through the BOADICEA website, and the British, Dutch, French and Swedish genetics societies. Cross-sectional data from 443 participants who provided at least 50% responses were analysed. Respondents varied in age and, clinical seniority, but mainly comprised women (77%) and genetics professionals (82%). Some expressed negative opinions about the scientific validity of BOADICEA (9%) and BWA v3 risk presentations (7-9%). Data entry time (62%), clinical utility (22%) and ease of communicating BWA v3 risks (13-17%) received additional negative appraisals. In multivariate analyses, controlling for gender and country, data entry time was perceived as longer by genetic counsellors than clinical geneticists (p < 0.05). Respondents who (1) considered hormonal BC risk factors as more important (p < 0.01), and (2) communicated numerical risk estimates more frequently (p < 0.001), judged BWA v3 of lower clinical utility. Respondents who carried out less frequent clinical activity (p < 0.01) and respondents with '11 to 15 years' seniority (p < 0.01) had less favourable opinions of BWA v3 risk presentations. Seniority of '6 to 10 years' (p < 0.05) and more frequent numerical risk communication (p < 0.05) were associated with higher fear of communicating the BWA v3 risks to patients. The level of genetics training did not affect opinions. Further development of BWA should consider technological, genetics service delivery and training initiatives.

Description

Keywords

Appraisal, Breast cancer, Clinical practice, Risk prediction model, Survey, Tool, BRCA1 Protein, BRCA2 Protein, Breast Neoplasms, Cross-Sectional Studies, Female, Genetic Predisposition to Disease, Genetic Testing, Humans, Medical Informatics Applications, Multivariate Analysis, Mutation, Risk Assessment

Journal Title

Fam Cancer

Conference Name

Journal ISSN

1389-9600
1573-7292

Volume Title

17

Publisher

Springer Science and Business Media LLC
Sponsorship
European Commission Horizon 2020 (H2020) Societal Challenges (634935)
European Commission Horizon 2020 (H2020) Societal Challenges (633784)